Armon C, Peterson G W, Liwnicz B H
Department of Neurology, Loma Linda University School of Medicine, California 92354, USA.
J Clin Neurophysiol. 2000 Sep;17(5):511-8. doi: 10.1097/00004691-200009000-00011.
Alzheimer's disease is a known risk factor for seizures, and age older than 60 years is a recognized risk factor for poor outcome from convulsive and nonconvulsive status epilepticus. The authors suspect that there may be a causal relationship between dementia pathology and the development and maintenance of refractory seizures. They report two selected patients with complex partial status epilepticus whose presentation and clinical course provide partial support for this hypothesis. Their methods include case reports with clinical, EEG, imaging, and pathologic correlations. The patients were 70 and 85 years of age. Both had central and peripheral brain atrophy on imaging studies (with some regions that were affected more than others), left temporal seizure foci corresponding to areas of greatest cortical atrophy, and early presentation with inhibitory epileptic symptoms (aphasia), with evolution to complex partial status epilepticus. Pathologic confirmation of Alzheimer's disease was obtained in one patient who had not been diagnosed previously. It involved maximally the cortex underlying the seizure focus. A diagnosis of probable Alzheimer's disease was established in the other patient. Alzheimer's disease may be causal in some cases of complex partial status epilepticus. Additional observations in support of this hypothesis are needed.
阿尔茨海默病是已知的癫痫发作风险因素，60岁以上是惊厥性和非惊厥性癫痫持续状态预后不良的公认风险因素。作者怀疑痴呆病理与难治性癫痫发作的发生和维持之间可能存在因果关系。他们报告了两名复杂性部分性癫痫持续状态的患者，其临床表现和临床过程为这一假说提供了部分支持。他们的方法包括结合临床、脑电图、影像学和病理学相关性的病例报告。患者分别为70岁和85岁。影像学研究均显示有中枢和外周脑萎缩（某些区域比其他区域受累更严重），左侧颞叶癫痫病灶对应于皮质萎缩最严重的区域，且早期表现为抑制性癫痫症状（失语症），随后进展为复杂性部分性癫痫持续状态。其中一名此前未被诊断出的患者经病理证实患有阿尔茨海默病，病变主要累及癫痫病灶下方的皮质。另一名患者被诊断为可能的阿尔茨海默病。在某些复杂性部分性癫痫持续状态的病例中，阿尔茨海默病可能是病因。需要更多支持这一假说的观察结果。
