《儿童心因性(功能性)非痫性发作的评估和管理共识(2023)》要点解读

Interpretation of Consensus Recommendations for Assessment and Management of Psychogenic non-epileptic(functional)seizures(PNES)in Children

心因性非痫性发作(PNES)是易被误诊为癫痫的发作性事件,但缺乏相关的脑电图改变。将PNES误诊为癫痫发作会导致诊断延误、不必要的抗癫痫药物治疗和过度检查,使儿童面临潜在的医源性不良反应及反复就诊的压力。目前,尚缺乏儿童PNES的评估和管理指南。为填补这一空白,2023年国际抗癫痫联盟(ILAE)儿童精神问题工作组发布了《儿童心因性(功能性)非痫性发作的评估和管理共识》,从儿童PNES的评估、管理及PNES患儿的精神和认知障碍的评估和管理3个方面提供了22条建议。本文对该共识的要点进行解读,以期提高对儿童PENS的识别和管理能力。

Psychogenic non-epileptic seizures(PNES)are epileptic events that are easily misdiagnosed as epilepsy,but lack associated EEG changes.The incorrect diagnosis of PNES as epileptic seizures can result in diagnostic delays,unnecessary treatment with anti-seizure medication(ASM),and unnecessary investigations.This can expose children to potential iatrogenic adverse reactions and pressure of repeated visits to hospital.At present,there is a lack of assessment and management guidelines for children's PNES.To fill this gap,the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy published"Consensus Recommendations for Assessment and Management of Psychogenic non-epileptic(functional)seizures(PNES)in Children"in 2023.It provides 22 recommendations from three aspects:assessment of PNES,management of PNES,assessment and management of psychopathology in children with PNES.In this paper,the main points of this consensus are interpreted to improve the ability of identifying and managing children's PENS.