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目的了解以疼痛发病癫的临床特点、误诊原因及对策。方法回顾我院2002-02-2012-02收治的以疼痛发病被误诊,经脑电图、试验治疗后确诊的癫患者22例的临床资料。结果以腹痛伴恶心、呕吐发病误诊为急腹症15例,以发作性肢痛为首发被误诊为风湿性关节炎、低钙性抽搐2例,以牙痛发病误诊为牙周炎、龋齿各1例,以头痛伴恶心、呕吐发病误诊为血管神经性头痛2例,以心前区疼痛为首发误诊为冠心病、心绞痛1例。结论临床医生应提高对以疼痛为首发癫的认识,排除常见疼痛病因后,应想到癫的可能。
Objective To understand the clinical features of epilepsy with pain, misdiagnosis reasons and countermeasures. Methods The clinical data of 22 patients with epilepsy who were diagnosed with pain by EEG and experiment after treatment were retrospectively reviewed in our hospital from February 2002 to February 2012. Results The abdominal pain with nausea and vomiting was misdiagnosed as acute abdomen in 15 cases. The first episode of paroxysmal limb pain was misdiagnosed as rheumatoid arthritis. Two cases had hypocalcemic convulsion. The incidence of toothache was misdiagnosed as periodontitis and dental caries. For example, headache with nausea, vomiting misdiagnosed as vascular neuropathic headache in 2 cases, pre-angina pain as the first misdiagnosed as coronary heart disease, angina pectoris in 1 case. Conclusion Clinicians should raise their awareness of pain as the first epilepsy. After excluding the common cause of pain, the possibility of epilepsy should be considered.