22例非痫性发作误诊为癫痫发作原因分析

Causative analysis of 22 patients with non-epileptic seizures passed for epileptic seizures

目的分析非痫性发作误诊为痫性发作的原因,以提高癫痫的诊断水平,减少误诊误治。方法回顾性分析我院22例非癫痫发作性疾病被误诊为癫痫的临床资料。结果22例中,2例为阵发性运动诱发性运动障碍,4例为偏头痛,假性甲状旁腺功能减退症、椎基底动脉系TIA、低血糖发作各1例,4例为睡眠障碍,6例为精神性发作,3例为急性焦虑发作。误诊的主要原因:①病史采集不完整,对非痫性发作与痫性发作的特点认识不足;②过分相信其他医叶:或队院的诊断;⑧知识面窄,对临床少见疾病认识不足;④缺乏脑电图知识;⑤依据治疗效果而诊断。结论临床医生对于癫痫的鉴别应该有足够的认识,诊断一定要慎重,否则不但耽误治疗,还将给患者及其亲属带来不必要的心理和经济负担。

Objective To analysis the causes of non-epileptic seizures misdiagnosedas epileptic seizures.Methods Clinical data of 22 patients with non-epileptic seizures misdiagnosed as epileptic seizures were analysed retrospectively.Results Ont of 22 patients,2 were paroxysmal kinesigenic dyskinesia,4 were migraine,4 were sleep disorder,6 were psychic seizure,3 were acute anxiety attack,and pseudohypoparathyroidism,vertebra-basilar artery TIA,hypoglycemia attack was 1 case respectively.The main causes ofmisdiagnosis were as follows:(1)taking the history was not complete,and didnt have a good command of differential diagnosis between epileptic seizures and non-epileptic seizures;(2)doctors concering the event believed readily other doctors'diagnosis;(3)narrow extent of medical knowledge,concered doctors was blind to rare causes of diseases (4)concered doctors lacked necessary EEG knowledge;(5)diagnosis a-bout epilepsy was based on therapeutic effect.Conclusion:C1 inical doctors should attach much importance to epileptic discrimination; diagnosis of epilepsy must be prudent,otherwise,it not only delayed treatment,but also brought about psychological andeconomic burden for the patients themselves and their relatives.