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癫痫性部分性持续状态作为运动皮质发育异常的孤立表现

Epilepsia partialis continua as an isolated manifestation of motor cortical dysplasia.

作者信息

Misawa Sonoko, Kuwabara Satoshi, Hirano Shigeki, Shibuya Kazumoto, Arai Kimihito, Hattori Takamichi

机构信息

Department of Neurology, Chiba University School of Medicine, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan.

出版信息

J Neurol Sci. 2004 Oct 15;225(1-2):157-60. doi: 10.1016/j.jns.2004.07.014.

Abstract

Cortical dysplasia has been increasingly recognized as a cause of epilepsy. We describe herein a 31-year-old female patient with epilepsia partialis continua (EPC) in the right extremities, which had lasted for 15 years without generalized seizures and other neurological deteriorations. MRI showed a focal thickening around the left motor area, indicative of cortical dysplasia, with adjacent subcortical abnormal T2 high intensity, suggestive of dysmyelination. Transcranial magnetic stimulation revealed low motor thresholds and markedly prolonged latencies of motor-evoked potentials (MEP) of the affected side, consistent with hyperexcitability of the cortical motoneurons accompanied by dysmyelination. This case demonstrates that motor cortex dysplasia can result in a mild and non-progressive form of epilepsia partialis continua, associated with the characteristic MRI and MEP abnormalities.

摘要

皮质发育异常已越来越被认为是癫痫的一个病因。我们在此描述一名31岁女性患者,其右侧肢体持续性部分性癫痫(EPC)已持续15年,无全面性发作及其他神经功能恶化。磁共振成像(MRI)显示左侧运动区周围有局灶性增厚,提示皮质发育异常,相邻皮质下T2高信号异常,提示髓鞘形成异常。经颅磁刺激显示患侧运动阈值低,运动诱发电位(MEP)潜伏期明显延长,这与伴有髓鞘形成异常的皮质运动神经元兴奋性过高一致。该病例表明,运动皮质发育异常可导致一种轻度且非进行性的持续性部分性癫痫,伴有特征性的MRI和MEP异常。

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