Lopez M Raquel, LaFrance W Curt
University of Miami, 1120 NW 14th St., Miami, FL, 33136, USA.
VA Miami Health Care System, Miami, FL, USA.
Curr Neurol Neurosci Rep. 2022 Aug;22(8):467-474. doi: 10.1007/s11910-022-01209-3. Epub 2022 Jun 8.
Psychogenic nonepileptic seizures (PNES) are the most common Functional Neurological Disorder/Conversion Disorder subtype. Significant advances have been made related to diagnosis, neurobiology, and treatment. In this review, we summarize updates in diagnosis and management over the past 3 years.
Although evidence is mixed for the treatment of PNES, psychotherapeutic modalities remain a powerful instrument to empower patients and reduce seizures. A multidisciplinary, holistic approach is beneficial. While seizure freedom in all patients may not be the achieved endpoint in this chronic, paroxysmal disorder, quality of life can be improved with treatment. Additional treatment modalities and further research are needed for patients who are refractory to current treatment. Evidence-based therapies exist for PNES, and recent findings represent an increased understanding of the clinical and neurophysiologic aspects of PNES.
心理性非癫痫性发作（PNES）是最常见的功能性神经障碍/转换障碍亚型。在诊断、神经生物学和治疗方面已取得重大进展。在本综述中，我们总结过去3年中诊断和管理方面的更新情况。
尽管PNES治疗的证据不一，但心理治疗方式仍然是增强患者能力和减少发作的有力手段。多学科、整体的方法是有益的。虽然在这种慢性阵发性疾病中，并非所有患者都能实现无发作这一终点，但治疗可改善生活质量。对于当前治疗难治的患者，需要额外的治疗方式和进一步的研究。PNES存在循证疗法，最近的发现表明对PNES的临床和神经生理学方面有了更多了解。
