Giménez-Roldán S, Hípola D, de Andrés C, Mateo D, Orengo F
Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Rev Neurol. 1998 Sep;27(157):395-400.
Recognition of different ictal motor patterns in psychogenic seizures may be useful in terms of differentiation from epileptic seizures and may also improve understanding the underlying psychopathology.
To outline recognizable ictal motor patterns that may help to distinguish psychogenic motor seizures from epileptic convulsive episodes.
Chart review from 54 patients with motor psychogenic seizures and no clinical or EEG evidence of concomitant epilepsy.
Only 5 patients (9.2%) experienced more than one ictal motor pattern along their illness. Categorization into four subtypes according to ictal motor behaviour was possible in all other patients: psychogenic seizures with flaccid unconsciousness (32.6%), combativeness (32.6%), a hypermobile subtype (24.4%) as defined by the presence of intentional movements or slow rhythmic oscillations of a segment or the entire body, and rigidity (10.2%).
Many psychogenic motor seizures consistently present with recognizable motor phenomena which may be readily identified providing the availability of a reliable witness. Psychogenic seizures as presented spontaneously in a general neurology setting may differ from those reported in biased referrals to video-EEG laboratories. Recognition of characteristic patterns may help differentiation from tonic-clonic convulsions, avoid unnecessary examinations, and may provide insights into their underlying psychopathological mechanisms.
识别精神性发作中不同的发作期运动模式，对于鉴别癫痫发作可能有用，也有助于增进对潜在精神病理学的理解。
概述可识别的发作期运动模式，以帮助区分精神性运动性发作与癫痫惊厥发作。
回顾54例精神性运动性发作患者的病历，且无临床或脑电图证据表明合并癫痫。
仅5例患者（9.2%）在病程中经历过一种以上的发作期运动模式。所有其他患者均可根据发作期运动行为分为四种亚型：伴有弛缓性意识丧失的精神性发作（32.6%）、搏斗性发作（32.6%）、由某一肢体或整个身体的随意运动或缓慢节律性摆动定义的多动亚型（24.4%）以及强直发作（10.2%）。
许多精神性运动性发作持续表现出可识别的运动现象，若有可靠目击者则易于识别。在普通神经科环境中自发出现的精神性发作可能与转诊至视频脑电图实验室的有偏倚病例报告中所描述的发作不同。识别特征性模式有助于与强直阵挛性惊厥相鉴别，避免不必要的检查，并可能有助于深入了解其潜在的精神病理机制。
