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[心因性非癫痫性发作。与癫痫的鉴别诊断、临床表现及治疗方法]

[Psychogenic non-epileptic seizures. Differential diagnosis with epilepsy, clinical presentation and therapeutic approach].

作者信息

Scévola Laura, Korman Guido, Oddo Silvia, Kochen Silvia, D'Alessio Luciana

机构信息

Servicio de Salud Mental y Centro de Epilepsia, Hospital Ramos Mejía.

出版信息

Vertex. 2014 Jul-Aug;25(116):266-73.

Abstract

The current term psychogenic non-epileptic seizures were coined by contemporary neurologists and epileptologists, since the implementation of Video electroencephalogram, considered today the gold standard diagnostic tool. Patients with psychogenic non-epileptic seizures comprise a heterogeneous group from the psychiatric point of view. The diagnosis that describes the psychogenic non-epileptic seizures is "conversion disorder", often associated with dissociative disorder. These disorders are frequently co-morbid with depression, anxiety and posttraumatic stress disorder. Furthermore, usually coexist with personality disorders, especially borderline personality disorder, although dependence personality disorder has also been described. A history of trauma is very important in the pathogenesis and development of psychogenic non-epileptic seizures. The symptoms "core" of the psychogenic non-epileptic seizures (conversion and dissociation), some co-morbidities and personality disorders are treated with psychotherapy, while psychotropic drugs are used for co-morbidities such as depression and posttraumatic stress disorder.

摘要

当前术语“心因性非癫痫性发作”是由当代神经科医生和癫痫专家创造的,自视频脑电图应用以来,视频脑电图如今被视为金标准诊断工具。从精神病学角度来看,心因性非癫痫性发作患者构成了一个异质性群体。描述心因性非癫痫性发作的诊断是“转换障碍”,常与分离性障碍相关。这些障碍常与抑郁症、焦虑症和创伤后应激障碍共病。此外,通常还与人格障碍共存,尤其是边缘型人格障碍,尽管也有关于依赖型人格障碍的描述。创伤史在心因性非癫痫性发作的发病机制和发展中非常重要。心因性非癫痫性发作的“核心”症状(转换和分离)、一些共病和人格障碍采用心理治疗,而精神药物用于治疗抑郁症和创伤后应激障碍等共病。

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