Kistelska-Nielubowicz H, Iwińska B, Kazubska M
Neurol Neurochir Pol. 1979 Jul-Aug;13(4):353-9.
The authors examined on an outpatient basis 14 patients treated previously at the Neurological Department, Institute of Psychoneurology in Warsaw or at the Neurological Department of the Grochów Hospital in the years 1965--1972 in whom epilepsy had been diagnosed but who had also had hysterical seizures. Young women aged 20--30 years with temporal-lobe epilepsy prevailed in this group. In most of them hysterical seizures appeared within 5 years after the first epileptic seizure when the frequency of true seizures decreased. In more than half these patients it was possible to find a connection between the occurrence of hypsterical seizures and conflict situations. Psychiatric examination failed to find in most cases any symptoms of epileptic characteropathy, but mood disturbances of the type of depression with dysphoria were disclosed, other findings included immature personality, egocentrism and extraversion. Although the clinical material reviewed by the authors contained only a negligible proportion of cases, it may be possible that they are more numerous among outpatients and the correct diagnosis of these cases is particularly important for further treatment since anticonvulsants are insufficient and sociotherapy with psychotherapy are indicated.
作者对14例患者进行了门诊检查,这些患者曾于1965年至1972年期间在华沙精神神经学研究所神经科或格罗乔夫医院神经科接受治疗,他们被诊断患有癫痫,但也有癔症性发作。该组中以20至30岁患有颞叶癫痫的年轻女性为主。在大多数患者中,癔症性发作出现在首次癫痫发作后的5年内,此时真正癫痫发作的频率降低。在超过半数的这些患者中,有可能发现癔症性发作的发生与冲突情境之间的联系。精神科检查在大多数病例中未发现任何癫痫性人格障碍的症状,但发现了伴有烦躁不安的抑郁类型的情绪障碍,其他发现包括不成熟的人格、自我中心主义和外向性。尽管作者所回顾的临床资料中此类病例所占比例微不足道,但在门诊患者中可能更为常见,而且对这些病例的正确诊断对进一步治疗尤为重要,因为抗惊厥药并不充分,需要进行社会治疗和心理治疗。