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癫痫中的精神病——分类与脑电图研究(作者译)

[Psychoses in epilepsy--classification and EEG-studies (author's transl)].

作者信息

Köhler G K

出版信息

Fortschr Neurol Psychiatr Grenzgeb. 1975 Mar;43(3):99-153.

PMID:1041249
Abstract

It is necessary to classify the epileptic psychoses before starting a comparative study between psychopathological and electroencephalographic findings. The knowledge of the epileptic psychoses is at the moment too incomplete for a systematic order following aetiological or topic aspects. The traditionally system of epileptic psychoses distributes in chronic and episodic, phasic, especially circular, reversible and irreversible psychopathological manifestations. We differentiate psychotic states with or without disturbances of consciousness. Well-known in EEG studies of symptomatic and endogenic psychoses is, that in these psychoses the same clinical syndrom can be related to normal and to pathological electroencephalographic findings. This contradiction could often be explained when the activity of the psychoses was taken into consideration. The activity of the psychoses is to be determined by the duration, number, intensity and variability of the psychopathological symptoms. From his own investigations from 30 patients with schizophreniform epileptic psychoses, episode affective disorders and both depressive and manic psychoses, it could be shown, that normal EEGs are markedly infrequent. Most often they occur in subacute schizophreniform epileptic psychoses. The EEG of active and particularly of schizophreniform epileptic psychoses is most often characterized by simultaneous appearance of sharp waves, paroxysmal dysrhythmias and abnormal rhythm formations. Active schizophreniform psychoses correlate usually with abnormal rhythms. These abnormal rhythms ("parenrhythmien") diminish parallel with loss of activity of the psychotic process, are correspondingly seldom seen in subacute psychoses, and are not demonstrable in inactive psychoses. The experience of an alternating correspondence between epileptic psychoses and frequency of seizures could be confirmed.

摘要

在开始对精神病理学和脑电图检查结果进行比较研究之前,有必要对癫痫性精神病进行分类。目前,关于癫痫性精神病的知识还不够完整,无法按照病因学或主题方面进行系统排序。传统的癫痫性精神病分类系统包括慢性和发作性、阶段性(尤其是循环性)、可逆性和不可逆性精神病理表现。我们区分伴有或不伴有意识障碍的精神病状态。在症状性和内源性精神病的脑电图研究中,众所周知,在这些精神病中,相同的临床综合征可能与正常和异常的脑电图检查结果相关。当考虑到精神病的活动时,这种矛盾往往可以得到解释。精神病的活动程度由精神病理症状的持续时间、数量、强度和变异性来决定。从他对30例精神分裂样癫痫性精神病、发作性情感障碍以及抑郁和躁狂性精神病患者的自身研究中可以看出,正常脑电图极为罕见。它们最常出现在亚急性精神分裂样癫痫性精神病中。活动性精神分裂样癫痫性精神病,尤其是这种类型的精神病,其脑电图最常表现为尖波、阵发性心律失常和异常节律形成同时出现。活动性精神分裂样精神病通常与异常节律相关。这些异常节律(“parenrhythmien”)随着精神病过程活动的丧失而平行减少,因此在亚急性精神病中相应地很少见,在非活动性精神病中则无法检测到。癫痫性精神病与癫痫发作频率之间交替对应的经验得到了证实。

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