Sheth Shabina A, Chandra Nilanjan C, Mehta Ritambhara Y
Department of Psychiatry, Government Medical College and New Civil Hospital, Surat, Gujarat, India.
Indian J Psychol Med. 2017 Jul-Aug;39(4):527-530. doi: 10.4103/0253-7176.211761.
True and psychogenic nonepileptic seizures (PNES) go hand in hand. One colors the picture of other. Although it is thought that children carry lower risk for PNES than adults, this may represent the under-diagnosis of this condition in childhood due to few studies on this specific topic. Again, true seizure can be misdiagnosed by dramatic and varied manifestations appearing as psychological phenomena. We report a case of a 9-year-old boy presenting with sudden onset, short lasting, off and on different "melodramatic" episodic behavioral problems with La-Belle' indifference without loss of consciousness, appearing to be of psychogenic origin but finally ended with a diagnosis of temporal lobe epilepsy and responded dramatically with antiepileptics. The goal of this case report is to alert the reader to be cautious about rarer presentations of epilepsy and see each case holistically which may be misguided as PNES.
真性癫痫发作与精神性非癫痫性发作(PNES)并存。二者相互影响。尽管一般认为儿童患PNES的风险低于成人,但这可能是由于针对该特定主题的研究较少,导致儿童期该病症诊断不足。此外,真性癫痫发作可能因表现为心理现象的戏剧性和多样症状而被误诊。我们报告一例9岁男孩,其突然起病,发作持续时间短,反复出现不同的“夸张”发作性行为问题,呈“泰然漠视”状态,无意识丧失,看似源于精神因素,但最终诊断为颞叶癫痫,使用抗癫痫药物后反应显著。本病例报告的目的是提醒读者,对于癫痫的罕见表现要谨慎,全面看待每个病例,因为这些病例可能被误诊为PNES。