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Psychogene nichtepileptische Anfälle

Differenzialdiagnostische Merkmale

Psychogenic non epileptic seizures

Differential diagnostic features

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Zusammenfassung

Psychogene nichtepileptische Anfälle (PNEA) sind in der Differenzialdiagnostik transienter Bewusstseinsstörungen zu beachten. Ihre Abgrenzung zu Synkopen, epileptischen Anfällen oder vaskulären Erkrankungen ist häufig schwierig und erfordert ein fundiertes Wissen über semiologische Elemente von PNEA und ihrer Differenzialdiagnosen. Fehldiagnosen und sich daraus ableitende Therapiemaßnahmen gehen mit einer erhöhten Morbidität, steigenden Kosten und einer Verschlechterung des Therapieerfolgs für die Patienten einher. Ziel des vorliegenden Artikels ist es, eine Übersicht über PNEA und ihre Abgrenzung zu den wichtigen neurologischen und internistischen Krankheitsbildern Epilepsie und Synkope zu geben.

Abstract

Psychogenic nonepileptic seizures (PNES) are to be considered in the differential diagnosis of a transient loss of consciousness. Their discrimination from syncope, epileptic seizures or vascular events can be difficult and requires profound knowledge about the semiology and clinical presentation of PNES and their differential diagnoses. Erroneous diagnoses and the resulting therapies lead to elevated morbidity, elevated costs and a poorer outcome. The aim of the present article is to provide an overview on PNES and their delineation from the clinical pictures of epilepsy and syncope.

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Abbreviations

GTKA:

Generalisierter tonisch-klonischer Anfall

PNEA:

Psychogene nichtepileptische Anfälle

PNES:

„Psychogenic non epileptic seizures“

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Authors and Affiliations

  1. Epilepsiezentrum Frankfurt Rhein-Main, Zentrum der Neurologie und Neurochirurgie, Universitätsklinikum Frankfurt, Schleusenweg 2–16, 60528, Frankfurt am Main, Deutschland

    Philipp S. Reif,  Laurent M. Willems,  Adam Strzelczyk,  Karl Martin Klein &  Felix Rosenow

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  1. Philipp S. Reif
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Correspondence to Philipp S. Reif.

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Interessenkonflikt

P.S. Reif erhielt außerhalb der eingereichten Arbeit Drittmittelzuwendungen im Rahmen des LOEWE-Programm des Landes Hessen. L.M. Willems erhielt außerhalb der eingereichten Arbeit Reisekostenunterstützung von der Firma Eisai. A. Strzelczyk erhielt außerhalb der eingereichten Arbeit Honorare von Desitin Arzneimittel, Eisai, LivaNova, Sage Therapeutics, UCB Pharma und Zogenix sowie Drittmittelzuwendungen im Rahmen des LOEWE-Programm des Landes Hessen. K.M. Klein erhielt außerhalb der eingereichten Arbeit Honorare von UCB Pharma, Eisai und Novartis sowie Drittmittelzuwendungen im Rahmen des LOEWE-Programm des Landes Hessen. F. Rosenow erhielt außerhalb der eingereichten Arbeit Zuwendungen von Eisai, UCB, Desitin Arzneimittel, Novartis, Medronic, Cerbomed, ViroPharma, Sandoz, Shire und dem vfa, sowie Drittmittelzuwendungen von der Europäischen Union, der Deutschen Forschungsgemeinschaft, dem LOEWE-Programm des Landes Hessen und von dem Detlev-Wrobel-Fonds für Epilepsie-Forschung.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Reif, P.S., Willems, L.M., Strzelczyk, A. et al. Psychogene nichtepileptische Anfälle. Herzschr Elektrophys 29, 155–160 (2018). https://doi.org/10.1007/s00399-018-0557-z

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  • DOI: https://doi.org/10.1007/s00399-018-0557-z

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