{"id":8698,"date":"2020-11-26T20:44:14","date_gmt":"2020-11-26T17:44:14","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=8698"},"modified":"2020-11-30T21:33:09","modified_gmt":"2020-11-30T18:33:09","slug":"epileptik-olmayan-psikojenik-nobetler-eopn-psodonobetler","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/epileptik-olmayan-psikojenik-nobetler-eopn-psodonobetler\/","title":{"rendered":"Epileptik Olmayan Psikojenik N\u00f6betler (EOPN): ps\u00f6don\u00f6betler"},"content":{"rendered":"\n

NED\u0130R?<\/h3>\n\n\n\n
\"\"<\/figure><\/div>\n\n\n\n

Epileptik Olmayan Psikojenik N\u00f6betler (EOPN), ger\u00e7ek n\u00f6betleri and\u0131ran ancak EEG de\u011fi\u015fimlerinin ve sempatik sinir sistemi disfonksiyonlar\u0131n\u0131n e\u015flik etmedi\u011fi paroksismal<\/a>[1]<\/a>  davran\u0131\u015f epizodudur<\/a>[2]<\/a> . Epileptik olmayan psikojenik n\u00f6betlerin epileptik n\u00f6betlerden ayr\u0131lmas\u0131 do\u011fru tedavi y\u00f6nteminin belirlenmesi a\u00e7\u0131s\u0131ndan \u00e7ok \u00f6nemlidir. Epileptik olmayan n\u00f6betlerin s\u00fcresinin epileptik n\u00f6betlere g\u00f6re uzun olu\u015fu ay\u0131r\u0131c\u0131 tan\u0131 i\u00e7in olduk\u00e7a \u00f6nemlidir. Bunun i\u00e7in bilin\u00e7 kayb\u0131 ile klini\u011fe ba\u015fvuran hastalarda epileptik olmayan n\u00f6bet ve epileptik n\u00f6bet aras\u0131nda kal\u0131nd\u0131\u011f\u0131nda video EEG g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemine ba\u015fvurulur.<\/p>\n\n\n\n

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https:\/\/flic.kr\/p\/bnAaZs<\/a><\/figcaption><\/figure><\/div>\n\n\n\n

DO\u011eRU TANI NEDEN \u00d6NEML\u0130? <\/h3>\n\n\n\n

Tedaviye diren\u00e7li epilepsi \u00f6n tan\u0131s\u0131 ile uzmanlara veya merkezlere g\u00f6nderilen hastalar\u0131n en az %20\u2019sinin non-epileptik ataklar oldu\u011fu ve bu hastalar\u0131n gereksiz yere ara\u015ft\u0131r\u0131ld\u0131\u011f\u0131 ve gereksiz tedavi ald\u0131klar\u0131 iddia edilmektedir. (Betts 1990). Baz\u0131 prevalans hesaplar\u0131na g\u00f6re (Scott 1982); 70 ya\u015f\u0131na kadar olan n\u00fcfusta tekrarlayan n\u00f6betleri olanlar\u0131n %2.5\u2019inde yalanc\u0131 epileptik n\u00f6bet vard\u0131r. Bu rakamlar yurdumuza uyarland\u0131\u011f\u0131nda yakla\u015f\u0131k 1.200.000 yalanc\u0131 n\u00f6bet olu\u015fmaktad\u0131r. Her n\u00f6bet i\u00e7in ortalama 10 milyon TL tutar\u0131nda ara\u015ft\u0131rma-ila\u00e7 vs. harcamas\u0131 yap\u0131ld\u0131\u011f\u0131 varsay\u0131l\u0131rsa, y\u0131lda 12 trilyon TL tutar\u0131nda gereksiz bir harcama yap\u0131ld\u0131\u011f\u0131n\u0131 ortaya \u00e7\u0131kar\u0131r. <\/p>\n\n\n\n

NEDEN VE NASIL ORTAYA \u00c7IKAR?<\/h3>\n\n\n\n

Tampa\u2019da, South Florida \u00dcniversitesi,\nKapsaml\u0131 Epilepsi B\u00f6l\u00fcm\u00fc Program\u0131\u2019n\u0131n Direkt\u00f6r\u00fc ve N\u00f6roloji Profes\u00f6r\u00fc Dr. Selim\nBenbadis epileptik n\u00f6betlere beyindeki anormal elektriksel de\u015farjlar\u0131n sebep\noldu\u011funu fakat EOPN\u2019nin \u00f6z\u00fcnde psikolojik veya duygusal n\u00f6betler oldu\u011funu\ns\u00f6ylemektedir. Bu y\u00fczden, bir hasta EOPN ge\u00e7irdi\u011fi zaman, altta yatan\npsikolojik rahats\u0131zl\u0131klar ger\u00e7ek fiziksel semptomlara sebep olurlar. Uzmanlar\nbu rahats\u0131zl\u0131klar\u0131n bilin\u00e7siz bir \u015fekilde n\u00f6rolojik bir duruma d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fcne\ninanmaktad\u0131r.<\/p>\n\n\n\n

New York \u00dcniversitesi (NYU) T\u0131p\nMerkezi N\u00f6roloji, N\u00f6ro\u015fir\u00fcrji ve Psikiyatri Profes\u00f6r\u00fc ve NYP Epilepsi Merkezi\nDirekt\u00f6r\u00fc Dr. Orrin Devinsky strese neden olan psikolojik etkenlerin nas\u0131l tam\nolarak n\u00f6bet gibi fiziksel semptomlara d\u00f6n\u00fc\u015ft\u00fc\u011f\u00fc halen belirsizli\u011fini\nkorumaktad\u0131r, diyor.<\/p>\n\n\n\n

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https:\/\/www.brighamandwomens.org\/about-bwh\/locations\/boston-main-hospital-campus<\/a><\/figcaption><\/figure><\/div>\n\n\n\n

Strese neden olan psikolojik etkenler\ngenel olarak cinsel veya fiziksel taciz, sevilen birinin \u00f6l\u00fcm\u00fc veya hastan\u0131n\nuzak durmaya ihtiyac\u0131 oldu\u011fu ac\u0131 veren duygular\u0131 i\u00e7erir. Baz\u0131 hastalara g\u00f6re\nn\u00f6betler post-travmatik stres bozuklu\u011funun d\u0131\u015fa vurumudur. Harvard T\u0131p\nFak\u00fcltesi N\u00f6roloji B\u00f6l\u00fcm\u00fc\u2019nden ve Boston, Massachusets\u2019de Women\u2019s Hospital ve\nBrigham EEG Laboratuvar\u0131 Direkt\u00f6r\u00fc Do\u00e7. Dr. Barbara Ann Dworetzky bir\u00e7ok EOPN\nhastas\u0131n\u0131n psikolojik travma ya da taciz hikayelerinin oldu\u011funa de\u011finmektedir.\nEOPN \u00f6zellikle taciz hikayesi olan gen\u00e7 kad\u0131nlarda daha yayg\u0131n olarak\ng\u00f6r\u00fclmektedir.<\/p>\n\n\n\n

NASIL TEDAV\u0130 ED\u0130L\u0130R?<\/h3>\n\n\n\n

N\u00f6betlerin psikolojik sebeplerden\nkaynakland\u0131\u011f\u0131na emin olunca n\u00f6rolog hastay\u0131 psikiyatriye sevk eder. Psikoterapi\ng\u00f6rmeden sadece psikiyatrik ila\u00e7lar kullanan hastalar\u0131n %70\u2019inde n\u00f6betler\ng\u00f6r\u00fclmeye devam etmi\u015ftir ancak Rhode Island\u2019da g\u00f6rev yapan Dr. LaFrance\u2019in\ng\u00f6zlemlerine g\u00f6re bili\u015fsel davran\u0131\u015f\u00e7\u0131 terapi g\u00f6ren non-epileptik psikojenik\nn\u00f6betler ge\u00e7iren 17 hastan\u0131n 11\u2019i tedavi sonras\u0131nda hi\u00e7 n\u00f6bet ge\u00e7irmemi\u015ftir.<\/p>\n\n\n\n

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Dr. Aaron Beck: Davran\u0131\u015f\u00e7\u0131 bili\u015fsel terapinin fikir babas\u0131 ve bir grup \u00f6\u011frencisi<\/em> <\/figcaption><\/figure>\n\n\n\n
\n\n\n\n

KAYNAK\u00c7A:<\/p>\n\n\n\n

Bajestan SN, LaFrance WC Jr. Clinical\nApproaches to Psychogenic Nonepileptic Seizures. Focus (Am Psychiatr Publ).\n2016 Oct;14(4):422-431. doi: 10.1176\/appi.focus.20160020. Epub 2016 Oct 7.\nPMID: 31975822; PMCID: PMC6519589.<\/p>\n\n\n\n

Tolchin B, Dworetzky BA, Martino S,\nBlumenfeld H, Hirsch LJ, Baslet G. Author response: Adherence with\npsychotherapy and treatment outcomes for psychogenic nonepileptic seizures.\nNeurology. 2019 Nov 26;93(22):981. doi: 10.1212\/WNL.0000000000008560. PMID:\n31767663.<\/p>\n\n\n\n

VARLI, Kubilay. “Yalanc\u0131\nEpileptik N\u00f6betler.” Klinik Psikiyatri Dergisi 2.2: 101-104.<\/p>\n\n\n\n

\u00c7AKIL, Duygu. \u201cEpilepsi ay\u0131r\u0131c\u0131\ntan\u0131s\u0131nda psikojenik non-epileptik n\u00f6betler\u201d G\u00f6ztepe T\u0131p Dergisi 41-47 (2013)<\/p>\n\n\n\n

 [2]<\/a>Hastal\u0131k n\u00f6beti, kriz<\/p>\n\n\n\n

 [1]<\/a>Ani ve ge\u00e7ici krizler halinde gelen<\/p>\n\n\n\n

\n","protected":false},"excerpt":{"rendered":"

NED\u0130R? Epileptik Olmayan Psikojenik N\u00f6betler (EOPN), ger\u00e7ek n\u00f6betleri and\u0131ran ancak EEG de\u011fi\u015fimlerinin ve sempatik sinir sistemi disfonksiyonlar\u0131n\u0131n e\u015flik etmedi\u011fi paroksismal[1] <\/p>\n","protected":false},"author":391,"featured_media":8709,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[1463,1464,1462],"acf":[],"views":2492,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8698"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/391"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=8698"}],"version-history":[{"count":17,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8698\/revisions"}],"predecessor-version":[{"id":8778,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8698\/revisions\/8778"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/8709"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=8698"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=8698"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=8698"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}