Good M I
Massachusetts Mental Health Center, Boston.
Can J Psychiatry. 1991 Oct;36(8):597-9. doi: 10.1177/070674379103600810.
This report describes an acute organic brain syndrome with a fugue-like state in association with antimigraine pharmacotherapy. The differential diagnosis of: 1. possible psychotoxic effects of the combination of propranolol, imipramine, and butalbital; 2. confusional migraine with amnesia; and 3. psychogenic dissociation is considered. Although organically induced dissociative states are of clinical, neuropsychological and medico-legal significance, the DSM-III and DSM-III-R have specific categories only for dissociative conditions that are strictly psychogenic in origin.
本报告描述了一种与抗偏头痛药物治疗相关的伴有神游样状态的急性器质性脑综合征。文中考虑了以下鉴别诊断：1. 普萘洛尔、丙咪嗪和布他比妥联合使用可能产生的精神毒性作用；2. 伴有失忆的混淆性偏头痛；3. 心因性解离。尽管器质性诱发的解离状态具有临床、神经心理学和法医学意义，但《精神疾病诊断与统计手册》第三版（DSM-III）和第三版修订本（DSM-III-R）仅对严格源自心因性的解离状态设有特定类别。
