Escosa Bagé M, Villarejo Ortega F J, Pérez Jiménez M A, González Mediero I
Hospital Universitario Niño Jesus, Madrid, España.
Rev Neurol. 2004;38(7):643-6.
Psychosis is an acknowledged, although infrequent, complication that occurs in 0.5 9% of all cases of epilepsy. In this work, we present a case of complex partial epilepsy due to a dysembryoplastic neuroectodermal tumour in the right hippocampus, which began as acute psychosis and was cured following its surgical removal. Both its aetiology and its pathogenesis are discussed.
We describe the case of a 17 year old male with a family history of schizophrenia. While studying his last years of secondary education, and apparently well adapted, he was taken into custody and hospitalised urgently because of personality disorders. The patient suffered from somatic and auditory hallucinations, simple visual pseudohallucinations, formal alterations to his thinking, cosmovisions, delusions of influence, persecution, grandeur and of a mystic nature, with no other neurological focus. At the same time, the patient also had complex partial seizures. Magnetic resonance imaging revealed a cystic tumour in the right temporal lobe. Pathology laboratory findings showed a dysembryoplastic neuroepithelial tumour. For a period of two years following surgical removal, the schizophrenic symptoms and the complex partial seizures disappeared and the patient no longer required antipsychotic medication.
Epileptic psychosis may be related to pathological conditions of the hippocampus. In this study we present what we believe to be the first case of a dysembryoplastic neuroepithelial tumour giving rise to such psychosis. Surgical removal of the tumour cured both entities.
精神病是一种公认的癫痫并发症，虽然并不常见，在所有癫痫病例中发生率为0.5%至9%。在本研究中，我们报告一例因右侧海马区胚胎发育不良性神经上皮肿瘤导致的复杂部分性癫痫病例，该病例最初表现为急性精神病，手术切除肿瘤后得以治愈。本文还讨论了其病因及发病机制。
我们描述了一名17岁男性患者，他有精神分裂症家族史。在接受中学最后几年教育期间，他表面上适应良好，但因人格障碍被紧急拘留并住院。该患者出现躯体和幻听、简单视幻觉、思维形式障碍、宇宙观、被影响妄想、被害妄想、夸大妄想及神秘主义妄想，未发现其他神经学病灶。同时，患者还伴有复杂部分性发作。磁共振成像显示右侧颞叶有一个囊性肿瘤。病理实验室检查结果显示为胚胎发育不良性神经上皮肿瘤。手术切除后的两年时间里，精神分裂症症状和复杂部分性发作均消失，患者不再需要抗精神病药物治疗。
癫痫性精神病可能与海马区的病理状况有关。在本研究中，我们报告了我们认为首例由胚胎发育不良性神经上皮肿瘤引发此类精神病的病例。手术切除肿瘤治愈了这两种病症。
