NONEPILEPTIC SEIZURES AND CHILDHOOD SEXUAL AND PHYSICAL ABUSE
NONEPILEPTIC SEIZURES AND CHILDHOOD SEXUAL AND PHYSICAL ABUSE
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DOI：
10.1212/wnl.43.10.1950
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发表时间：
1993-10-01
期刊：
影响因子：
9.9
通讯作者：
LUCIANO, D
中科院分区：
文献类型：
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作者：
ALPER, K;DEVINSKY, O;LUCIANO, D
非癫痫性发作（内斯）必须与癫痫区分开来，以避免不必要的抗癫痫药物的不良反应，并开始适当的精神治疗。尽管没有前瞻性对照研究比较内斯和癫痫患者，但怀疑内斯患者既往性虐待的频率更高。一系列转换障碍患者表现为癫痫和140例复杂部分性癫痫（CPE）没有转换的证据，从一系列连续入院的综合性癫痫中心。两组在年龄、受教育年限、种族或婚姻状况方面没有差异，但转换内斯组的女性比例（73.2%）高于CPE对照组（50.7%; p < 0.002）。内斯组有性虐待或身体虐待史的频率（32.4%）高于CPE对照组（8.6%; p < 0.000）。内斯组性虐待的严重程度显著高于对照组（p < 0.05）。与CPE对照组相比，内斯患者中性虐待实施者与受害者的关系有更密切的趋势（p < 0.1）。这些结果支持这样的印象，即儿童虐待是更常见的转换内斯比癫痫患者，并表明在某些情况下，儿童虐待可能是一个致病因素。
Nonepileptic seizures (NES) must be distinguished from epilepsy to avoid the adverse effects of unnecessary antiepileptic drugs and to initiate appropriate psychiatric treatment. A higher frequency of prior sexual abuse has been suspected in NES, although no prospective controlled study has compared patients with NES and epilepsy. A series of patients with conversion disorder presenting as epilepsy and 140 patients with complex partial epilepsy (CPE) without evidence of conversion were selected from a series of consecutive admissions to a comprehensive epilepsy center. The groups did not differ with respect to age, years of education, race, or marital status, but the percentage of women was greater in the conversion NES group (73.2%) than in the CPE control group (50.7%; p < 0.002). The frequency of a history of sexual or physical abuse was greater in the NES group (32.4%) than in the CPE controls (8.6%; p < 0.000). Severity of sexual but not physical abuse was significantly greater in the NES group relative to controls (p < 0.05). There was a trend for a closer relationship of the perpetrator of sexual abuse to the victim among the NES patients compared with CPE controls (p < 0.1). These results support the impression that childhood abuse is more common among patients with conversion NES than with epilepsy, and suggests that in some cases childhood abuse may be a contributory pathogenetic factor.