催眠明确儿童惊厥病因

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Cause Of Children's Seizures Pinpointed By Hypnosis
催眠明确儿童惊厥病因
It was no way for an 11-year-old to live. For a month the boy had endured daily episodes of uncontrollable jerking and foaming at the mouth, and his physicians at Lucile Packard Children's Hospital at Stanford were concerned that the boy had epilepsy. Before starting the boy on a lifetime of anti-seizure medications, though, they turned to an unconventional diagnostic tool: hypnosis.
11岁的男孩近一个月来天天忍受着无法控制的口角痉挛发作和口吐白沫，他的在斯坦福Lucile Packard儿童医院的医生认为他患了癫痫，在开始终身服用抗癫痫药物之前，他们采用了一项非常规的诊断方法：催眠。
\"Children are highly suggestible and they have great imaginations,\" said Packard Children's child psychiatrist Richard Shaw, MD. \"We've found that if we suggest that they are going to have one of their events while they are in a hypnotic trance, they will usually have one.\"
“儿童因为有丰富的想像力所以容易接受暗示”，Packard儿童医院儿童精神病学家Richard Shaw博士说，“我们发现在催眠状态下我们建议发生某项事件，他们通常会做到。”
But wait. Aren't physicians supposed to try to STOP seizures rather than searching for new ways to cause them? In a word, yes. But in order to treat seizures effectively, doctors must learn which parts of the brain are causing the trouble. Many children who seem to be having epileptic seizures are actually having an involuntary physical reaction to psychological stress in their lives. These events require a vastly different treatment than do true epileptic seizures.
但是等一下，难道医生不是想阻止惊厥发作而不是寻找新的发作诱因吗？一句话，是的。但是为了有效治疗惊厥，医生必须知道大脑的哪一个部分障碍导致的。很多看上去有癫痫发作的儿童事实上生活中存在心理压力，从而有下意识的身体反应。这些心理状态比真正的癫痫发作更需要很多不同的治疗。
The only way to pinpoint the true cause is to monitor the child's brain activity during an event. Connecting a panel of electrodes to a child's scalp is relatively easy and painless. Conducting a \"seizure watch\" of indefinite length is another matter.
找出发作真实原因需要在惊厥过程中监测患儿大脑活动，将电极连在孩子头皮上相对容易且无创，操作不定长度的“惊厥表”是另外回事。
\"It's very difficult for parents to spend three or four days in the hospital hoping their child has a seizure,\" said Packard Children's chief of pediatric neurology, Donald Olson, MD. \"It puts them in a very uncomfortable place emotionally.\" Furthermore, some hospitalized children, removed from the very stressors that may be causing the events, never have a seizurelike event.
“让父母花3-4天在医院里等患儿出现惊厥发作是很困难的。” Packard儿童医院儿童神经科主任Donald Olson博士说，“这让他们感觉很不舒服。”而且一些住院儿童，除非很紧张刺激可能导致惊厥发作，很少能出现惊厥样发作。
Hypnosis can speed the process considerably, say Shaw and Olson. Together with former medical student Neva Howard, they tested the procedure on nine children between the ages of 8 to 16 whose seizurelike events included twitching, loss of consciousness, shaking, jerking and falling. Their results were published online in Epilepsy & Behavior. The physicians needed to know whether these were true epileptic events, which are best treated by medication, or non-epileptic events caused by psychological stress or other neurological problems.
催眠可以相当大地加速进程，Shaw和Olson说，与前医学生Neva Howard一起，他们在年龄于8-16岁的9名儿童中进行了催眠，发现了癫痫样事件包括颤抖、意识丧失、摇晃、抽痉和跌倒。他们的结果发表在“癫痫和行为表现”上。医学家需要了解这些是否是真正的需要治疗的癫痫事件还是心理紧张或其他神经学上问题引起的非癫痫事件。
\"We can't always distinguish epileptic from non-epileptic events visually, or through descriptions by family or friends,\" said Olson, an associate professor of neurology, of neurosurgery and of pediatrics at the Stanford University School of Medicine. \"But regardless of the cause, these are disabling, life-altering events that need to be treated.\"
“我们不能从肉眼判别癫痫与否，或者从家人朋友的描述来判定。”Olson说，是斯坦福大学医学院儿童神经病及神经外科教授，“但是不管什么原因，它是致残的改变生活的事件，需要进行治疗。”
The authors believe that, although hypnosis may not work for every child, the technique is an important tool that can speed proper diagnosis and treatment for children suffering from seizurelike events.
作者相信虽然不能给每个儿童进行催眠，但是这项技术是让惊厥样发作的孩子得到快速正确诊治的重要方法。
To hypnotize the subjects, Shaw, an associate professor of psychiatry and behavioral sciences and of pediatrics at the School of Medicine, first used a combination of deep breathing and progressive muscle relaxation to induce a state of relaxation and deep focused attention in the subjects. He then used a combination of imagery and suggestion to induce one of their typical seizurelike events. Children typically visualize being at one of their favorite places - for one teen, it was on a beach in the Bahamas. After a hypnotic trance was established, Shaw would then direct the child to recall the feelings or events that usually precede a typical seizure. Electrodes on the child's scalp recorded their brain activity during the session.
在催眠过程中，医学院的儿童心理和行为教授Shaw教授一开始联合深呼吸和肌肉放松诱导进入放松状态并集中思想，接着他连用想像和建议诱导出一项典型惊厥样发作。孩子置身于他们喜爱的地方，在巴哈马海滩上。进入催眠状态后，Shaw指导孩子回忆惊厥发作前的感觉，在这过程中有电极连在患儿头皮上记录大脑活动。
In eight out of nine cases, Shaw could successfully trigger a seizurelike event with this procedure. After an appropriate monitoring interval, Shaw then directed the hypnotized child to \"return\" to his or her favorite place and the episode would stop. Using this technique, the physicians found that all eight of the subjects were experiencing non-epileptic events.
9个孩子中8个在这过程中成功诱发了惊厥样发作。经过适当的监测阶段，Shaw指导催眠儿童回到他们喜欢的场景，惊厥发作停止。在这项技术中医学家发现这八个儿童无癫痫发作。
\"We had a number of clues that these particular children might not have epilepsy,\" said Olson, \"but hypnosis helped us confirm our suspicions.\" Physicians begin to suspect causes other than epilepsy if an individual has a variety of episodes, if the person's cognition is unaffected despite frequent seizures or if the person has a pre-existing psychiatric diagnosis.
“我们有些证据说明这些儿童可能没有癫痫”，Oison说，“而催眠帮助我们证实猜测。”医学家开始怀疑如果患者惊厥表现多样，或者频繁抽搐后认知不受影响，或者曾经有精神病的诊断，那么发生惊厥的原因就不是癫痫。
Were the kids in the study relieved to find they didn't have epilepsy? \"Yes and no,\" said Shaw. \"It's important to explain very clearly that although these events are psychologically based, they are completely out of a child's control.\" He and Olson compare the events, which are a type of condition called conversion disorder, to other well-known ways that stress and emotions affect other bodily functions, such as migraines, ulcers and blushing.
是不是这些研究过的孩子可以放心他们没有患癫痫？“可能是，也可能不是”，Shaw说，“重要的是必须解释清楚，虽然这些事件发生在心理问题上，他们完全不受孩子控制。”他和Olson比较了一些称之为一种转换紊乱的事件，就象一些众所周知的压力和情绪影响身体功能的疾病，如偏头痛、溃疡和潮热。
Stanford is part of an ongoing multicenter study of these non-epileptic events to better understand their causes and possible treatments. For now, Shaw often couples psychotherapy with self-hypnosis lessons to teach children how to avoid the events.
斯坦福是非癫痫事件多中心研究的一个部分，这个中心是为了更好地理解病因和可行的治疗，到现在，Shaw经常一对一地对孩子进行自我催眠的心理治疗，以教他们摆脱这些事件。
\"When they're feeling out of control, this is a tool they can use. They know that they were able to 'turn off' an event during the initial hypnosis, and that gives them confidence to try it themselves,\" said Shaw.
“当他们感觉无法控制自己，这是个他们能采取的办法，他们知道他们有能力在催眠发生时停止事件，并且给他们自信去自己尝试。”Shaw说。
In general, people are growing more comfortable with the idea of hypnosis in a medical setting, said Olson. \"The first reaction of many people may be to equate hypnosis with some sort of black magic. But once we explain the reasons and benefits, they're very accepting.\"
一般来说，在医疗设备下人们感觉进入催眠更舒服，Olson说，“很多人第一反应把催眠等同于巫术，但是我们这样解释原因和优点，他们很能接受。”