Bonilha Leonardo, Cendes Fernando, Ghizoni Enrico, Vieira Ronan José, Li Li Min
Neuroimaging Laboratory, Department of Neurology, State University of Campinas, Campinas, Brazil.
Arch Neurol. 2004 Aug;61(8):1294-6. doi: 10.1001/archneur.61.8.1294.
Symptomatic acute epileptic seizures may occur in up to 5% of individuals, especially children, with scorpion stings. The occurrence of a long-lasting brain lesion or the development of epilepsy after a scorpion sting has never been observed.
To describe the development of epilepsy secondary to an extensive hemispheric destructive brain lesion after a scorpion sting.
A 15-year-old with a moderate global cognitive impairment and a mild left hemiparesis, with seizures occurring approximately once monthly.
The mother reported that the patient at the age of 4 years was stung by a brown scorpion, Tityus serrulatus. The patient soon developed local pain and paresthesias followed by diaphoresis and somnolence. Approximately 24 hours after the sting, she began to convulse. She was then taken to a hospital where she achieved suboptimal seizure control, with daily tonic-clonic seizures and left hemiplegia during the following week. During our clinical investigation, her routine electroencephalogram showed the presence of interictal spikes and diffuse slowing in the right brain hemisphere. Magnetic resonance imaging showed a widespread destructive lesion of her right cerebral hemisphere affecting both the cortical and subcortical structures.
This is a rare illustration of the biological effects of the toxin of T serrulatus concerning its excitotoxicity and the potential to induce a brain lesion of an epileptogenic nature.
有症状的急性癫痫发作可能发生在高达5%的被蝎子蜇伤的个体中，尤其是儿童。从未观察到蝎子蜇伤后出现持久的脑损伤或癫痫的发展。
描述蝎子蜇伤后广泛的半球破坏性脑损伤继发癫痫的发展情况。
一名15岁的患者，有中度的整体认知障碍和轻度左侧偏瘫，癫痫发作大约每月一次。
母亲报告说，患者4岁时被一只棕色蝎子，锯齿脂尾蝎蜇伤。患者很快出现局部疼痛和感觉异常，随后出汗和嗜睡。蜇伤后约24小时，她开始抽搐。然后她被送往一家医院，在那里癫痫控制不佳，在接下来的一周里每天都有强直阵挛发作和左侧偏瘫。在我们的临床调查中，她的常规脑电图显示右侧脑半球存在发作间期棘波和弥漫性减慢。磁共振成像显示她的右侧大脑半球有广泛的破坏性病变，影响皮质和皮质下结构。
这是一个罕见的例子，说明了锯齿脂尾蝎毒素的生物学效应，涉及其兴奋毒性和诱发致痫性脑损伤的潜力。
