Dual diagnosis of epilepsy and psychogenic nonepileptic seizures: Systematic review and meta-analysis of frequency, correlates, and outcomes

被引:121
作者
Kutlubaev, Mansur A. [1 ,2 ]
Xu, Ying [3 ,4 ]
Hackett, Maree L. [3 ,4 ]
Stone, Jon [5 ]
机构
[1] GG Kuvatov Republican Clin Hosp, Dept Neurol, Dostoevsky Str 132, Ufa, Russia
[2] Bashkir State Med Univ, Dept Neurol, Ufa, Russia
[3] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia
[4] Univ New South Wales, George Inst Global Hlth, Fac Med, Camperdown, NSW, Australia
[5] Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland
基金
英国医学研究理事会;
关键词
Epilepsy; Psychogenic nonepileptic seizure; Comorbidity; Dual diagnosis; Dissociative seizure; Psychogenic; DETAILED SEMIOLOGICAL ANALYSIS; VIDEO-EEG; CLINICAL CHARACTERISTICS; COMORBID EPILEPSY; RISK-FACTORS; PSEUDOEPILEPTIC SEIZURES; DISSOCIATIVE EXPERIENCES; DIFFERENTIAL-DIAGNOSIS; COEXISTING EPILEPSY; ADULTS;
D O I
10.1016/j.yebeh.2018.10.010
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Comorbid epilepsy and psychogenic nonepileptic seizures (PNES) represent a serious challenge for the clinicians. However, the frequency, associations, and outcomes of dual diagnosis of epilepsy and PNES are unclear. The aim of the review was to determine the frequency, correlates, and outcomes of a dual diagnosis. A systematic review of all published observational studies (from inception to Dec. 2016) was conducted to determine the frequency, correlates, and outcomes of dual diagnosis. We included studies of individuals of any age reporting a dual diagnosis of epilepsy and PNES. All observational study designs were included with the exception of case reports and case series with fewer than 10 participants. The mean frequency of epilepsy in patients with PNES across all studies was 22% (95% confidence intervals [CI] 20 to 25%, range: 0% to 90%) while the mean frequency of PNES in patients with epilepsy was 12% (95% CI 10 to 14%, range: 1% to 62%). High heterogeneity means that these pooled estimates should be viewed with caution. A number of correlates of dual diagnosis were reported. Some studies delineated differences in semiology of seizures in patients with dual diagnosis vs. PNES or epilepsy only. However, most of the correlates were inconclusive. Only a few studies examined outcome in patients with dual diagnosis. Dual diagnosis is common in clinical practice, especially among patients referred to specialized services, and requires careful diagnosis and management. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:70 / 78
页数:9
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