突发性口吃:心因性非癫痫发作的信号

来源 :世界核心医学期刊文摘(神经病学分册) | 被引量 : 0次 | 上传用户:qq343246680
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Objective: To determine if ictal stuttering (IS) is more common among patients with psychogenic nonepileptic seizures (PNES) than patients with epileptic seizures (ES). Methods: The authors prospectively reviewed the medical records, EEG video recordings, and Minnesota Multiphasic Personality Inventory 2 (MMPI- 2) scores of consecutive adults of normal intelligence diagnosed with either PNES or ES. Results: A total of 230 (117 PNES and 113 ES) patients were studied. PNES patients were older (p = 0.029), more likely to be female (p < 0.001), and had a shorter duration of seizure disorder (p < 0.001) than ES cases. Ten (8.5% ) PNES subjects and no ES cases demonstrated IS. The proportion of patients with IS in these two groups was significantly different (p = 0.004). PNES patients with IS were of similar age as but had an even shorter (p = 0.010) duration of seizure disorder (mean = 3.0 years) than those without IS. Scores on the hypochondriasis, depression (D), and hysteria scales of the MMPI 2 were significantly higher among PNES subjects than in ES patients (p≤ 0.002). However, seven PNES patients with IS had a lower mean score on the D scale than did 98 PNES cases without stuttering (p = 0.005). This produced a more sharply defined “conversion V” appearance on the MMPI 2 graph in the stutterers. Conclusions: Ictal stuttering was present in 8.5% of 117 consecutive patients with psychogenic nonepileptic seizures, but was not observed in a consecutive series of 113 adults with epileptic seizures. Patients with psychogenic nonepileptic seizures with ictal stuttering had a shorter duration of seizure disorder and a more prominent conversion profile on the Minnesota Multiphasic Personality Inventory than either patients with psychogenic nonepileptic seizures without stuttering or subjects with epileptic seizures. Objective: To determine if ictal stuttering (IS) is more common among patients with psychogenic none pileptic seizures (PNES) than patients with epileptic seizures (ES). Methods: The authors prospectively reviewed the medical records, EEG video recordings, and Minnesota Multiphasic Personality Inventory 2 (MMPI-2) scores of consecutive adults of normal intelligence diagnosed with either PNES or ES. Results: A total of 230 (117 PNES and 113 ES) patients were studied. PNES patients were older (p = 0.029) The proportion of patients with IS in these two groups was (p <0.001), and had a shorter duration of seizure disorder (p <0.001) than in ES cases. Ten significantly different (p = 0.004). PNES patients with IS of similar age as but had an even shorter (p = 0.010) duration of seizure disorder (mean = 3.0 years) than those without IS. Scores on the hypochondria, depression (D ), and hysteria scales of th However, seven PNES patients with IS had a lower mean score on the D scale than did 98 PNES cases without stuttering (p = 0.005). This produced more MMPs 2 than PNES subjects than in ES patients (p ≦ 0.002). a more sharply defined "conversion V appearance on the MMPI 2 graph in the stutterers. Conclusions: Ictal stuttering was present in 8.5% of 117 consecutive patients with psychogenic none pileptic seizures, but was not observed in a consecutive series of 113 adults with epileptic seizures. Patients with psychogenic none pileptic seizures with ictal stuttering had a shorter duration of seizure disorder and a more prominent conversion profile on the Minnesota Multiphasic Personality Inventory than either patients with psychogenic none pileptic seizures without stuttering or subjects with epileptic seizures.
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