Alsaadi Taoufik M, Marquez Anna Vinter
Department of Neurology, University of California, Davis, Medical Center, Sacramento, California 95817-2307, USA.
Am Fam Physician. 2005 Sep 1;72(5):849-56.
Psychogenic nonepileptic seizures are episodes of movement, sensation, or behaviors that are similar to epileptic seizures but do not have a neurologic origin; rather, they are somatic manifestations of psychologic distress. Patients with psychogenic nonepileptic seizures frequently are misdiagnosed and treated for epilepsy. Video-electroencephalography monitoring is preferred for diagnosis. From 5 to 10 percent of outpatient epilepsy patients and 20 to 40 percent of inpatient epilepsy patients have psychogenic nonepileptic seizures. These patients inevitably have comorbid psychiatric illnesses, most commonly depression, posttraumatic stress disorder, other dissociative and somatoform disorders, and personality pathology, especially borderline personality type. Many patients have a history of sexual or physical abuse. Between 75 and 85 percent of patients with psychogenic nonepileptic seizures are women. Psychogenic nonepileptic seizures typically begin in young adulthood. Treatment involves discontinuation of antiepileptic drugs in patients without concurrent epilepsy and referral for appropriate psychiatric care. More studies are needed to determine the best treatment modalities.
心因性非癫痫性发作是指运动、感觉或行为发作，类似于癫痫发作，但并非起源于神经系统；相反，它们是心理困扰的躯体表现。心因性非癫痫性发作患者经常被误诊为癫痫并接受相应治疗。视频脑电图监测是诊断的首选方法。门诊癫痫患者中有5%至10%、住院癫痫患者中有20%至40%患有心因性非癫痫性发作。这些患者不可避免地合并有精神疾病，最常见的是抑郁症、创伤后应激障碍、其他解离性和躯体形式障碍以及人格病理学，尤其是边缘型人格类型。许多患者有性虐待或身体虐待史。75%至85%的心因性非癫痫性发作患者为女性。心因性非癫痫性发作通常始于青年期。治疗包括在无合并癫痫的患者中停用抗癫痫药物，并转诊至适当的精神科治疗。需要更多研究来确定最佳治疗方式。
