Gale Seth, Safar Laura, Robbins Jeffrey, Daffner Kirk
Center for Brain-Mind Medicine (CBMM), Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Epilepsy Behav Case Rep. 2014 Feb 12;4:104-7. doi: 10.1016/j.ebcr.2014.01.005. eCollection 2015.
The authors report a case of unilateral functional neurological symptoms (nonepileptic convulsions) in a 38-year-old man with mild, motor-predominant cerebral palsy. His convulsions are all lateralized to the same side as his paretic limbs. His episodes significantly decreased after several months of weekly psychodynamic-oriented psychotherapy. Functional neurological disorders have been rarely reported in children or adults with cerebral palsy. Among patients with brain injury, right-hemispheric brain disease may be more helpful than either handedness or the side of symptoms in clinically profiling patients with suspected functional disorders. This case raises biomechanistic questions about brain injury, the development of functional disorders, and the lateralization of functional symptoms.
作者报告了一例38岁男性单侧功能性神经症状(非癫痫性惊厥)的病例,该男性患有轻度、以运动为主的脑瘫。他的惊厥均出现在与他患侧肢体相同的一侧。经过数月每周一次的心理动力学导向心理治疗后,他的发作明显减少。功能性神经障碍在患有脑瘫的儿童或成人中很少有报道。在脑损伤患者中,右半球脑疾病在对疑似功能性障碍患者进行临床特征分析时,可能比用手习惯或症状侧更有帮助。该病例引发了关于脑损伤、功能性障碍的发展以及功能性症状偏侧化的生物力学问题。