Joos A, Baumann K, Scheidt C E, Lahmann C, König R, Busch H-J, Schulze-Bonhage A
Zentrum für Psychische Erkrankungen, Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Universität Freiburg, Hauptstraße 8, 79104, Freiburg, Deutschland.
Kliniken Schmieder, Psychotherapeutische Neurologie, Gailingen, Deutschland.
Nervenarzt. 2017 Oct;88(10):1147-1152. doi: 10.1007/s00115-017-0401-4.
Patient history taking and semiology provide seminal clues to the diagnosis of dissociative seizures. Openness and alertness of the treating physician are essential. Video-electroencephalogram(EEG)-based analyses of the events are crucial to establish the correct diagnosis, particularly in complex cases. The patient-doctor relationship is of particular importance in order to successfully motivate the patient for psychotherapeutic treatment. Coexisting psychiatric morbidity as well as other functional somatic symptoms must be actively explored. Current changes in the established diagnostic manuals, including ICD-11, reflect the ongoing vivid interest and controversial discussions in the field of dissociative disorders.
采集患者病史和进行症状分析可为分离性癫痫的诊断提供重要线索。主治医生保持开放态度和警觉至关重要。基于视频脑电图(EEG)对这些事件进行分析对于做出正确诊断至关重要,尤其是在复杂病例中。医患关系对于成功激发患者接受心理治疗尤为重要。必须积极探究并存的精神疾病以及其他功能性躯体症状。包括《国际疾病分类第11版》(ICD - 11)在内的现行诊断手册的变化,反映了分离性障碍领域持续浓厚的兴趣和存在的争议性讨论。