Morgan Lindsey A, Buchhalter Jeffrey
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Alberta Children's Hospital, Calgary, Alberta, Canada.
Pediatr Neurol. 2015 Jul;53(1):13-22. doi: 10.1016/j.pediatrneurol.2015.03.017. Epub 2015 Mar 23.
Paroxysmal nonepileptic events are common in children. Events with a psychological basis, historically referred to as pseudoseizures, are a large subset of paroxysmal nonepileptic events.
A review of the relevant pediatric and adult literature was performed.
It was found that these events have many semioloigc features similar to epileptic events and can be challenging to correctly identify. The use of a detailed history in combination with video encephalography and knowledge of psychogenic paroxysmal nonepileptic events will facilitate making the correct diagnosis. Paroxysmal nonepileptic events are important to identify as comorbid disorders such as depression, anxiety disorder, family discord, and school issues are frequent. In addition, prior sexual, emotional, and/or physical abuse may be present.
Pediatric patients with paroxysmal nonepileptic events need to be recognized in order to avoid unnecessary antiepileptic drugs and emergency department or hospital visits and to facilitate appropriate psychological intervention to address the underlying etiologies. This review will focus on evaluation and identification of paroxysmal nonepileptic events, in addition to reviewing the various comorbidities, effective treatments, and outcomes for pediatric patients. The key differences between pediatric and adult patients with paroxysmal nonepileptic events are addressed.
阵发性非癫痫性事件在儿童中很常见。具有心理基础的事件，历史上称为假性癫痫发作，是阵发性非癫痫性事件的一个很大的子集。
对相关的儿科和成人文献进行了综述。
发现这些事件具有许多与癫痫性事件相似的症状学特征，正确识别可能具有挑战性。结合详细病史、视频脑电图以及对心理性阵发性非癫痫性事件的了解将有助于做出正确诊断。识别阵发性非癫痫性事件很重要，因为诸如抑郁症、焦虑症、家庭不和及学校问题等共病很常见。此外，可能存在既往性、情感和/或身体虐待史。
需要识别患有阵发性非癫痫性事件的儿科患者，以避免不必要的抗癫痫药物治疗以及急诊科就诊或住院，并便于进行适当的心理干预以解决潜在病因。本综述将重点关注阵发性非癫痫性事件的评估和识别，此外还将回顾儿科患者的各种共病、有效治疗方法及治疗结果。文中阐述了患有阵发性非癫痫性事件的儿科患者与成人患者之间的关键差异。
