Service de Neurologie, CHRU Central Nancy, 54000 Nancy, France; Pôle Universitaire du Grand Nancy, Centre Psychothérapique de Nancy, 54000 Laxou, France.
Service de Neurologie, CHRU Central Nancy, 54000 Nancy, France.
Epilepsy Behav. 2021 Jul;120:108000. doi: 10.1016/j.yebeh.2021.108000. Epub 2021 May 5.
Medical international guidelines recommend regular psychiatric consultations for patients with epilepsy, in order to detect comorbidities. However, there is a lack of guidance about PNES that constitute both a differential diagnosis and a comorbidity of epilepsy. While waiting for the ideal collaboration between neurologists and psychiatrists, we develop a pragmatic approach. Wrong diagnosis between epilepsy and Psychogenic nonepileptic seizures (PNES) is frequent and may lead to iatrogenic consequences for patients. To limit the risk of misdiagnosis, psychiatrists and neurologists should collaborate and be more trained about epilepsy, PNES, and their comorbidities. We illustrate the aim of this collaboration through the case of a patient, initially diagnosed with epilepsy, then with PNES only and finally with comorbid epilepsy and PNES. The correct final diagnosis would not have been performed without the collaboration of psychiatrists and neurologists, trained in "Epi-Psy" approach.
医学国际指南建议癫痫患者定期进行精神科会诊，以发现共病。然而，对于构成癫痫的鉴别诊断和共病的非癫痫性发作（PNES），缺乏相关指导。在等待神经科医生和精神科医生之间理想的合作的同时，我们采用了一种实用的方法。癫痫和心因性非癫痫性发作（PNES）之间的误诊很常见，可能给患者带来医源性后果。为了降低误诊风险，精神科医生和神经科医生应该合作，并接受更多关于癫痫、PNES 及其共病的培训。我们通过一个患者的病例来说明这种合作的目的，该患者最初被诊断为癫痫，然后仅被诊断为 PNES，最后被诊断为癫痫和 PNES 共病。如果没有接受过“Epi-Psy”方法培训的精神科医生和神经科医生的合作，就无法做出正确的最终诊断。
