没有一般化的双半球性发作
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
The Neurohospitalist
|April 26, 2024
概括
这项研究报告了一例罕见的双半球焦点发作病例,该病例发生在患有急性腹腔内血瘤的患者身上,该患者表现为保持意识和运动症状. 这些发现挑战了典型的发作局部化,并突出了偏管发作性病变的诊断困难.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 临床医学 临床医学
背景情况:
- 焦点发作通常起源于单一半球,并且可以泛滥,通常与意识受损有关.
- 已知急性亚皮血瘤 (SDH) 会引起发作,但双边半球参与而没有泛化是罕见的.
- 寄生虫性发性病变在临床和电图上都很难局部化.
研究的目的:
- 为了呈现焦点的第一个视觉报告,两个半球的临床发作与保持意识.
- 讨论急性腹腔内血瘤在促进双边性发作的潜在作用.
- 为了突出诊断挑战在定位发作源于寄生虫病变的发作.
主要方法:
- 一个70岁的男性的病例报告,经常出现抽动作.
- 临床检查显示半和虚弱.
- 计算机断层扫描 (CT) 扫描识别了急性腹腔内血瘤.
- 在服用抗发作药物后进行脑电图 (EEG).
主要成果:
- 患者经历了左半身和右下肢抽的反复发作,保持了意识.
- 电脑扫描显示了右侧形急性腹膜下垂体血瘤.
- 在洛拉泽巴姆和 levetiracetam 治疗后,发作停止,软弱改善.
- 脑电图显示非特异性的theta减速,没有检测到型活动.
结论:
- 这种病例表明焦点,双半球发作没有意识受损,这种表现以前没有被视觉记录.
- 帕拉法尔辛下皮质血瘤可能导致了双边半球发性.
- 这些发现凸显出,即使在正常的脑电图检测结果下,也很难将来自偏肌病变的发作局部化.
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