Department of Human Motor Sciences and Neurodegenerative Diseases Unit, Institute of Aging (Ce.S.I) University G. d'Annunzio Foundation, Chieti-Pescara, Italy.
J Neurol Sci. 2009 Oct 15;285(1-2):262-4. doi: 10.1016/j.jns.2009.07.006. Epub 2009 Aug 6.
A 57-year-old man, operated eight years before for a left frontal falx meningioma, presented with short lasting, stereotyped episodes of paresthesias ascending from the right foot to the hand. A diagnosis of somatosensory seizures with jacksonian march was made. The patient was given antiepilectics but 5 days later, a few hours after another paresthesic episodes, he developed right hemiplegia, hemianesthesia and dysartria due to an infarct of left capsular posterior limb. We deem that in this patient the paresthesic episodes were more likely an expression of a capsular warning syndrome than of parietal epilepsy because of the frontal localization of the surgical lesion, the absence of motor components in all episodes, the negativity of repeated EEG, and the lack of recurrences after stroke. In capsular warning syndrome sensory symptoms mimicking a jacksonian march can be due to ischemic depolarization progressively recruiting the somatotopically arranged sensory fibers in the posterior capsular limb.
一位 57 岁男性，八年前因左额镰状脑膜瘤接受手术治疗，现出现短暂、刻板的感觉异常发作，从右脚向上延伸到手。诊断为杰克逊氏感觉运动性癫痫发作。给予抗癫痫药物治疗，但 5 天后，在另一次感觉异常发作几小时后，由于左壳核后肢梗死导致右侧偏瘫、半身感觉缺失和构音障碍。我们认为，在这种情况下，感觉异常发作更可能是壳核警告综合征的表现，而不是顶叶癫痫，因为手术病变的部位在前额，所有发作均无运动成分，多次脑电图检查均为阴性，且中风后无复发。在壳核警告综合征中，类似于杰克逊氏感觉运动性癫痫发作的感觉症状可能是由于缺血性去极化逐渐募集壳核后肢排列有序的感觉纤维。
