Can Fam Physician. 1987 Mar;33:755-63.
Introduction of new anticonvulsants, widespread use of serum anticonvulsant-level measurement, and availability of equipment for simultaneous video-electroencephalogram (EEG) monitoring have shown that not everyone who has seizures has epilepsy, even when other medical conditions have been excluded. Non-epileptic seizures, or pseudoseizures, occur in 20% of patients with conversion syndromes and can be difficult to diagnose and treat. Patients with pseudoseizures do not respond to anticonvulsants, may display paradoxical reactions to prescribed treatment regimens, and may develop abnormal neurological signs as a result of anticonvulsant toxicity. Both epileptic and non-epileptic patients may suffer pseudoseizures, which should be suspected when seizures, which should be suspected when seizure control is unpredictable or difficult, or when ictal or post-ictal EEGs are normal and psychopathology is present. Video-EEG monitoring is the "gold standard" of pseudoseizure diagnosis. A case history illustrates how difficult the clinical diagnosis can be, and how useful a normal post-ictal EEG can be when the etiology of a seizure disorder is obscure.
介绍新的抗癫痫药物、血清抗癫痫药物水平检测的广泛应用以及同时进行视频-脑电图（EEG）监测设备的可用性表明，即使排除了其他医疗条件，并非所有患有癫痫发作的人都患有癫痫。非癫痫性发作，或假性发作，在转换综合征患者中发生的比例为 20%，且诊断和治疗可能较为困难。假性发作患者对抗癫痫药物无反应，可能对规定的治疗方案出现矛盾反应，并可能因抗癫痫药物毒性而出现异常神经体征。癫痫性和非癫痫性患者均可发生假性发作，当癫痫发作难以控制或控制不佳，或发作期和发作后 EEG 正常而存在精神病理学表现时，应怀疑假性发作。视频-脑电图监测是假性发作诊断的“金标准”。一个病例说明了临床诊断可能有多么困难，以及当癫痫发作的病因不明确时，正常的发作后 EEG 是多么有用。
