Study On The Correlation Between Aura And Depression In Patients With Focal Origin Epilepsy

Objective: To summarize the clinical manifes tations of patients with focal seizures with auras,to explore the correlation between aura and depression,and to clarify the depression and influencing factors of these patients,in order to guide clinical diagnosis and t reatment.Methods: 245 patients with focal epilepsy diagnosed in the epilepsy clinic of our hospital from August 2018 to October 2019 were taken as the object of this study.The clinical data of the patients were recorded,such as sex,age of first visit,educational level,age of onset,course of disease,aura,medication,treatment,EEG and imaging findings and selfrating depression scale(SDS).The subjects were divided into two groups with or without aura: focal seizure group with aura and focal seizure group without aura.Statistical methods were used to analyze the data.Results:(1)There were 109 patients with aura group(51 males and 58 females)and 136 patients without aura(74 males and 62 females).The average age of first visit was(34.77±13.15)years in aura group and(37.79±14.94)years in non-aura group.There were 109 cases of aura group,including 48 cases of junior high school and below,24 cases of senior high school,37 cases of university and above,and 136 cases of non-aura group,including 56 cases of junior high sch ool and below,35 cases of senior high school education and 45 cases of university degree or above.(2)In 109 epileptic patients with aura,there were 8 forms of aura,a total of 130 times.The most common is autonomic aura,followed by sensory aura and v ertigo aura.(3)The aura of 58 patients with temporal lobe epilepsy can be manifested as palpitation,chest tightness,nausea,a rising air in epigastric,abdominal discomfort,fear,déjà vu and vertigo.Dizziness,fear,verbal aura and general somatosensory aura in 8 cases of frontal lobe epilepsy,and visual aura in 2 cases of occipital lobe epilepsy.The main signs of hippocampal sclerosis or atrophy were autonomic aura for 3 times(palpitation,chest tightness,abdominal discomfort),followed by vertigo aura for 2 times and mental aura for 2 times.(4)There was no significant difference in head MRI,hippocampal sclerosis or atrophy,EEG monitoring results,epilepsy origin,antiepileptic drug between the aura group and the non-aura group.There was significant difference in the degree of epilepsy control between the aura group and the non-aura group.(5)In patients with epilepsy,aura is related to depression in patients with epilepsy.In the depression group,there were 47 cases with aura symptoms and 40 cases without aura symptoms,while in the normal group,there were 65 cases with aura symptoms and 96 cases without aura symptoms.The effect of aura on depression was compared between the two groups(P<0.05),and the difference was statistically significant.(6)Among the patients with epilepsy,there were 87 patients in the depression group and 158 patients in the normal group.Chi-square test was performed on patients' gender,educational level,age of first onset,course of disease,different origin of epilepsy,different AEDs treatment schemes and treatment effect.P value was 0.918,0.947,0.835,0.488,0.514,0.463,and 0.559,respectively.The difference was not statistically significant(P>0.05),and there was no correlation with depression in pa tients with epilepsy.(7)The depressive disorder in the aura group was more severe than that in the non-aura group.The total crude scores of SDS scale in aura group and non-aura group were(39.48±8.33)and(36.04±7.3)respectively.Compared with the group without aura,the SDS score of patients with aura was significantly higher,and the score of SDS scale of the two groups was significantly higher than that of the group without aura(?2= 3.442,P<0.05).(8)The scores of SDS in patients with aura were as follows: psychotic emotional symptoms,physical disorders,psychomotor disorders and depressi on were(4.09±1.39),(15.6±3.73),(3.77±1.37)and(16.09±4.33),respectively.In the non-aura group,the scores of psychotic emotional symptoms,physical disorder,psychomotor disorder and depression were(3.64±1.24),(14.04±3.11),(3.69±1.55)and(15.4±9.41)respectively.There was significant difference in the scores of psychotic emotional state an d physical disorder between the two groups(P < 0.05).(9)In the group with aura,the degree of depressive disorder with inability to respond to aura was more severe than that to aura.In response to aura,the total score of SDS,physical disorder,psychomotor disorder and depression were(36.16 ±7.04),(13.79±3.11),(3.46±1.25),(14.7±4.05)respectively.Unable to respond to aura,the total score of SDS,physical disorder,psychomotor disorder and depression were(42.86 ±8.08),(16.78±3.78),(4.08±1.44)and(17.46±4.06)respectively.There was significant difference betw een the two groups(P<0.05).(10)In the group with aura,the total score and subentry score of SDS of different aura types were compared,P > 0.05,and the difference was not statistically significant(other aura types were not counted because of the smal l number of cases).Conclusions:(1)Aura is an independent risk factor for depression in patients with focal epilepsy.Different types of aura had no effect on depression in patients with epilepsy.The degree of depressive disorder in patients with aura sympt oms is more serious,which is mainly manifested in psychotic emotional state and physical disorders.(2)Whether to respond to aura has an impact on depression,and the degree of depressive disorder is more severe in patients with focal seizures who are unable to respond to aura,mainly manifested in physical disorders,psychomotor disorders and psychological disorders of depression.(3)The aura is related to the control of epilepsy,and the therapeutic effect of epilepsy with aura is poor.