Department of Neurology, Myongji Hospital, Kwandong University College of Medicine, Republic of Korea.
Epilepsy Behav. 2012 Jan;23(1):71-3. doi: 10.1016/j.yebeh.2011.08.043. Epub 2011 Nov 18.
Epilepsia partialis continua (EPC) is clinically defined as a syndrome of continuous focal jerking of a body part, usually a distal limb, occurring over hours, days, or even years. It is considered the status epilepticus equivalent of simple partial motor seizures. A 48-year-old right-handed man with a history of traumatic intracranial hemorrhage was admitted for right-sided hemiplegia and drowsiness after complex partial status epilepticus. An EEG showed periodic lateralized epileptiform discharges over the left hemisphere. Brain MRI revealed extensive multifocal encephalomalaciac changes in the left temporo-parieto-occpital lobe and both frontal lobes with some hemorrhagic residual change. After administration of a loading dose of intravenous phenytoin, his mental status returned to normal. However, his weakness only partially improved. [(18)F]Fluorodeoxyglucose PET (FDG-PET) demonstrated severe hypometabolism in the left cerebral hemisphere, including the basal ganglia and thalamus, with cerebellar diaschisis. At the 3-month follow-up, he complained of symptoms of alien hand phenomenon. Follow-up MRI revealed more extensive encephalomalaciac changes in previously noted regions with thinning of the posterior end of the body of the corpus callosum. Moreover, FDG-PET demonstrated persistent severe hypometabolism over the left cerebral hemisphere. We suggest that the alien hand phenomenon was a result of thinning of the corpus callosum related to EPC.
部分连续性癫痫(EPC)在临床上定义为身体部位(通常是远端肢体)持续出现局灶性抽搐的综合征,持续数小时、数天甚至数年。它被认为是简单部分运动性癫痫持续状态的癫痫持续状态等效物。一位 48 岁的右利手男性,因复杂部分性癫痫持续状态后出现右侧偏瘫和嗜睡而入院。脑电图显示左侧半球有周期性偏侧癫痫样放电。脑 MRI 显示左颞顶枕叶和双侧额叶广泛多灶性脑软化改变,伴有一些出血性残留改变。静脉注射苯妥英钠负荷剂量后,他的精神状态恢复正常。然而,他的无力仅部分改善。[(18)F]氟脱氧葡萄糖 PET(FDG-PET)显示左侧大脑半球严重代谢低下,包括基底节和丘脑,伴有小脑去神经支配。在 3 个月的随访中,他出现了异手现象的症状。随访 MRI 显示以前注意到的区域有更多的脑软化改变,胼胝体体后部变薄。此外,FDG-PET 显示左侧大脑半球持续存在严重的代谢低下。我们认为,异手现象是 EPC 相关的胼胝体变薄的结果。