Misumi Youhei, Hirano Teruyuki, Matsumoto Noriko, Yamashita Taro, Uyama Eiichiro, Uchino Makoto
Department of Neurology, Graduate School of Medical Sciences, Kumamoto University.
Rinsho Shinkeigaku. 2006 Mar;46(3):214-7.
We reported a patient with sudden onset seizure resulting in prolonged amnesia. MRI revealed a T2 high signal lesion with swelling in the right medial temporal lobe. Because the MRI lesion remained to be the same in size for two months, biopsy specimens were obtained under informed consent to rule out the brain tumor. Based on histological findings showing brain edema without specific abnormal findings (malignancy, inflammation etc), we concluded that the temporal lesion was the edema induced by the seizure attack. In Japan, many papers on non-herpetic acute limbic encephalitis (NHALE) have recently been published. In their reports, seizures were frequently observed as a preceding symptom; moreover, clinical courses and MRI findings are similar to those of seizure-induced brain edema. The secondary brain edema induced by the seizure must be considered in patients with NHALE and other CNS disorders, especially if the patient has a history of the recent seizure.
我们报告了一名突发癫痫发作并导致长期失忆的患者。磁共振成像（MRI）显示右侧颞叶内侧有一个T2高信号病灶且伴有肿胀。由于该MRI病灶在两个月内大小保持不变，因此在获得知情同意后获取了活检标本以排除脑肿瘤。基于组织学检查结果显示为脑水肿且无特异性异常发现（恶性肿瘤、炎症等），我们得出结论，颞叶病灶是由癫痫发作引起的水肿。在日本，最近发表了许多关于非疱疹性急性边缘性脑炎（NHALE）的论文。在他们的报告中，癫痫发作常被观察到是前驱症状；此外，临床病程和MRI表现与癫痫诱发的脑水肿相似。对于NHALE和其他中枢神经系统疾病患者，尤其是有近期癫痫发作史的患者，必须考虑癫痫发作诱发的继发性脑水肿。
