The aetiology of psychogenic non-epileptic seizures: risk factors and comorbidities

被引:134
作者
Popkirov, Stoyan [1 ]
Asadi-Pooya, Ali A. [2 ,3 ]
Duncan, Roderick [4 ]
Gigineishvili, David [5 ]
Hingray, Coraline [6 ,7 ]
Kanner, Andres Miguel [8 ]
LaFrance, W. Curt [9 ,10 ]
Pretorius, Chrisma [11 ]
Reuber, Markus [12 ]
机构
[1] Ruhr Univ Bochum, Univ Hosp Knappschaftskrankenhaus Bochum, Dept Neurol, Bochum, Germany
[2] Shiraz Univ Med Sci, Shiraz Med Sch, Neurosci Res Ctr, Shiraz, Iran
[3] Thomas Jefferson Univ, Dept Neurol, Jefferson Comprehens Epilepsy Ctr, Philadelphia, PA 19107 USA
[4] Univ Otago, Dept Neurol, Christchurch, New Zealand
[5] Tbilisi State Univ, Dept Neurol & Neurosurg, Tbilisi, Georgia
[6] Pole Hosp Univ Psychiat Adultes, Grand Nancy Ctr Psychotherap Nancy, Laxou, France
[7] CHU Nancy, Dept Neurol, Nancy, France
[8] Univ Miami, Miller Sch Med, Dept Neurol, Coral Gables, FL 33124 USA
[9] Rhode Isl Hosp, Brown Med Sch, Dept Neurol, Providence, RI USA
[10] Rhode Isl Hosp, Brown Med Sch, Dept Psychiat, Providence, RI USA
[11] Univ Stellenbosch, Dept Psychol, Stellenbosch, South Africa
[12] Univ Sheffield, Royal Hallamshire Hosp, Acad Neurol Unit, Sheffield, S Yorkshire, England
关键词
dissociative seizures; psychogenic non-epileptic seizures; aetiology; risk factors; comorbidity; QUALITY-OF-LIFE; POSTTRAUMATIC-STRESS-DISORDER; PSYCHIATRIC COMORBIDITY; CHILDHOOD MALTREATMENT; MOVEMENT-DISORDERS; ATTACHMENT STYLE; PSYCHOLOGICAL DISTRESS; INTERNATIONAL LEAGUE; NEUROLOGY CLINICS; EPILEPSY SURGERY;
D O I
10.1684/epd.2019.1107
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Psychogenic non-epileptic seizures (PNES), also known as dissociative seizures, are paroxysms of altered subjective experience, involuntary movements and reduced self-control that can resemble epileptic seizures, but have distinct clinical characteristics and a complex neuropsychiatric aetiology. They are common, accounting for over 10% of seizure emergencies and around 30% of cases in tertiary epilepsy units, but the diagnosis is often missed or delayed. The recently proposed "integrative cognitive model" accommodates current research on experiential, psychological and biological risk factors for the development of PNES, but in view of the considerable heterogeneity of presentations and medical context, it is not certain that a universal model can capture the full range of PNES manifestations. This narrative review addresses key learning objectives of the ILAE curriculum by describing the demographic profile, common risk factors (such as trauma or acute stress) and comorbid disorders (such as other dissociative and functional disorders, post-traumatic stress disorder, depressive and anxiety disorders, personality disorders, comorbid epilepsy, head injury, cognitive and sleep problems, migraine, pain, and asthma). The clinical implications of demographic and aetiological factors for diagnosis and treatment planning are addressed.
引用
收藏
页码:529 / 547
页数:19
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