心因性假性癫痫发作患者15例临床特征分析

Clinical characteristics analysis of 15 cases of psychogenic nonepileptic seizures

目的探讨心因性假性癫痫发作(PNES)的临床特点。方法对15例PNES患者临床资料进行回顾性分析。结果 15例PNES患者中10例曾被误诊,其中8例被误诊为癫痫长期服用抗癫痫药物治疗,2例被误诊为短暂性脑缺血发作。15例患者按照Dhiman等提出的PNES分型方法分为5种类型:异常运动性反应6例,情感或情绪行为发作1例,意识障碍发作2例,非癫痫性先兆1例,混合性发作4例,PNES与癫痫合并存在1例。结论由于认识不足,PNES易误诊,临床医师需提高对PNES的重视,以期早期诊断和治疗,降低误诊率。

Objective To investigate the clinical characteristics of psychogenic nonepileptic seizures（PNES）.Methods Clinical data of 15 cases were analyzed retrospectively.Results Of 15 cases,10 cases were misdiagnosed.Eight cases were misdiagnosed with epilepsy and prescribed anti-epileptic drug,2 cases were misdiagnosed with transient ischemic attack.We categorized 15 cases into 5 categories based on the classification of Dhiman：7 cases of abnormal motor response,1 case of affective/emotional behavior phenomena,2 cases of dialeptic type,1 case of nonepileptic aura and 4 cases of mixed pattern.1 case coexisted PNES and epileptic seizures.ConclusionDue to the lack of recognizing of PNES,patients are often misdiagnosed.Clinicians should improve awareness of PNES in order to have an early diagnosis and treatment and decrease misdiagnosis rate.