Department of Pediatrics, Jeju National University College of Medicine, Jeju-do, Republic of Korea.
Epilepsy Behav. 2012 Jul;24(3):336-40. doi: 10.1016/j.yebeh.2012.03.022. Epub 2012 May 11.
The purpose of the study was to evaluate the clinical characteristics of paroxysmal nonepileptic events (PNEs) in pediatric patients. Reports of 1108 patients who underwent long-term video-EEG monitoring at Seoul National University Children's Hospital were reviewed retrospectively. One hundred forty-three (12.9%) patients were diagnosed as having PNEs. The most common type of PNE was staring. Staring, tonic posturing, sleep myoclonus, and sleep-related disorders were more common in patients younger than 6 years old. Psychogenic nonepileptic seizure was the most common PNE in patients older than 6 years. Patients who were younger than 6 years old showed shorter disease duration and more varied types of PNEs when compared to older patients (6 years old or older). Presence of epilepsy was not significantly related to clinical difference in PNEs. In patients with developmental delay, staring and tonic posture were significantly more frequent than patients without developmental delay. Thirty-two patients without concurrent epilepsy were misdiagnosed with epilepsy, and AEDs were discontinued after the correct diagnosis of PNEs. Whenever the diagnosis of paroxysmal abnormal behavior is uncertain, correct diagnosis should be made using long-term video-EEG monitoring, especially in younger pediatric patients and patients with developmental delay.
本研究旨在评估儿科患者阵发性非癫痫性事件 (PNEs) 的临床特征。回顾性分析了在首尔国立大学儿童医院接受长期视频-脑电图监测的 1108 例患者的报告。143 例 (12.9%) 患者被诊断为患有 PNE。最常见的 PNE 类型是凝视。6 岁以下患者更常见的是凝视、强直姿势、睡眠肌阵挛和与睡眠相关的障碍。6 岁以上患者中最常见的 PNE 是心因性非癫痫性发作。与年长患者相比，年龄较小的患者疾病持续时间更短，PNE 类型更多（6 岁或以上）。癫痫的存在与 PNE 的临床差异无显著相关性。在发育迟缓的患者中，凝视和强直姿势比无发育迟缓的患者更常见。32 例无伴发癫痫的患者被误诊为癫痫，在正确诊断为 PNE 后停用了抗癫痫药物。每当阵发性异常行为的诊断不确定时，应使用长期视频-脑电图监测进行正确诊断，尤其是在年轻的儿科患者和发育迟缓的患者中。
