Multidisciplinary management of pediatric nonepileptic seizures

作者：Plioplys Sigita^*; Asato Miya R; Bursch Brenda; Salpekar Jay A; Shaw Richard; Caplan Rochelle

来源：Journal of the American Academy of Child and Adolescent Psychiatry, 2007, 46(11): 1491-1495.

DOI：10.1097/chi.0b013e31814dab98

In May 2005 the National Institute of Neurological Disorders and Stroke, the National Institute of Mental Health, and the American Epilepsy Society sponsored a multidisciplinary workshop for a group of experts to develop a research agenda for nonepileptic seizure (NES) treatment trials. In this article, we use the term NESs as recommended by this workgroup (LaFrance et al., 2006) and focus solely on NESs associated with the DSM-IV diagnosis of conversion disorder. We are not using the term psychogenic because some find it prematurely dismissive of possible biological processes. Although NESs have historically been widely recognized, they continue to present dilemmas for clinicians. Differing views regarding etiology, associated vague terminology, and the lack of standardized diagnostic criteria and treatment guidelines leave clinicians perplexed and discouraged. Arriving at an accurate NES diagnosis takes about 3.5 years (median delay), by which time 50% to 95% of the children are taking antiepileptic drugs (AEDs; Paolicchi, 2002; Wyllie et al., 1999). Over time, episodes can become more stereotyped and increasingly resemble epileptic seizures, making diagnosis more difficult. Consequently, early diagnosis and treatment of NESs may prevent unnecessary diagnostic procedures and treatments as well as iatrogenic complications. The aim of this article is to share our clinical experience with the management of children with NESs in tertiary urban pediatric hospitals.

• 出版日期2007-11
• 单位西北大学