Maeda J, Moriwaki Y, Tamura S, Hada T, Higashino K
Third Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Nov;30(11):2002-6.
A rare case of neurosarcoidosis presenting with psychomotor seizure is reported. A 35-year-old woman was admitted to our ward for further evaluation of syncopal attacks and suspected sarcoidosis. The patient had a history of syncopal attacks for about 15 years prior to admission; however, the pathogenesis was not clarified in spite of various examinations. Three months prior to admission, left peripheral facial nerve palsy, bilateral hypopion and bilateral hilar lymphadenopathy on plain chest film were noted at the departments of neurosurgery and ophthalmology of our hospital. She was referred and admitted to our ward. The diagnosis of sarcoidosis was made by scalene node biopsy. The syncopal attacks could not be controlled by several anticonvulsant agents. Although no significant findings were observed on brain CT and cerebral angiography, spike wave was revealed on electroencephalography (EEG) in the parieto-temporal lead. The syncopal attacks were diagnosed psychomotor seizures from both the clinical features and the EEG findings. We concluded that syncope was caused by neurosarcoidosis. The patient was prescribed steroid with much improvement of these symptoms.
报告了一例以精神运动性癫痫发作为表现的罕见神经结节病病例。一名35岁女性因晕厥发作及疑似结节病入院接受进一步评估。患者入院前有大约15年的晕厥发作史；然而，尽管进行了各种检查，其发病机制仍未明确。入院前三个月，我院神经外科和眼科检查发现左侧周围性面神经麻痹、双侧前房积脓以及胸部平片显示双侧肺门淋巴结肿大。她被转诊并入住我们病房。通过斜角肌淋巴结活检确诊为结节病。多种抗惊厥药物无法控制晕厥发作。尽管脑部CT和脑血管造影未发现明显异常，但脑电图（EEG）颞顶导联显示有棘波。综合临床特征和脑电图结果，晕厥发作被诊断为精神运动性癫痫。我们得出结论，晕厥是由神经结节病引起的。患者接受了类固醇治疗，这些症状有了很大改善。
