功能性抽动研究进展

doi:10.3969/j.issn.1672-6731.2025.06.015

摘要/Abstract

摘要：

功能性抽动是较少见的功能性神经系统疾病临床表型，其病因和发病机制尚未完全明确，且临床对其认识尚不全面。本文通过系统梳理近年国内外功能性抽动相关研究，对其临床特征、影响因素、共患病、诊断、治疗与预后进行分析和概述，旨在为后续功能性抽动的诊断与治疗提供理论参考。

关键词: 转换障碍, 抽搐性运动障碍, 综述

Abstract:

Functional tic-like behaviors (FTLBs) is a kind of rare clinical phenotype of functional neurological disorder (FND), its etiology and pathogenesis have not been fully defined, and the clinical understanding of it is not comprehensive. This paper systematically reviews the relevant studies of FTLBs in recent years, and analyzes and summarizes its clinical characteristics, influencing factors, comorbidities, diagnosis, treatment and prognosis, aiming to provide theoretical reference for the subsequent diagnosis and treatment of FTLBs.

Key words: Conversion disorder, Tic disorders, Review

乔福强, 徐可莹, 王磊. 功能性抽动研究进展[J]. 中国现代神经疾病杂志, 2025, 25(6): 551-555.

Fu-qiang QIAO, Ke-ying XU, Lei WANG. Research progress on functional tic-like behaviors[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2025, 25(6): 551-555.

https://journal11.magtechjournal.com/cjcnn/CN/Y2025/V25/I6/551

图/表 1

参考文献 36

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诊断标准	描述
主要标准	（1）症状出现年龄：≥ 12 岁（2）症状演变速度：①症状进展快速，并很快演变为严重程度。②可具体表述症状出现时间（3）抽动表现（任意出现 ≥ 4种表现即可确诊）：①抽动行为增加。②复杂抽动多于简单抽动。③抽动样行为也有不同表现，即非刻板动作。④表现出复杂运动抽动。⑤非轻度到重度的进程，而是突然发作。⑥表现出发声抽动的行为包括重复单词或短语，这些重复的内容有时与上下文相关，有时仅是攻击性词汇。⑦表现的抽动行为受周围环境或会环境的影响。⑧抽动症状出现频率和强度呈现很大变化，抽动会突然发作。⑨抽动行为呈较大变动，每天或每隔几天会出现新的抽动行为
次要标准	（1）判断患者是否存在共患病，即共患焦虑情绪或抑郁症状、自伤行为（即抓伤、割伤）、自杀意念、经历过的创伤或负性生活事件（2）判断患者是否存在功能性神经疾病或躯体障碍，如同时存在其他的功能性神经疾病（如功能性癫痫、瘫痪）或躯体症状障碍（如功能性腹痛）等

诊断标准	描述
主要标准	（1）症状出现年龄：≥ 12 岁（2）症状演变速度：①症状进展快速，并很快演变为严重程度。②可具体表述症状出现时间（3）抽动表现（任意出现 ≥ 4种表现即可确诊）：①抽动行为增加。②复杂抽动多于简单抽动。③抽动样行为也有不同表现，即非刻板动作。④表现出复杂运动抽动。⑤非轻度到重度的进程，而是突然发作。⑥表现出发声抽动的行为包括重复单词或短语，这些重复的内容有时与上下文相关，有时仅是攻击性词汇。⑦表现的抽动行为受周围环境或会环境的影响。⑧抽动症状出现频率和强度呈现很大变化，抽动会突然发作。⑨抽动行为呈较大变动，每天或每隔几天会出现新的抽动行为
次要标准	（1）判断患者是否存在共患病，即共患焦虑情绪或抑郁症状、自伤行为（即抓伤、割伤）、自杀意念、经历过的创伤或负性生活事件（2）判断患者是否存在功能性神经疾病或躯体障碍，如同时存在其他的功能性神经疾病（如功能性癫痫、瘫痪）或躯体症状障碍（如功能性腹痛）等

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