Nixon J, Bateman D, Moss T
Department of Neurology, Royal United Hospital, Bath, UK.
Seizure. 2001 Dec;10(8):588-91. doi: 10.1053/seiz.2001.0553.
We report a case of fatal status epilepticus of unknown origin resulting in acute neuropathological changes in the hippocampus and claustrum. The case history, brain magnetic resonance images, and results of neuropathological study of the whole brain were obtained. The subject was a 35 year old male with no significant previous medical history who presented with generalized epileptic seizures progressing to status epilepticus. He died 6 days after developing status epilepticus. Magnetic resonance imaging (MRI) brain scans were performed before and four days after developing status epilepticus. The first scan was normal and the second showed high signal lesions on T2 weighted images in the medial aspects of both temporal lobes and in the right claustrum. Neuropathological studies showed severe neuronal loss in the Sommer section of both hippocampi with early glial reactive changes. Similar changes were seen in the claustrum on both sides. There was no evidence of other causes of brain injury such as infectious encephalitis or global hypoxic-ischaemic change. The patient died of status epilepticus for which no underlying cause was found despite extensive investigation. In this case the radiological and pathological changes found bilaterally in the claustrum and hippocampus appear to be the direct result of the status epilepticus.
我们报告一例不明原因的致命性癫痫持续状态，其导致海马体和屏状核出现急性神经病理学改变。获取了病例病史、脑部磁共振成像以及全脑神经病理学研究结果。该患者为一名35岁男性，既往无重大病史，表现为全身性癫痫发作并进展为癫痫持续状态。在出现癫痫持续状态6天后死亡。在出现癫痫持续状态之前及之后4天进行了脑部磁共振成像（MRI）扫描。首次扫描正常，第二次扫描显示双侧颞叶内侧及右侧屏状核在T2加权图像上有高信号病变。神经病理学研究显示双侧海马体的 Sommer 区有严重神经元丢失，并伴有早期胶质细胞反应性改变。双侧屏状核也有类似变化。没有证据表明存在其他脑损伤原因，如感染性脑炎或全身性缺氧缺血性改变。尽管进行了广泛调查，但未发现该患者癫痫持续状态的潜在病因，患者最终死于癫痫持续状态。在该病例中，双侧屏状核和海马体发现的影像学和病理学改变似乎是癫痫持续状态的直接结果。
