Meierkord H, Will B, Fish D, Shorvon S
University Department of Clinical Neurology, Queen Square, London, UK.
Neurology. 1991 Oct;41(10):1643-6. doi: 10.1212/wnl.41.10.1643.
A total of 110 patients underwent diagnostic evaluation for attacks of uncertain origin by means of video-EEG telemetry and had a diagnosis of pseudoseizures confirmed. Eighty-six patients (78%) were female, mean age of onset 25 years, and mean duration of attacks was 3 years. Many of the patients had erroneously been thought to be suffering from epilepsy. The attacks could be divided into two broad categories: attacks of collapse (one-third) and attacks with prominent motor activity (two-thirds). In some patients, the attacks were associated with incontinence and injury. The differential diagnosis and clinical features of the attacks are described. Additional psychiatric features were present in 52 (47%) patients. Follow-up (for a median 5 years; range, 1 to 14 years) showed that 40% of these patients stopped having pseudoseizures. This favorable outcome was associated with being female, leading an independent life, a formal psychological approach to therapy and counseling, and the absence of coexisting epilepsy, but not with the duration of pseudoepilepsy, prior episodes of pseudostatus, the coexistence of overt psychiatric disease, or the clinical features of the attacks.
共有110例患者通过视频脑电图遥测对病因不明的发作进行了诊断评估，并确诊为假性发作。86例患者（78%）为女性，平均发病年龄25岁，发作平均持续时间为3年。许多患者曾被误诊为患有癫痫。发作可分为两大类：虚脱发作（三分之一）和伴有明显运动活动的发作（三分之二）。在一些患者中，发作与大小便失禁和受伤有关。描述了发作的鉴别诊断和临床特征。52例（47%）患者存在其他精神症状。随访（中位时间5年；范围1至14年）显示，这些患者中有40%停止了假性发作。这一良好结果与女性、独立生活、正规的心理治疗和咨询方法以及不存在并存癫痫有关，但与假性癫痫的持续时间、既往假性癫痫持续状态发作、明显精神疾病的并存或发作的临床特征无关。
