Primavera A, Fonti A, Novello P, Roccatagliata G, Cocito L
Clinica Neurologica dell'Università di Genova, Italy.
J Neurol Neurosurg Psychiatry. 1994 Nov;57(11):1419-22. doi: 10.1136/jnnp.57.11.1419.
Acute catatonic syndrome is a condition that can be caused by a variety of metabolic, neurological, psychiatric, and toxic conditions, including neuroleptic malignant syndrome. Although ictal catatonia as a manifestation of non-convulsive status epilepticus has been described, reference to the occurrence of seizures in patients with acute catatonic syndrome is anecdotal. Twenty nine patients with acute catatonic syndrome were reviewed to identify patients with seizures after the onset of acute catatonic syndrome. Patients were divided into four diagnostic groups: affective (15), schizophrenic (eight), toxic (two), and organic (four). Seizures occurred in four patients (13.8%): two patients with dystonic seizures had viral encephalitis and schizophrenic disorder respectively; one patient with complex partial seizures had viral encephalitis and one patient with absence status had neuroleptic malignant syndrome. The results indicate the value of EEG in detection of epileptic activity in patients with acute catatonic syndrome, both at onset and in the course of such disturbance, particularly to provide a differential diagnosis between pseudo-seizures and neuroleptic-induced acute dystonia.
急性紧张症综合征是一种可由多种代谢、神经、精神和中毒性疾病引起的病症，包括抗精神病药物恶性综合征。尽管已经描述了发作性紧张症作为非惊厥性癫痫持续状态的一种表现，但关于急性紧张症综合征患者癫痫发作的报道多为轶事。回顾了29例急性紧张症综合征患者，以确定急性紧张症综合征发作后出现癫痫发作的患者。患者分为四个诊断组：情感性（15例）、精神分裂症性（8例）、中毒性（2例）和器质性（4例）。4例患者（13.8%）出现癫痫发作：2例肌张力障碍性癫痫发作患者分别患有病毒性脑炎和精神分裂症；1例复杂部分性癫痫发作患者患有病毒性脑炎，1例失神状态患者患有抗精神病药物恶性综合征。结果表明，脑电图在检测急性紧张症综合征患者癫痫活动方面具有价值，无论是在发作时还是在这种紊乱过程中，特别是有助于鉴别假性癫痫发作和抗精神病药物引起的急性肌张力障碍。
