Lobello Kasia, Morgenlander Joel C, Radtke Rodney A, Bushnell Cheryl D
Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Epilepsy Behav. 2006 Feb;8(1):261-6. doi: 10.1016/j.yebeh.2005.10.010. Epub 2005 Dec 6.
To establish the number of monitoring days needed to distinguish psychogenic nonepileptic seizures (PNES) from epileptic seizures (ES) in adult patients admitted for video/EEG monitoring (VEM), we performed a retrospective chart review on 199 consecutive admissions for behavioral event diagnosis with VEM. Of the 199 adult patients admitted for VEM, 83.9% (n = 167) had a clinical event during admission, and a definitive diagnosis was made in 75.9% (n = 151). Of patients who had clinical events, 87.7% (n = 143) had their first event on admission day 1 or 2. Factors associated with ES (vs PNES) included an abnormal baseline EEG (P < 0.001), an abnormal brain MRI (P = 0.01), and history of events lasting less than 1minute (P = 0.01). There was no association between time to first event and discharge diagnosis. VEM differentiated between ES and PNES in the majority of adult patients evaluated. Most behavioral events were characterized within 2 days of admission.
为确定在接受视频/脑电图监测（VEM）的成年患者中区分精神性非癫痫性发作（PNES）和癫痫性发作（ES）所需的监测天数，我们对199例因行为事件诊断而连续接受VEM的患者进行了回顾性病历审查。在199例接受VEM的成年患者中，83.9%（n = 167）在住院期间发生了临床事件，75.9%（n = 151）做出了明确诊断。在发生临床事件的患者中，87.7%（n = 143）在入院第1天或第2天首次发生事件。与ES（对比PNES）相关的因素包括基线脑电图异常（P < 0.001）、脑MRI异常（P = 0.01）以及事件持续时间少于1分钟的病史（P = 0.01）。首次事件发生时间与出院诊断之间无关联。在大多数接受评估的成年患者中，VEM能够区分ES和PNES。大多数行为事件在入院2天内得以明确特征。
