Cragar Dona E, Berry David T R, Fakhoury Toufic A, Cibula Jean E, Schmitt Frederick A
Department of Psychology, University of Kentucky Medical Center, Lexington 40536, USA.
Neuropsychol Rev. 2002 Mar;12(1):31-64. doi: 10.1023/a:1015491123070.
The diagnosis of psychogenic nonepileptic seizures (PNES) is complex. Long-term electroencephalogram monitoring with video recording (video EEG) is the most common method of differential diagnosis of epilepsy and PNES. However, video EEG is complex, costly, and unavailable in some areas. Thus, alternative diagnostic techniques have been studied in the search for a diagnostic method that is as accurate as video EEG, but more cost effective, convenient, and readily available. This paper reviews the literature regarding possible diagnostic alternatives and organizes findings into 7 areas of study: demographic and medical history variables, seizure semiology, provocative testing, prolactin levels, single photon emission computed tomography, psychological testing, and neuropsychological testing. For each area, the literature is summarized, and conclusions about the accuracy of the technique as a diagnostic tool are drawn. Overall, it appears unlikely that any of the reviewed alternative techniques will replace video EEG monitoring; rather they may be more successful as complementary diagnostic tools. An important focus for further investigations involves combinations of diagnostic techniques for the differential diagnosis of epilepsy and PNES.
心因性非癫痫性发作（PNES）的诊断较为复杂。长期脑电图监测结合视频记录（视频脑电图）是癫痫与PNES鉴别诊断最常用的方法。然而，视频脑电图检查复杂、成本高，且在某些地区无法开展。因此，人们研究了其他诊断技术，以期找到一种诊断方法，其准确性与视频脑电图相当，但成本效益更高、更便捷且更容易获得。本文回顾了有关可能的替代诊断方法的文献，并将研究结果归纳为7个研究领域：人口统计学和病史变量、发作症状学、激发试验、催乳素水平、单光子发射计算机断层扫描、心理测试和神经心理测试。针对每个领域，对文献进行了总结，并得出了该技术作为诊断工具的准确性结论。总体而言，似乎所审查的任何替代技术都不太可能取代视频脑电图监测；相反，它们作为辅助诊断工具可能会更成功。进一步研究的一个重要重点涉及用于癫痫与PNES鉴别诊断的诊断技术组合。
