短暂意识丧失病因诊断的研究进展

doi:10.3969/j.issn.1004-583X.2021.12.019

摘要/Abstract

摘要：

短暂意识丧失( transient loss of consciousness, TLOC)是指真正或貌似意识丧失的一种状态。TLOC的病因很多,超过90%的TLOC被诊断为晕厥、癫痫、心因性发作,但三者间的误诊率高达30%。本文就TLOC前三大病因诊断的研究进展进行综述,以明确病因,为鉴别诊断提供依据。

中图分类号:

R741

王娜, 王兰桂. 短暂意识丧失病因诊断的研究进展[J]. 临床荟萃, 2021, 36(12): 1144-1147.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.12.019

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I12/1144

参考文献 37

[1]	Smith PE, O'Callaghan PA. Transient loss of consciousness ('blackouts') in adults and young people (NICE)[J]. Pract Neurol, 2011, 11(2):108-110. doi: 10.1136/jnnp.2011.241828 URL
[2]	van Dijk JG, Thijs RD, Benditt DG, et al. A guide to disorders causing transient loss of consciousness: Focus on syncope[J]. Nat Rev Neurol, 2009, 5(8):438-448. doi: 10.1038/nrneurol.2009.99 URL
[3]	Wardrope A, Newberry E, Reuber M. Diagnostic criteria to aid the differential diagnosis of patients presenting with transient loss of consciousness: A systematic review[J]. Seizure, 2018, 61:139-148. doi: 10.1016/j.seizure.2018.08.012 URL
[4]	刘文玲, 胡大一, 郭继鸿等. 晕厥诊断与治疗中国专家共识 (2014 年更新版 )[J]. 中华内科杂志, 2014, 53(11):916-925.
[5]	Brown RJ, Reuber M. Psychological and psychiatric aspects of psychogenic non-epileptic seizures (PNES): A systematic review[J]. Clin Psychol Rev, 2016, 45:157-182. doi: 10.1016/j.cpr.2016.01.003 URL
[6]	Rodrigues TR, Sternick EB, Moreira MC. Epilepsy or syncope? An analysis of 55 consecutive patients with loss of consciousness, convulsions, falls, and no EEG abnormalities[J]. Pacing Clin Electrophysiol, 2010, 33(7):804-813. doi: 10.1111/j.1540-8159.2009.02685.x URL
[7]	Kustov GV, Zinchuk MS, Rider FK, et al. Psychogenic non-epileptic seizures[J]. Zh Nevrol Psikhiatr Im S S Korsakova, 2021, 121(8):112-118.
[8]	Kerr WT, Chau AM, Janio EA, et al. Reliability of reported peri-ictal behavior to identify psychogenic nonepileptic seizures[J]. Seizure, 2019, 67:45-51. doi: 10.1016/j.seizure.2019.02.021 URL
[9]	Zou R, Wang S, Zhu L, et al. Calgary score and modified Calgary score in the differential diagnosis between neurally mediated syncope and epilepsy in children[J]. Neurol Sci, 2017, 38(1):143-149. doi: 10.1007/s10072-016-2740-5 URL
[10]	Shmuely S, Bauer PR, van Zwet EW, et al. Differentiating motor phenomena in tilt-induced syncope and convulsive seizures[J]. Neurology, 2018, 90(15):1339-1346. doi: 10.1212/WNL.0000000000005301 pmid: 29549227
[11]	Gilmour GS, MacIsaac R, Subotic A, et al. Diagnostic accuracy of clinical signs and symptoms for psychogenic nonepileptic attacks versus epileptic seizures: A systematic review and meta-analysis[J]. Epilepsy Behav, 2021, 121:108030. doi: 10.1016/j.yebeh.2021.108030 URL
[12]	Rawlings GH, Jamnadas-Khoda J, Broadhurst M, et al. Panic symptoms in transient loss of consciousness: Frequency and diagnostic value in psychogenic nonepileptic seizures, epilepsy and syncope[J]. Seizure, 2017, 48:22-27. doi: S1059-1311(17)30214-5 pmid: 28371670
[13]	Seneviratne U, Minato E, Paul E. How reliable is ictal duration to differentiate psychogenic nonepileptic seizures from epileptic seizures?[J]. Epilepsy Behav, 2017, 66:127-131. doi: S1525-5050(16)30360-2 pmid: 28039841
[14]	Beghi M, Zhang L, Beghi E, et al. History of violence/maltreatment and psychogenic non-epileptic seizures[J]. Seizure, 2020, 81:8-12. doi: 10.1016/j.seizure.2020.07.012 URL
[15]	Ludwig L, Pasman JA, Nicholson T, et al. Stressful life events and maltreatment in conversion (functional neurological) disorder: Systematic review and meta-analysis of case-control studies[J]. Lancet Psychiatry, 2018, 5(4):307-320. doi: S2215-0366(18)30051-8 pmid: 29526521
[16]	Kerr WT, Janio EA, Braesch CT, et al. Identifying psychogenic seizures through comorbidities and medication history[J]. Epilepsia, 2017, 58(11):1852-1860. doi: 10.1111/epi.2017.58.issue-11 URL
[17]	Nass RD, Sassen R, Elger CE, et al. The role of postictal laboratory blood analyses in the diagnosis and prognosis of seizures[J]. Seizure, 2017, 47:51-65. doi: 10.1016/j.seizure.2017.02.013 URL
[18]	Doğan EA, Ünal A, Ünal A, et al. Clinical utility of serum lactate levels for differential diagnosis of generalized tonic-clonic seizures from psychogenic nonepileptic seizures and syncope[J]. Epilepsy Behav, 2017, 75:13-17. doi: 10.1016/j.yebeh.2017.07.003 URL
[19]	Komiyama T, Nagata E, Hashida T, et al. Neurally mediated syncope diagnosis based on adenylate cyclase activity in Japanese patients[J]. PLoS One, 2019, 14(4):e0214733. doi: 10.1371/journal.pone.0214733 URL
[20]	丁芳芳, 杨素君, 高云云, 等. 3D-ASL灌注成像和血清Hcy、NPY水平与癫痫患者病情及认知功能的相关性探究[J]. 影像科学与光化学, 2021, 39(1):128-133.
[21]	Hanin A, Demeret S, Denis JA, et al. Serum neuron-specific enolase: A new tool for seizure risk monitoring after status epilepticus[J]. Eur J Neurol, 2021.
[22]	Ninni S, Kouakam C, Szurhaj W, et al. Usefulness of head-up tilt test combined with video electroencephalogram to investigate recurrent unexplained atypical transient loss of consciousness[J]. Arch Cardiovasc Dis, 2019, 112(2):82-94. doi: 10.1016/j.acvd.2018.08.004 URL
[23]	Petkar S, Hamid T, Iddon P, et al. Prolonged implantable electrocardiographic monitoring indicates a high rate of misdiagnosis of epilepsy--REVISE study[J]. Europace, 2012, 14(11):1653-1660. doi: 10.1093/europace/eus185 URL
[24]	Maggi R, Rafanelli M, Ceccofiglio A, et al. Additional diagnostic value of implantable loop recorder in patients with initial diagnosis of real or apparent transient loss of consciousness of uncertain origin[J]. Europace, 2014, 16(8):1226-1230. doi: 10.1093/europace/euu051 URL
[25]	İdil H, Kılıc TY. Diagnostic yield of neuroimaging in syncope patients without high-risk symptoms indicating neurological syncope[J]. Am J Emerg Med, 2019, 37(2):228-230. doi: 10.1016/j.ajem.2018.05.033 URL
[26]	Velmurugan J, Nagarajan SS, Mariyappa N, et al. Magnetoencephalography imaging of high frequency oscillations strengthens presurgical localization and outcome prediction[J]. Brain, 2019, 142(11):3514-3529. doi: 10.1093/brain/awz284 pmid: 31553044
[27]	Xu MY, Ergene E, Zagardo M, et al. Proton MR spectroscopy in patients with structural MRI-negative temporal lobe epilepsy[J]. J Neuroimaging, 2015, 25(6):1030-1037. doi: 10.1111/jon.12263 URL
[28]	Foley E, Quitadamo LR, Walsh AR, et al. MEG detection of high frequency oscillations and intracranial-EEG validation in pediatric epilepsy surgery[J]. Clin Neurophysiol, 2021, 132(9):2136-2145. doi: 10.1016/j.clinph.2021.06.005 URL
[29]	陈自谦, 赵春雷, 刘耀, 等. 18F-FDG PET/CT脑显像与EEG用于颞叶癫痫灶术前定位[J]. 中华核医学与分子影像杂志, 2012, 32(3):166-169.
[30]	González Otárula KA, Khoo HM, von Ellenrieder N, et al. Spike-related haemodynamic responses overlap with high frequency oscillations in patients with focal epilepsy[J]. Brain, 2018, 141(3):731-743. doi: 10.1093/brain/awx383 pmid: 29360943
[31]	Chen T, Guo L. The role of SISCOM in preoperative evaluation for patients with epilepsy surgery: A meta-analysis[J]. Seizure, 2016, 41:43-50. doi: 10.1016/j.seizure.2016.06.024 URL
[32]	von Oertzen TJ, Mormann F, Urbach H, et al. Prospective use of subtraction ictal SPECT coregistered to MRI (SISCOM) in presurgical evaluation of epilepsy[J]. Epilepsia, 2011, 52(12):2239-2248. doi: 10.1111/j.1528-1167.2011.03219.x pmid: 22136078
[33]	张蕾, 李章勇, 刘晓燕, 等. 儿童自主神经介导性晕厥与心因性假性晕厥的临床特征及鉴别[J]. 临床儿科杂志, 2016, 34(10):755-760.
[34]	Umesh S, Tikka SK, Goyal N, et al. Aberrant gamma band cortical sources and functional connectivity in adolescents with psychogenic non-epileptic seizures: A preliminary report[J]. Psychiatry Res, 2017, 247:51-54. doi: 10.1016/j.psychres.2016.11.003 URL
[35]	Johnstone B, Velakoulis D, Yuan CY, et al. Early childhood trauma and hippocampal volumes in patients with epileptic and psychogenic seizures[J]. Epilepsy Behav, 2016, 64:180-185. doi: S1525-5050(16)30321-3 pmid: 27743551
[36]	Barzegaran E, Carmeli C, Rossetti AO, et al. Weakened functional connectivity in patients with psychogenic non-epileptic seizures (PNES) converges on basal ganglia[J]. J Neurol Neurosurg Psychiatry, 2016, 87(3):332-337. doi: 10.1136/jnnp-2014-309483 pmid: 25855401
[37]	Li R, Li Y, An D, et al. Altered regional activity and inter-regional functional connectivity in psychogenic non-epileptic seizures[J]. Sci Rep, 2015, 5:11635. doi: 10.1038/srep11635 URL

短暂意识丧失病因诊断的研究进展

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 37

相关文章 15

编辑推荐

Metrics

本文评价

[1]	赵淑珍, 王三萍, 赵晓云. 遗传性癫痫伴热性惊厥附加症SLC32A1基因变异1例并文献复习[J]. 临床荟萃, 2023, 38(5): 451-454.
[2]	丁思奇, 刘时华, 张超, 钟平, 曹立. 迟发性卒中后癫痫的危险因素及其与血Hcy、hs-CRP和D-D的相关性[J]. 临床荟萃, 2023, 38(10): 893-897.
[3]	王贞芸, 王兰桂. 癫痫共患认知功能障碍的机制研究进展[J]. 临床荟萃, 2022, 37(8): 753-758.
[4]	曾晓晴, 庄伟端, 陈丽芬. 卒中后癫痫发作发病机制的研究进展[J]. 临床荟萃, 2022, 37(2): 174-177.
[5]	吝娜1，曹磊2. 水通道蛋白4在中枢神经系统疾病中的研究进展[J]. 临床荟萃, 2019, 34(6): 567-571.
[6]	苗婵婵1，高学军1，杨阳2. 抗癫痫药对癫痫患者骨代谢影响及骨骼健康作用机制的研究进展[J]. 临床荟萃, 2019, 34(11): 1042-1045.
[7]	王敏a, 高微b, 胡小伟a, 吴超b, 徐敏a. 多病灶难治性癫痫的术前定位和手术疗效分析[J]. 临床荟萃, 2018, 33(12): 1031-1035.
[8]	赵德豪，沈虹，徐翔. 成人亚临床脑电图节律性放电3例并文献复习[J]. 临床荟萃, 2017, 32(11): 989-991,994.
[9]	董莉a，李湘海b. 奥卡西平治疗婴幼儿部分性癫痫的疗效及对免疫功能的影响分析[J]. 临床荟萃, 2017, 32(10): 881-884.
[10]	王柳清，王永伟，张守成. 癫痫与妊娠的相关问题研究进展[J]. 临床荟萃, 2016, 31(12): 1384-1386,1390.
[11]	刘俊艳. 一过性意识丧失的病因识别及处理[J]. 临床荟萃, 2016, 31(10): 1143-1143.
[12]	王玉珍;洪源;刘艳芹;张双;庞保东. 左乙拉西坦添加治疗儿童难治性癫痫的疗效和安全性[J]. 临床荟萃, 2014, 29(8): 942-943.
[13]	王志慧;王世东;孟淑萍;卫俊枫. 二氧化碳激光治疗致患者晕厥原因分析及防治措施[J]. 临床荟萃, 2014, 29(4): 439-440.
[14]	穆宏地;刘石岭;耿丽娟. 激光氧液对癫痫持续状态大鼠海马神经元巢蛋白表达的影响[J]. 临床荟萃, 2013, 28(5): 525-0.
[15]	毕明慧;俞正霞;何悦;赵轶. 老年癫痫患者外周血P糖蛋白、白细胞介素6和肿瘤坏死因子α的检测[J]. 临床荟萃, 2013, 28(3): 308-309.