转换障碍伴类似癫痫发作误诊1例报告
Misdiagnosis of conversion disorder with seizure-like episodes: a case report
投稿时间:2019-04-19  修订日期:2019-08-02
DOI:
中文关键词:  心因性假性癫痫发作  癫痫  转换障碍  视频脑电图监测
英文关键词:Psychogenic non-epileptic seizures(PNES)  Epilepsy  Conversion disorders  video-EEG
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作者单位E-mail
吕丽 济宁医学院 1764151032@qq.com 
刘传新 济宁医学院 Liuchuanxin2003b@163.com 
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中文摘要:
      本文研究的目的是为心因性假性癫痫发作(PNES)的早期诊断、鉴别及治疗提供参考。PNES是转换障碍最常见临床表现之一,常于患者情绪激动或受暗示时突然发病,表现类似癫痫发作,但并无大脑异常的癫痫样放电活动。目前,对PNES与癫痫的鉴别已有相关报道,但尚无明确的诊断标准,临床中仍会有误诊或诊断不明的情况。若PNES患者被误诊为癫痫,并接受抗癫痫治疗,不仅不能改善症状,可能还会延误病情,导致疾病进一步加重,严重影响患者的生活。因此关于二者的鉴别还需进一步明确与研究。该病例报道了一位中年女性多次出现类似癫痫发作,结合病史及辅助检查诊断为“转换障碍-心因性假性癫痫发作”,经对症治疗后病情好转。
英文摘要:
      The purpose of this report is to provide clinical evidence for the early diagnosis, differentiation and treatment of psychogenic non-epileptic seizures (PNES) . PNES are one of the most common clinical manifestations of conversion disorders, which often occur suddenly with resemble epileptic seizures but without epileptic discharges in the brain when patients are emotionally aroused or suggestive. At present, the differential diagnosis between PNES and epilepsy has been reported, but there is no clear diagnostic criteria. There are still some cases of misdiagnosis or unclear diagnosis in clinical practice. If PNES is misdiagnosed as epilepsy and treated with anti-epilepsy, will not only can’t improve the symptoms, but also may delay the condition, leading to further aggravation of the disease and seriously affecting the lives of patients. Therefore, the identification of the two needs further clarification and research. This case mainly reported that a middle-aged woman had several epilepsy-like seizures, which were diagnosed as “psychogenic non-epileptic seizures of conversion disorders” combined with medical history and auxiliary examinations. After symptomatic treatment and psychotherapy, her condition improved.
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