癫痫鉴别诊断中的会话特征分析

Analysis of Conversational Features in Diff erential Diagnosis of Epilepsy

对患者人际互动过程的会话分析在临床诊断中的作用已获证实,其中最具代表性的是,对患者会话中互动特征、话题特征和语言特征的分析能够有效鉴别临床上不易鉴别的痫性发作和心因性非痫性发作。对汉语痫性发作和心因性非痫性发作患者的会话特征分析证实:患者会话中提供发作信息的主动性、陈述的努力程度、否定性表达的使用等特征对于鉴别诊断痫性发作与心因性非痫性发作具有重要价值。研究也进一步表明,会话分析在医学临床诊断中具有实际的应用价值,通过病史记录阶段的医患沟通特征的会话分析,能够为某些神经系统疾病的鉴别诊断提供借鉴。

Epilepsy is a neurological disorder that aff ects the central nervous system and causes seizures or periods of unusual behavior,sensations,and sometimes loss of awareness.In clinical diagnosis,a conversation analysis approach to patients’interaction has proved to be an eff ective method to diagnose epilepsy.Most typically,the interactional,topical,and linguistic features in patients’talk are analyzed to help the diff erentiation of epileptic seizure(ES)and psychogenic non-epileptic seizure(PNES),two types of epilepsy that are diffi cult to be distinguished in clinical practice.With a conversation analysis of the talks of Chinese patients with ES and PNES,this study shows that the initiative of providing seizure information,the eff orts of presentation,and the use of negative expressions in patients’talk are of great value in diff erentiating ES from PNES.The study also indicates that conversation analysis has practical and applicational value in medical clinical diagnosis,which can provide a reference for differential diagnosis of some neurological diseases through an analysis of doctor-patient interactions in medical history records.