Ueki Y, Terada K, Otsuka A, Kanda M, Akiguchi I
Department of Neurology, Takeda General Hospital, Kyoto.
Rinsho Shinkeigaku. 2000 Apr;40(4):339-43.
A 62-year-old right-handed woman had presented progressive speech impediment over 4 months. She was alert without any convulsions or involuntary movements. Neurological examination showed Wernicke's aphasia, constructional apraxia. Her magnetic resonance imaging (MRI) showed an old cerebral infarction in the left parieto-occipital area, in addition to ischemic changes in the bilateral deep white matter. Electroencephalography (EEG) revealed periodic lateralized epileptiform discharges (PLEDs) predominant in the posterior left hemisphere. The PLEDs as well as the cortical symptoms improved after an administration of anti-convulsive agents, thus establishing the diagnosis of non-convulsive status epilepticus (NSE). It should be emphasized that NSE manifesting as Wernicke's aphasia should be distinguished from dementia syndrome because it is a treatable disorder.
一名62岁右利手女性在4个月内出现进行性言语障碍。她神志清醒，无抽搐或不自主运动。神经系统检查显示韦尼克失语、结构性失用症。她的磁共振成像（MRI）显示左侧顶枕区有陈旧性脑梗死，双侧深部白质也有缺血性改变。脑电图（EEG）显示左侧后半球为主的周期性局灶性癫痫样放电（PLEDs）。给予抗惊厥药物后，PLEDs以及皮质症状有所改善，从而确诊为非惊厥性癫痫持续状态（NSE）。应当强调的是，表现为韦尼克失语的NSE应与痴呆综合征相鉴别，因为它是一种可治疗的疾病。
