Institute for Mother and Child Health, University of Belgrade, 6-8 Radoje Dakic Street, 11070 Belgrade, Serbia.
Neurol Sci. 2011 Dec;32(6):1007-12. doi: 10.1007/s10072-010-0442-y. Epub 2010 Oct 30.
Various inflammatory diseases of central nervous system, including subacute sclerosing panencephalitis, could cause epilepsia partialis continua. Two boys with epilepsia partialis continua with onset in terminal phase of atypical subacute sclerosing panencephalitis have been reported. Children were not vaccinated against measles, and the second case had history of measles at an early age. In both cases, the onset of subacute sclerosing panencephalitis was characterized by altered behavior and cognitive decline with very fast mental and neurological deterioration. One boy was suffering from complex partial seizures and myoclonic jerks synchronous with periodic electroencephalographic pattern. Diagnosis was proved by increased titers of antimeasles antibodies in both serum and cerebrospinal fluid. In terminal phase of the disease, epilepsia partialis continua of localized group of the muscles was diagnosed, with good response to intravenous infusion of midazolam. Surface electroencephalographic recordings during epilepsia partialis continua did not show the epileptic discharges. During the terminal phase of the disease, no other type of seizures and movement disorders were recognized, except epilepsia partialis continua. In spite of the treatment, period from the onset of disease to death lasted less than 3 months, suggesting very fulminant course of subacute sclerosing panencephalitis.
各种中枢神经系统炎症性疾病,包括亚急性硬化性全脑炎,都可能导致部分性癫痫持续状态。有两例亚急性硬化性全脑炎终末期起病的部分性癫痫持续状态患儿被报道。两名患儿均未接种麻疹疫苗,其中第二例患儿幼年时曾患麻疹。在这两例中,亚急性硬化性全脑炎的起病特征均为行为改变和认知能力下降,伴有非常迅速的精神和神经功能恶化。一名患儿患有复杂部分性癫痫发作和肌阵挛性抽搐,伴有周期性脑电图模式。血清和脑脊液中抗麻疹抗体滴度升高证实了这一诊断。在疾病的终末期,诊断为局灶性肌肉部分性癫痫持续状态,咪达唑仑静脉输注有良好的反应。部分性癫痫持续状态期间的表面脑电图记录未显示癫痫放电。在疾病的终末期,除了部分性癫痫持续状态外,未识别出其他类型的癫痫发作和运动障碍。尽管进行了治疗,但从发病到死亡的时间不到 3 个月,提示亚急性硬化性全脑炎的病程非常迅猛。