以疼痛为首发癫22例临床误诊分析

Analysis of the disdiagnosis of 22 cases of epilepsy with pain as the initial symptoms

目的了解以疼痛发病癫的临床特点、误诊原因及对策。方法回顾我院2002-02-2012-02收治的以疼痛发病被误诊,经脑电图、试验治疗后确诊的癫患者22例的临床资料。结果以腹痛伴恶心、呕吐发病误诊为急腹症15例,以发作性肢痛为首发被误诊为风湿性关节炎、低钙性抽搐2例,以牙痛发病误诊为牙周炎、龋齿各1例,以头痛伴恶心、呕吐发病误诊为血管神经性头痛2例,以心前区疼痛为首发误诊为冠心病、心绞痛1例。结论临床医生应提高对以疼痛为首发癫的认识,排除常见疼痛病因后,应想到癫的可能。

Objective To study on the clinical manifestations,misdiagnosis reasons and prevention from misdiagnosis of epilepsy with pain as the initial symptoms.Methods The data of 22patients with epilepsy in our hospital from February 2002 to February 2012 were retrospectively analyzed.Results The initial symptoms of these patients were 15 cases of nausea and emesis misdiagnosed as acute abdominal disease,2 cases of paroxysmal acroaesthesia misdiagnosed as rheumatic arthritis and low calcium seizures,1 case of toothache misdiagnosed as periodontitis or tooth decay,2 cases of headache accompanied with nausea and emesis misdiagnosed as cluster headache syndrome,1 case of precordial pain misdiagnosed as angina and coronary disease.Conclusion Clinicians should deepen the understanding about epilepsy with pain as the initial symptoms,and epilepsy should be taken into account besides elimination on common pain etiology.