Kawakami Yasuhiko, Hirayama Tsunenori, Hashimoto Kiyoshi, Kuwabara Kentaro, Fujita Takehisa, Fujino Osamu
Department of Pediatrics, Nippon Medical School Second Hospital, Kawasaki, Kanagawa, Japan.
J Nippon Med Sch. 2003 Aug;70(4):351-4. doi: 10.1272/jnms.70.351.
We report a case of adversive seizures featuring neck rotation and conjugate deviation induced by the hyperventilation maneuver. At the age of 6 years the patient suffered from conjugate deviation to the left. She herself felt no symptoms other than oculomotor symptoms. Hyperventilation induced an adversive seizure and ictal EEG showed sharp waves in the right frontal, central, and parietal areas. No brain image showed abnormal findings. Zonisamide completely attenuated her attacks. It is well known that hyperventilation induces absence seizures, and it has been reported that hyperventilation can induce complex partial seizures. However, no previous reports have described patients diagnosed as having adversive seizures with conjugate deviation induced by hyperventilation. We report the present case because, although its epileptogenesis is unknown, the patient is a rare case not only clinically but also electrophysiologically.
我们报告一例由过度换气诱发的以颈部旋转和同向偏视为特征的旋转性癫痫发作。患者6岁时出现向左同向偏视，除眼动症状外无其他自觉症状。过度换气诱发旋转性癫痫发作，发作期脑电图显示右侧额、中央和顶叶区域有尖波。脑部影像学检查未发现异常。唑尼沙胺完全控制了她的发作。众所周知，过度换气可诱发失神发作，且有报道称过度换气可诱发复杂部分性发作。然而，此前尚无关于过度换气诱发同向偏视性旋转性癫痫发作患者的报道。我们报告该病例是因为，尽管其癫痫发生机制不明，但该患者不仅在临床上，而且在电生理方面都是罕见病例。
