Gowda Vykuntaraju K, Amoghimath Raghavendraswami, Benakappa Naveen, Shivappa Sanjay K
Department of Pediatric Neurology, Indira Gandhi Institute of Child HealthBengaluru, KarnatakaIndia.
J Neurosci Rural Pract. 2019 Oct;10(4):608-612. doi: 10.1055/s-0039-3399472. Epub 2019 Dec 11.
Nonepileptic paroxysmal events (NEPEs) present with episodes similar to epileptic seizures but without abnormal electrical discharge on electroencephalogram (EEG). NEPEs are commonly misdiagnosed as epilepsy. Epilepsy is diagnosed on the basis of a detailed history and examination. Emphasis during history to rule out the possibility of NEPE is important. The wrong diagnosis of epilepsy can lead to physical, psychological, and financial harm to the child and the family. Hence, this study was planned. The objective of the study is to evaluate clinical profile, frequency, and spectrum of NEPE in children. This is a prospective observational study. Patients with NEPE between January 2014 and August 2016 aged < 18 years were enrolled. NEPEs were diagnosed on the basis of history, home video, and EEG recordings. Patients were divided into different categories according to age, specific type of disorder, and system responsible. Patients were followed for their NEPE frequency and outcome. A total of 3,660 children presented with paroxysmal events; of them 8% were diagnosed with NEPE. Patients diagnosed with NEPE were classified into three age groups on the basis of their age of onset of symptom; of the total 285 patients, there were 2 neonates (0.7%), 160 infants (56%), and 123 children and adolescents (43.1%). Fifty-eight percent patients were boys. The most common diagnoses were breath-holding spells 113 (39%), followed by syncope 38 (13.3%) and psychogenic nonepileptic seizures 37 (12.9%). About 9 and 5% of patients had concomitant epilepsy and developmental delay, respectively. NEPEs account for 8% of paroxysmal events. Most common NEPEs were breath-holding spells among infants and syncope and "psychogenic nonepileptic seizures" in children and adolescents.
非癫痫性发作性事件（NEPEs）表现出与癫痫发作相似的发作症状，但脑电图（EEG）上无异常放电。NEPEs常被误诊为癫痫。癫痫是根据详细的病史和检查来诊断的。在病史询问过程中重点排除NEPE的可能性很重要。癫痫的错误诊断会给儿童及其家庭带来身体、心理和经济上的伤害。因此，开展了本研究。本研究的目的是评估儿童NEPE的临床特征、发作频率和范围。这是一项前瞻性观察性研究。纳入了2014年1月至2016年8月期间年龄＜18岁的NEPE患者。NEPEs是根据病史、家庭录像和EEG记录来诊断的。患者根据年龄、特定疾病类型和相关系统被分为不同类别。对患者的NEPE发作频率和转归进行随访。共有3660名儿童出现发作性事件；其中8%被诊断为NEPE。被诊断为NEPE的患者根据症状发作年龄分为三个年龄组；在总共285名患者中，有2名新生儿（0.7%），160名婴儿（56%），以及123名儿童和青少年（43.1%）。58%的患者为男孩。最常见的诊断是屏气发作113例（39%），其次是晕厥38例（13.3%）和心因性非癫痫性发作37例（12.9%）。分别约有9%和5%的患者合并癫痫和发育迟缓。NEPEs占发作性事件的8%。最常见的NEPEs在婴儿中是屏气发作，在儿童和青少年中是晕厥和“心因性非癫痫性发作”。
