1Department of Neurology,Sunnybrook Health Sciences Centre,University of Toronto,Toronto,Ontario,Canada.
2Private Practice,Toronto Western Hospital,University Health Network,Toronto,Ontario,Canada.
Can J Neurol Sci. 2018 Mar;45(2):130-136. doi: 10.1017/cjn.2017.283. Epub 2018 Jan 8.
The purpose of this review is to provide an update of the research regarding the etiology, diagnosis and management of psychogenic non-epileptic seizures (PNES). A literature search using Pubmed, Ovid MEDLINE and EMBASE database was performed from 2000 up to August 2017. We have evaluated the different factors leading to PNES as well as the diagnostic approach and management of this disorder which continue to be very difficult. The coexistence of epilepsy and PNES poses special challenges and requires the coordinated efforts of the family physicians, psychiatrists, psychologists and neurologists. Although this condition has an overall poor prognosis, a multidisciplinary approach in the diagnosis and management of this disorder would likely improve the outcomes. We have proposed a diagnostic and treatment algorithm for PNES and suggested a national registry of patients suffering from this condition. The registry would contain data regarding treatment and outcomes to aid in the understanding of this entity.
本次综述的目的在于为心因性非癫痫性发作(PNES)的病因、诊断和管理的研究提供最新进展。我们使用 Pubmed、Ovid MEDLINE 和 EMBASE 数据库对 2000 年至 2017 年 8 月期间的文献进行了检索。我们评估了导致 PNES 的不同因素,以及该疾病的诊断方法和管理,后者仍然非常困难。癫痫与 PNES 共存带来了特殊的挑战,需要家庭医生、精神科医生、心理学家和神经科医生共同努力。尽管这种疾病的总体预后较差,但在该疾病的诊断和管理中采用多学科方法可能会改善结局。我们提出了一个 PNES 的诊断和治疗算法,并建议建立一个患有该疾病的患者国家登记处。该登记处将包含有关治疗和结局的数据,以帮助我们理解这种疾病。