心因性非痫性发作与癫痫的精准鉴别诊断研究进展

Research progress of precise differential diagnosis of psychogenic non-epilepsy seizures and epilepsy

心因性非痫性发作(PNES)是一种临床症状与癫痫相似但不伴痫样脑电改变的发作性疾病,常被误诊为癫痫。误诊不仅会延误PNES患者的治疗,还可能使其面临因错误使用抗癫痫药物而导致的不良反应。目前PNES的确诊手段是视频脑电图监测,但其最佳监测时长并无定论。近年来,多样的生理信号、脑影像学、实验室检查数据以及机器学习的应用为PNES与癫痫的精准鉴别提供了新思路。文中就PNES与癫痫精准鉴别诊断的研究进展进行综述。

Psychogenic non-epilepsy seizures(PNES)are defined as paroxysms with clinical symptoms similar to epilepsy without epileptiform discharges.It is often misdiagnosed as epilepsy.Misdiagnosis not only delays the time for patients with PNES to get correct diagnoses and treatments,but also may increase the risk of adverse effects from improper use of antiseizure medications.The diagnostic method of PNES is video electroencephalogram monitoring,but there is no consensus on the optimal duration of monitoring.At the same time,the use of diverse physiological signals,brain imaging,laboratory examination,and the application of machine learning provide new perceptions for the precise identification of PNES and epilepsy.This article reviewed the progress of precise differential diagnosis between PNES and epilepsy.