Drake M E
Clin Electroencephalogr. 1985 Jul;16(3):171-6. doi: 10.1177/155005948501600313.
Twenty patients with suspected pseudoseizures underwent saline infusion during prolonged sleep deprived EEG with video monitoring and nasopharyngeal electrodes. No patients had definite clinical evidence of epilepsy, but 35% had abnormal EEGs, 10% with epileptiform activity. Patients with epileptiform discharges did not experience pseudoseizures with saline infusion. Patients with generalized EEG slowing responded to saline infusion with characteristic seizures. Three groups of patients were differentiated. Eight patients had characteristic attacks with saline infusion, and in these patients females predominated, mean age was lower, and somatoform disorder was common. Six patients each either failed to respond to saline or had episodes different from their characteristic spells. These patients were more often male and more often had diagnoses of personality disorders. The findings suggest that, although saline infusion may identify pseudoseizures and confirm their non-epileptic nature, some patients may not be sufficiently suggestible to respond to saline infusion, while others may have non-epileptic attacks which are different from the spells under evaluation. Psychiatric and neuropsychological features suggestive of pseudoseizures may be more readily identified by psychiatric interview or psychometric testing. Ethical issues regarding saline infusion in the guise of a potent convulsant should also be considered.
20名疑似假性癫痫发作的患者在长时间睡眠剥夺脑电图监测及视频监测并使用鼻咽电极的过程中接受了生理盐水输注。没有患者有明确的癫痫临床证据，但35%的患者脑电图异常，其中10%有癫痫样活动。有癫痫样放电的患者在输注生理盐水时未出现假性癫痫发作。脑电图广泛性减慢的患者对生理盐水输注有特征性发作反应。区分出了三组患者。8名患者在输注生理盐水时有特征性发作，这些患者中女性居多，平均年龄较低，且躯体形式障碍常见。另外各有6名患者对生理盐水无反应或发作情况与其特征性发作不同。这些患者男性较多，且更常被诊断为人格障碍。研究结果表明，虽然生理盐水输注可能识别假性癫痫发作并证实其非癫痫性质，但一些患者可能对生理盐水输注的暗示性不足而无反应，而另一些患者可能有与所评估发作不同的非癫痫性发作。通过精神科访谈或心理测量测试可能更容易识别提示假性癫痫发作的精神和神经心理学特征。还应考虑以强效惊厥剂为幌子进行生理盐水输注的伦理问题。
