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[癫痫性精神病及其药物治疗]

[Epileptic psychoses and their drug treatment].

作者信息

Klosterkötter J, Penin H

机构信息

Psychiatrische Klinik und Poliklinik, Universität Bonn.

出版信息

Fortschr Neurol Psychiatr. 1989 Feb;57(2):61-9. doi: 10.1055/s-2007-1000745.

Abstract

This paper is concerned with classification, clinical-electroencephalographic correlation, principles of treatment, and pharmaceutic therapy of epileptic psychoses. Based on the system of the physically founded reversible psychoses, classification of epileptic psychoses is developed, which is easy to apply for clinical and research purposes. Its principles are the criteria of disturbance of consciousness and of connexion to epileptic seizures. Epileptic psychoses without disturbance of consciousness frequently go along with a forced normalization of epileptic EEG-changes. This clinical-electroencephalographic correlation is documented by the cases of a depressive-paranoid and a cenesthetic alternative-psychosis. Epileptic psychoses connected to seizures, going along with disturbances of consciousness, however, show, without any exception, a pathological changed EEG. Also in the cases of the often iatrogenically produced epileptic psychoses with disturbances of consciousness yet not connected to seizures, the EEG-results are of decisive diagnostic importance. Each of these three clinical-electroencephalographically defined groups of psychoses calls for concentration on particular pathogenetical aspects concerning a specific pharmaceutic therapy. The respective principles of treatment are developed in subtly differentiated ways and they are provided with suggestion as to medicamental treatment. Schizophrenia-like epileptic psychoses are a model for idiopathic schizophrenias and so important perspective opens up for research.

摘要

本文关注癫痫性精神病的分类、临床脑电图相关性、治疗原则及药物治疗。基于以身体为基础的可逆性精神病系统,发展出癫痫性精神病的分类,该分类便于临床及研究应用。其原则为意识障碍及与癫痫发作关联的标准。无意识障碍的癫痫性精神病常伴随癫痫脑电图改变的强制正常化。抑郁偏执型及本体感觉交替性精神病的病例记录了这种临床脑电图相关性。然而,与发作相关且伴有意识障碍的癫痫性精神病无一例外均显示脑电图病理性改变。同样,在常由医源性导致的有意识障碍但与发作无关的癫痫性精神病病例中,脑电图结果具有决定性诊断意义。这三组临床脑电图定义的精神病中的每一组都需要关注特定药物治疗的特定发病机制方面。各自的治疗原则以细微有别的方式制定,并提供了药物治疗建议。精神分裂症样癫痫性精神病是特发性精神分裂症的一个模型,因此为研究开辟了重要前景。

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