Okamoto Kensho, Okuda Bungo
Department of Neurology, Ehime Prefectural Central Hospital.
Rinsho Shinkeigaku. 2002 Feb;42(2):167-70.
A 18-year-old man was diagnosed as having measles on the basis of cutaneous and mucosal eruption and high grade fever on May 10, 2001. Six days after the skin eruption, the patient developed general convulsion (day1). He was admitted to our hospital because of status epilepticus. We made a diagnosis of acute measles encephalitis, based on the clinical features and pleocytosis with an increase in protein in the cerebrospinal fluid. Under artificial ventilation and sedation, he received intravenous immunoglobulin and dexamethasone. Electroencephalography (EEG) on day 4 revealed periodic synchronous discharge (PSD). Significant elevation of antibody titer for measles virus was found in the serum, but not in the cerebrospinal fluid. Polymerase chain reaction method did not show viral genes of measles virus, herpes simplex virus and herpes zoster virus. Serial EEG studies demonstrated a decrease in PSD, followed by irregular spike-wave complexes within 20 days. He recovered completely one month after the onset. It should be kept in mind that PSD can emerge on EEG in the early stage of acute measles encephalitis.
一名18岁男性于2001年5月10日因皮肤和黏膜出疹及高热被诊断为麻疹。出疹6天后，患者出现全身性惊厥（第1天）。因癫痫持续状态入院。根据临床特征以及脑脊液中细胞增多和蛋白升高，我们诊断为急性麻疹脑炎。在人工通气和镇静的情况下，他接受了静脉注射免疫球蛋白和地塞米松治疗。第4天的脑电图（EEG）显示有周期性同步放电（PSD）。血清中麻疹病毒抗体滴度显著升高，但脑脊液中未升高。聚合酶链反应方法未显示麻疹病毒、单纯疱疹病毒和带状疱疹病毒的病毒基因。系列脑电图研究显示PSD减少，随后在20天内出现不规则棘波复合波。发病1个月后他完全康复。应记住，PSD可在急性麻疹脑炎早期出现在脑电图上。
