Lund Caroline, Haraldsen Ira, Lossius Morten I, Bjørnaes Helge, Lossius Rasmus, Nakken Karl O
Epilepsisenteret - SSE Nevrologisk avdeling, Oslo, Norway.
Tidsskr Nor Laegeforen. 2009 Nov 19;129(22):2348-51. doi: 10.4045/tidsskr.09.0300.
Psychogenic non-epileptic seizure is the term used for epilepsy-like seizures assumed to have psychological causes. Many patients with such seizures are misdiagnosed with epilepsy, and are consequently treated with antiepileptic drugs for many years. Assessment of a thorough medical history and ictal EEG-recordings will lead to the right diagnosis in most cases. The article provides an overview of this condition, which often represents large diagnostic and therapeutic challenges and is the most frequent differential diagnosis in epilepsy.
The article is based on literature identified through a non-systematic search in PubMed up to January 2009.
Much literature is available in the field. 10-20 % of those referred to epilepsy centers because of therapy-resistant epilepsy, have psychogenic non-epileptic seizures. 70-80 % of these patients are women. The attacks may resemble all types of epileptic seizures, from absence-like episodes to tonic-clonic-like seizures.
Such seizures may have a wide spectre of causes, including chronic psychological conflicts and psychotraumas. Treatment should therefore be tailored to individuals.
心因性非癫痫性发作是指那些被认为由心理因素引起的类似癫痫发作的情况。许多患有此类发作的患者被误诊为癫痫，因此多年来一直接受抗癫痫药物治疗。全面的病史评估和发作期脑电图记录在大多数情况下能得出正确诊断。本文概述了这种疾病，它常常带来巨大的诊断和治疗挑战，并且是癫痫最常见的鉴别诊断。
本文基于截至2009年1月通过在PubMed上非系统性检索所确定的文献。
该领域有大量文献。因难治性癫痫被转诊至癫痫中心的患者中，10% - 20%患有心因性非癫痫性发作。这些患者中70% - 80%为女性。发作可能类似于所有类型的癫痫发作，从失神样发作到强直阵挛样发作。
此类发作可能有多种原因，包括慢性心理冲突和精神创伤。因此治疗应因人而异。
