癫痫发作与非癫痫性发作的鉴别诊断研究进展

Progress on distinguishing in epileptic and non-epileptic seizure

癫痫发作是大脑神经元过度同步化异常放电引起的阵发性神经功能障碍,发作时伴脑电图痫样放电。非癫痫性发作是多种原因引起的,与癫痫发作有类似临床表现的一组疾病,不伴与发作同步的发作期脑电图痫样放电,与癫痫发作鉴别诊断存在一定困难。视频脑电图已广泛应用于神经系统疾病的诊断与治疗,对癫痫发作与非癫痫性发作的鉴别诊断具有重要意义。本文综述症状学特征和脑电图特征对癫痫发作与非癫痫性发作的鉴别诊断意义,以及与癫痫发作相鉴别的常见非癫痫性发作,为癫痫的精准诊断与治疗提供理论依据。

Epileptic seizure is a paroxysmal brain dysfunction caused by the abnormal discharge of excessive synchronization of brain neurons, accompanied by epileptiform discharge of EEG. Non-epileptic seizure(NES) is a group of diseases caused by various reasons. Although they are not accompanied by epileptiform discharges of EEG, they have similar clinical manifestations to seizures, rendering the differentiation from seizures difficult. Video electroencephalography(VEEG) technology, which has been widely used in the diagnosis and treatment of nervous system diseases, is key to the differential diagnosis of epileptic seizures. This article reviews the role of symptomatic and EEG features in the differential diagnosis of epileptic seizure and NES, as well as common NES that can be differentiated from epileptic seizure, so as to provide theoretical basis for accurate diagnosis and treatment of epilepsy.