Vossler D G, Haltiner A M, Schepp S K, Friel P A, Caylor L M, Morgan J D, Doherty M J
Epilepsy Center and Clinical Neurophysiology Laboratories, Swedish Neuroscience Institute, 801 Broadway #901, Seattle, WA 98122, USA.
Neurology. 2004 Aug 10;63(3):516-9. doi: 10.1212/01.wnl.0000133208.57562.cb.
To determine if ictal stuttering (IS) is more common among patients with psychogenic nonepileptic seizures (PNES) than patients with epileptic seizures (ES).
The authors prospectively reviewed the medical records, EEG-video recordings, and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scores of consecutive adults of normal intelligence diagnosed with either PNES or ES.
A total of 230 (117 PNES and 113 ES) patients were studied. PNES patients were older (p = 0.029), more likely to be female (p < 0.001), and had a shorter duration of seizure disorder (p < 0.001) than ES cases. Ten (8.5%) PNES subjects and no ES cases demonstrated IS. The proportion of patients with IS in these two groups was significantly different (p = 0.004). PNES patients with IS were of similar age as but had an even shorter (p = 0.010) duration of seizure disorder (mean = 3.0 years) than those without IS. Scores on the hypochondriasis, depression (D), and hysteria scales of the MMPI-2 were significantly higher among PNES subjects than in ES patients (p < or = 0.002). However, seven PNES patients with IS had a lower mean score on the D scale than did 98 PNES cases without stuttering (p = 0.005). This produced a more sharply defined "conversion V" appearance on the MMPI-2 graph in the stutterers.
Ictal stuttering was present in 8.5% of 117 consecutive patients with psychogenic nonepileptic seizures, but was not observed in a consecutive series of 113 adults with epileptic seizures. Patients with psychogenic nonepileptic seizures with ictal stuttering had a shorter duration of seizure disorder and a more prominent conversion profile on the Minnesota Multiphasic Personality Inventory than either patients with psychogenic nonepileptic seizures without stuttering or subjects with epileptic seizures.
确定发作性口吃（IS）在精神性非癫痫性发作（PNES）患者中是否比癫痫性发作（ES）患者更常见。
作者前瞻性地回顾了连续诊断为PNES或ES的智力正常的成年患者的病历、脑电图-视频记录以及明尼苏达多相人格调查表-2（MMPI-2）评分。
共研究了230例患者（117例PNES和113例ES）。PNES患者年龄更大（p = 0.029），女性比例更高（p < 0.001），且癫痫发作疾病持续时间更短（p < 0.001）。10例（8.5%）PNES患者出现IS，而ES患者中未观察到。两组中出现IS的患者比例有显著差异（p = 0.004）。出现IS的PNES患者年龄与未出现IS的患者相似，但癫痫发作疾病持续时间更短（p = 0.010）（平均 = 3.0年）。PNES患者在MMPI-2的疑病、抑郁（D）和癔症量表上的得分显著高于ES患者（p ≤ 0.002）。然而，7例出现IS的PNES患者在D量表上的平均得分低于98例无口吃的PNES患者（p = 0.005）。这在口吃患者的MMPI-2图表上产生了更清晰的“转换V”外观。
在连续的117例精神性非癫痫性发作患者中，8.5%出现发作性口吃，但在连续的113例成年癫痫性发作患者中未观察到。与无口吃的精神性非癫痫性发作患者或癫痫性发作患者相比，有发作性口吃的精神性非癫痫性发作患者癫痫发作疾病持续时间更短，且在明尼苏达多相人格调查表上有更明显的转换特征。
