Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Seizure. 2021 Nov;92:200-204. doi: 10.1016/j.seizure.2021.09.009. Epub 2021 Sep 16.
Psychogenic nonepileptic seizures resemble epileptic seizures but lack the physiological basis of epileptic seizures. We conducted a systematic review to explore whether childhood abuse is a risk factor for subsequent development of PNES. We reviewed only papers with an epilepsy control group, which employed strict criteria for diagnosis of epilepsy and well-validated tools for assessing abuse history. Odds ratios (ORs) for the different categories of childhood abuse and for childhood abuse as a whole were calculated where not previously available, and pooled ORs were calculated where suitable. In papers where OR could not be calculated data are presented as p values. Most Odds Ratios fell between 1.8 and 5.2 with relatively narrow confidence intervals. In 14 out of 18 calculations, 95% confidence intervals did not cross 1. This suggests that the chance of reporting abuse is higher in people with PNES than those with epilepsy and may be a causative factor in developing PNES. Several limitations of the data and directions for future study are discussed.
心因性非癫痫性发作类似于癫痫发作，但缺乏癫痫发作的生理基础。我们进行了一项系统综述，以探讨儿童期虐待是否是随后发生心因性非癫痫性发作的危险因素。我们只回顾了有癫痫对照组的论文，这些论文采用了严格的癫痫诊断标准和经过充分验证的评估虐待史的工具。在以前没有计算出优势比 (OR) 的情况下，我们计算了不同类别的儿童期虐待和儿童期虐待的整体 OR，并在合适的情况下计算了合并 OR。在无法计算 OR 的论文中，数据以 p 值表示。大多数优势比在 1.8 到 5.2 之间，置信区间相对较窄。在 18 次计算中的 14 次中，95%的置信区间没有超过 1。这表明，心因性非癫痫性发作患者比癫痫患者更有可能报告虐待，这可能是导致心因性非癫痫性发作的一个因素。讨论了数据的一些局限性和未来研究的方向。
