CAJ | 학술논문

目的：分析视频脑电监测（VEEG）对误诊为癫痫发作性疾病的诊断价值。方法回顾性分析经VEEG检查对曾被误诊为癫痫而最终明确诊断为非癫痫性发作的病例共18例。入选标准：VEEG检查捕捉到发作，并结合病史分析、发作期床旁评价、通过多学科讨论，排除是癫痫发作的患者。结果 VEEG共记录到200余次的发作；3例有明显的诱因；1例伴小便失禁。18例患者VEEG发作间期、发作期均未见明显痫样放电。分析该18例患者的发作特点、脑电图表现，最终明确发作形式为非癫痫性心因性发作（NEPS）9例、头晕2例、低血糖发作2例，抽动障碍1例、肌张力增高1例、肌阵挛1例、睡眠障碍1例、运动诱发运动障碍1例。结论不少非癫痫性发作与癫痫在临床表现、发作形式方面非常相似。对于病程较长、抗癫痫药长期控制不佳的癫痫患者，应该重新评价非癫痫性发作的可能，及早行长程VEEG监测有利于明确诊断。
목적：분석시빈뇌전감측（VEEG）대오진위전간발작성질병적진단개치。방법회고성분석경VEEG검사대증피오진위전간이최종명학진단위비전간성발작적병례공18례。입선표준：VEEG검사포착도발작，병결합병사분석、발작기상방평개、통과다학과토론，배제시전간발작적환자。결과 VEEG공기록도200여차적발작；3례유명현적유인；1례반소편실금。18례환자VEEG발작간기、발작기균미견명현간양방전。분석해18례환자적발작특점、뇌전도표현，최종명학발작형식위비전간성심인성발작（NEPS）9례、두훈2례、저혈당발작2례，추동장애1례、기장력증고1례、기진련1례、수면장애1례、운동유발운동장애1례。결론불소비전간성발작여전간재림상표현、발작형식방면비상상사。대우병정교장、항전간약장기공제불가적전간환자，응해중신평개비전간성발작적가능，급조행장정VEEG감측유리우명학진단。
ObjectiveTo study the value of VEEG in paroxymal diseases of epilepsy misdiagonosing.MethodsTotal eighteen VEEG examination cases,of which had been misdiagonosed as epilepsy but confirmed as non-epileptic seizures,were collected from the hospital. Inclusion criteria:The paroxysm is captured by VEEG check,while the patients are excluded from eileptic seizures,combined with a history of analysis and multidisciplinary discussion.ResultsVEEG had recorded more than 200 times seizures,three of which had obvious causes,one of which had incontinence of urine. No obvious epileptiform discharges were discovered in ictal interictal and ictal VEEG of Eighteen patients. By Analysing seizure characteristics and VEEG results of the Eighteen patients,nine cases were nonepileptic psychogenic seizures,two cases were dizziness,two cases were hypoglycemic episodes, one case was tic disorder,one case was hypermyotonia,one case was myoclonus,one case was sleep disorder,and one case was paroxysmal kinesigenic dyskinesia.ConclusionMany non-epileptic seizures and epilepsy in clinical manifestation are very similar. For whom had a longer course of disease and poor long-term control of antiepileptic drugs,reevaluating the possibility of non epileptic seizures and taking the VEEG soon as possible are useful in diagnosis.