Zhang Li-Ping, Jia Yu, Huang Hao, Li Da-Wei, Wang Yu-Ping
Department of Pediatric, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Pediatr. 2021 Jan 25;8:596781. doi: 10.3389/fped.2020.596781. eCollection 2020.
To analyze the clinical features of children with psychogenic non-epileptic seizures in one tertiary center in China. Clinical data including medical records and video- electroencephalograph (video-EEG) monitoring records of 88 pediatric PNES patients hospitalized in the pediatric department of Xuanwu Hospital, Beijing, China from April, 2012 to April, 2018 were collected in this study. Demographic information of patients, semiological classification, duration, and frequency of symptoms, risk factors as well as comorbidity were summarized and analyzed. For semiological classification, all PNES related symptoms were divided into different categories: motor symptoms, unresponsiveness, sensory symptoms, visceral symptoms, and abnormal behaviors, among which motor symptoms were the most prevalent form. Risk factors were reviewed and categorized into two groups: persistent factors and predisposing factors, and patients were most frequently affected by the influences of families. The duration and frequency of symptoms varied substantially within PNES patients while the average time of duration was relatively longer than epilepsy as reported previously. Epilepsy was considered as the most frequent comorbidity of PNES and PNES patients misdiagnosed as epilepsy often mistreated with antiseizure medication. Our study showed that motor PNES are the most frequent seizure type. Family issues were a risk factor for PNES. Epilepsy was the most frequent co-existing neurological comorbidity.
分析中国一家三级中心儿童心理性非癫痫性发作的临床特征。本研究收集了2012年4月至2018年4月在中国北京宣武医院儿科住院的88例小儿心理性非癫痫性发作(PNES)患者的临床资料,包括病历和视频脑电图(video-EEG)监测记录。总结并分析了患者的人口统计学信息、症状学分类、症状持续时间和频率、危险因素以及合并症。对于症状学分类,所有与PNES相关的症状分为不同类别:运动症状、无反应性、感觉症状、内脏症状和异常行为,其中运动症状是最常见的形式。对危险因素进行了回顾并分为两组:持续性因素和易患因素,患者最常受到家庭影响。PNES患者的症状持续时间和频率差异很大,而平均持续时间比之前报道的癫痫相对更长。癫痫被认为是PNES最常见的合并症,被误诊为癫痫的PNES患者经常接受抗癫痫药物治疗。我们的研究表明,运动性PNES是最常见的发作类型。家庭问题是PNES的一个危险因素。癫痫是最常见的并存神经合并症。