24小时动态脑电图癔病诱发试验对癔病与癫痫的鉴别诊断价值

Hysteria provocative test with 24 hour ambulatory EEG recording to differentiate hysteria from epilepsy

目的寻找鉴别癔病性发作与癫痫发作的有效方法。方法对９６例发作性疾病患者进行２４小时动态脑电图监测及癔病诱发试验（ＡＥＥＧ－ＨＰＴ）研究。结果难治性癫痫疑伴癔病组（１８例）、癔病或癫痫发作诊断不定组（３６例）、癫痫组（１８例）、癔病组（２４例）４组中癔病诱发试验阳性率分别为７７．８％、６６．７％、５．６％、９１．７％；记录到非诱发下自发发作（癫痫或癔病）分别为３、７、３、１例；记录到发作间期癫痫性放电分别为１６、１８、１７、２例。９６．０％的患者明确诊断。结论ＡＥＥＧ－ＨＰＴ是鉴别癔病与癫痫发作的有效方法之一。

Objective To differentiate the pseudoseizures from the epileptic seizures. Methods We studied 96 patients with seizures with AEEG HPT (simultaneous 10% calcium gluconate injection together with psychological suggestions during ambulatory EEG recording). They were divided into four groups: Group A (18 patients) who were thought to have poorly controlled epileptic seizures which might associate with hysteia; Group B (36 patients) who had an indefinite diagnosis of seizure; Group C (18 patients) who had a definite diagnosis of epilepsy; Group D (24 patients) who had a difinite diagnosis of hysteria. Results The positive rate was 77.8%, 66.7%, 5.6%, and 91.7%. The numbers of the patients to whom spontaneous spells were recorded was 3, 7, 3 and 1 cases, and the numbers of the patients to whom the interictal epileptiform discharge was captured was 16, 18, 17 and 2 cases, in Groups A, B, C and D respectively. Finally 96% of them had a definite diagnosis. Conclusion It was suggested that AEEG HPT would be a very effective means of distinguishing hysteria from epilepsy.