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Updated: Jun 23, 2025

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頭痛およびてんかん重積状態から判明したパジェット骨病

Dahab Ouhabi1, Houyam Tibar1, Ali Benomar1

  • 1Department of Neurology B and Neurogenetics, Specialties Hospital, Ibn Sina Teaching Hospital, Mohammed V University in Rabat, Rabat, MAR.

Cureus
|June 19, 2024
PubMed

骨パジェット病（PDB）は、主に骨盤、大腿骨、および頭蓋骨において骨組織の過剰なリモデリングを特徴とする、高齢者の良性骨異形成症である。その神経学的症状は多岐にわたり、中枢神経系と末梢神経系の両方に影響を及ぼす。頭痛は頻繁に報告されるが、てんかん発作は稀である。我々は、慢性的に悪化する頭痛の既往があり、初回の発作で救急外来に搬送された75歳女性の症例を報告する。頭部画像診断では、不均一な骨肥厚と限局的な頭蓋骨骨粗鬆症が認められた。骨シンチグラフィでは、頭蓋骨と顔面に限定されたパジェット様病変が示された。アルカリホスファターゼ値は上昇していた。その他の生物学的検査および髄液検査により、他の代謝性疾患や中枢神経系感染症は除外された。患者にはビスホスホネート製剤および抗てんかん薬による治療が行われた。経過は良好であり、頭痛は漸次改善し、抗てんかん薬の中止後数ヶ月が経過しても発作は制御されていた。本症例報告は、高齢者の慢性頭痛を精査する際、脳実質の病変だけでなく、それを包含する構造物、本症例においては頭蓋骨についても検討することの重要性を強調するものである。

キーワード:
コットンウール徴候高齢者の頭痛てんかん局所性骨粗鬆症パジェット病

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