Li G, Zhang P, Yin R
Institute of Neurology, Xiangya Hospital, Hunan Medical University, Changsha 410008.
Hunan Yi Ke Da Xue Xue Bao. 1999;24(2):186-8.
To investigate the influence factors on correct diagnosis of non-epileptic seizures(NES) in childhood, we analyzed 24 h ambulatory electroencephalography(AEEG) and clinical features of the attacks in 159 children with NES. The results showed that 28% of all patients were identified as NES plus epileptic seizures. Epileptiform EEG discharges were observed in 10% of pure NES children. Abnormal findings on neurodiagnostic evaluation were obtained in 32% of NES plus epileptic seizure groups, in 11% of pure NES groups. Unnecessary anti-epileptic drugs were received in 18% of pure NES children and the kind or doses of the medicines were increased in 50% of NES plus epileptic seizure children who had been mistaken for refractory epilepsy. The influence factors on correct diagnosis of NES are mainly; variability of non-epileptic seizure expression, interictal epileptiform EEG discharges, neurologic abnormal findings, and anti-convulsant abuse.
为探讨影响儿童非癫痫性发作(NES)正确诊断的因素,我们分析了159例NES患儿的24小时动态脑电图(AEEG)及发作的临床特征。结果显示,所有患者中有28%被诊断为NES合并癫痫发作。10%的单纯NES患儿观察到癫痫样脑电图放电。在NES合并癫痫发作组中,32%的患儿神经诊断评估有异常发现;在单纯NES组中,这一比例为11%。18%的单纯NES患儿接受了不必要的抗癫痫药物治疗,50%被误诊为难治性癫痫的NES合并癫痫发作患儿的药物种类或剂量增加。影响NES正确诊断的因素主要有:非癫痫性发作表现的变异性、发作间期癫痫样脑电图放电、神经学异常发现及抗惊厥药物滥用。