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首页> 外文期刊>Seizure: the journal of the British Epilepsy Association >Psychogenic non-epileptic seizures--definition, etiology, treatment and prognostic issues: a critical review.
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Psychogenic non-epileptic seizures--definition, etiology, treatment and prognostic issues: a critical review.

机译：心因性非癫痫性癫痫发作-定义，病因，治疗和预后问题：严格的审查。

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In this review we systematically assess our currently available knowledge about psychogenic non-epileptic seizures (PNES) with an emphasis on the psychological mechanisms that underlie PNES, possibilities for psychological treatment as well as prognosis. Relevant studies were identified by searching the electronic databases. Case reports were not considered. 93 papers were identified; 65 of which were studies. An open non-randomized design, comparing patients with PNES to patients with epilepsy is the dominant design. A working definition for PNES is proposed. With respect to psychological etiology, a heterogeneous set of factors have been identified. Not all factors have a similar impact, though. On the basis of this review we propose a model with several factors that may interact in both the development and prolongation of PNES. These factors involve psychological etiology, vulnerability, shaping, as well as triggering and prolongation factors. A necessary first step of intervention in patients with PNES seems to be explaining the diagnosis with care. Although the evidence for the efficacy of additional treatment strategies is limited, variants of cognitive (behavioural) therapy showed to be the preferred type of treatment for most patients. The exact choice of treatment should be based on individual differences in the underlying factors. Outcome can be measured in terms of seizure occurrence (frequency, severity), but other measures might be of greater importance for the patient. Prognosis is unclear but studies consistently report that 1/3rd to 1/4th of the patients become chronic.
机译：在这篇综述中，我们系统地评估了我们目前有关心理性非癫痫性癫痫发作（PNES）的知识，重点是作为PNES基础的心理机制，心理治疗的可能性以及预后。通过搜索电子数据库确定了相关研究。没有考虑病例报告。确定了93篇论文;其中65项是研究。一项开放性的非随机设计是占主导地位的设计，将PNES患者与癫痫患者进行比较。提出了PNES的工作定义。关于心理病因，已经确定了一系列不同的因素。但是，并非所有因素都有类似的影响。在此综述的基础上，我们提出了一个具有多种因素的模型，这些因素可能会影响PNES的发展和延长。这些因素涉及心理病因，脆弱性，体形以及触发和延长因素。对PNES患者进行干预的必要的第一步似乎是谨慎地解释诊断。尽管有关其他治疗策略有效性的证据有限，但认知（行为）治疗的变体被证明是大多数患者的首选治疗类型。确切的治疗选择应基于潜在因素的个体差异。可以根据癫痫发作的发生率（频率，严重程度）来衡量结局，但其他措施对患者可能更重要。预后尚不清楚，但研究一致报告1/3/1/4的患者为慢性。

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