Asadi-Pooya Ali A, Bahrami Zahra
Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, PA, USA.
Neuroscience Research Center, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
Epilepsy Behav. 2019 Jan;90:119-121. doi: 10.1016/j.yebeh.2018.11.009. Epub 2019 Jan 22.
The aim of this study was to investigate the frequency of antiepileptic drug (AED) use in patients with psychogenic nonepileptic seizures (PNES) and to characterize the patients' historical risk factors that may be associated with such a practice.
In this retrospective database study, all patients with PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 to 2018, were studied. Patients with concomitant epilepsy or abnormal Electroencephalogram (EEG) were not included.
Two hundred and seventy patients had the inclusion criteria; 162 patients (60%) were taking AEDs, and 108 (40%) were not taking any AEDs at the time of the diagnosis. Reporting auras (odds ratio: 0.5; 95% confidence interval (CI): 0.301-0.952; p = 0.03), having ictal or postictal urinary incontinence (odds ratio: 3.86; 95% CI: 1.36-10.94; p = 0.01), reporting a dysfunctional family (odds ratio: 1.75; 95% CI: 1.002-3.072; p = 0.04), and a longer duration of the condition before the diagnosis (odds ratio: 1.057; 95% CI: 1.005-1.112; p = 0.03) were significantly associated with AED use; 63.7% of the cases were correctly predicted by the model that was generated by regression analysis (p = 0.0001).
Patients with PNES are at great risk of receiving unnecessary AEDs, and some patients' historical factors (e.g., urine incontinence) have a strong association with this practice.
本研究旨在调查精神性非癫痫性发作（PNES）患者使用抗癫痫药物（AED）的频率，并确定可能与此种用药情况相关的患者既往风险因素。
在这项回顾性数据库研究中，对2008年至2018年期间在设拉子医科大学设拉子综合癫痫中心接受检查的所有PNES患者进行了研究。排除合并癫痫或脑电图（EEG）异常的患者。
270例患者符合纳入标准；162例患者（60%）正在服用AED，108例（40%）在诊断时未服用任何AED。报告有先兆（比值比：0.5；95%置信区间（CI）：0.301 - 0.952；p = 0.03）、发作期或发作后尿失禁（比值比：3.86；95% CI：1.36 - 10.94；p = 0.01）、报告家庭功能失调（比值比：1.75；95% CI：1.002 - 3.072；p = 0.04）以及诊断前病情持续时间较长（比值比：1.057；95% CI：1.005 - 1.112；p = 0.03）与使用AED显著相关；回归分析生成的模型正确预测了63.7%的病例（p = 0.0001）。
PNES患者面临接受不必要AED治疗的巨大风险，一些患者的既往因素（如尿失禁）与这种用药情况密切相关。
