Gupta Nishtha, Davis Supriya, Dhamija Sana, Javadekar Archana, Saldanha Daniel
Department of Psychiatry, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India.
Ind Psychiatry J. 2021 Oct;30(Suppl 1):S210-S213. doi: 10.4103/0972-6748.328864. Epub 2021 Oct 22.
Manifestation of abnormal excessive synchronous cortical activity, which is what defines epileptic seizures, is typically absent in seizures with psychological etiology, a heterogeneous set of factors that have been identified. Distinguishing psychogenic nonepileptic seizures (PNES) from epileptic seizures may be difficult at the bedside. We report a case series of PNES which presented with diagnostic dilemma. Diagnostic delay of years with PNES is common. The exact choice of treatment is often difficult and should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is varied but studies consistently report that 1/3 to 1/4 of these cases become chronic.
异常过度同步皮质活动的表现是癫痫发作的定义特征,而在由多种已确定的异质性心理因素引起的发作中通常不存在这种表现。在床边区分精神性非癫痫性发作(PNES)和癫痫性发作可能很困难。我们报告了一系列存在诊断困境的PNES病例。PNES诊断延迟数年很常见。确切的治疗选择往往很困难,应基于潜在因素的个体差异。可以根据发作情况(频率、严重程度)来衡量治疗结果,但其他指标对患者可能更重要。预后各不相同,但研究一致报告,这些病例中有1/3至1/4会发展为慢性疾病。