Neurologic diagnostic criteria for functional neurologic disorders
Neurologic diagnostic criteria for functional neurologic disorders
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DOI：
10.1016/b978-0-12-801772-2.00017-5
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Lang, A. E.
中科院分区：
文献类型：
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作者：
Gasca-Salas, C.;Lang, A. E.
功能性神经障碍的诊断具有挑战性。在本章中，我们回顾了功能性/心因性感觉运动障碍、心因性非癫痫性发作（PNES）和功能性运动障碍（FMD）的诊断标准和评定量表。最近公布的感觉运动体征量表有一些局限性，但可能有助于诊断，据报道，四个运动和两个感觉体征是高度可靠的。有很好的证据表明，使用八个特定的迹象来区分PNES与癫痫发作。最近，制定了PNES的诊断标准；它们的敏感性和特异性需要评估。PNES的明确诊断可以通过在发作期间记录典型的阳性特征来做出，在少数病例中，与器质性病因的区分不容易做到，正常的脑电图提示诊断。fmd诊断依赖于诊断标准，这些标准随着时间的推移而不断完善，并可能通过某些表型的实验室测试加以补充。PNES和口蹄疫的评定量表可用于严重性措施，但仍有几个限制有待解决。
The diagnosis of functional neurologic disorders can be challenging. In this chapter we review the diagnostic criteria and rating scales reported for functional/psychogenic sensorimotor disturbances, psychogenic nonepileptic seizures (PNES) and functional movement disorders (FMD). A recently published scale for sensorimotor signs has some limitations, but may help in the diagnosis, and four motor and two sensory signs have been reported as highly reliable. There is good evidence using eight specific signs for the differentiation of PNES from seizures. Recently, diagnostic criteria were developed for PNES; their sensitivity and specificity need to be evaluated. The definitive diagnosis of PNES can be made by recording typical positive features during the spells, and in a low proportion of cases, where the distinction with an organic etiology cannot easily be done, a normal electroencephalogram suggests the diagnosis. FMDdiagnosis relies on diagnostic criteria, which have been refined over time and may be supplemented by laboratory tests in some phenotypes. Rating scales for PNES and FMD could be useful for severity measures, but several limitations remain to be addressed.