Vanhaesebrouck An E, Posch Barbara, Baker Sam, Plessas Ioannis N, Palmer Anthony C, Constantino-Casas Fernando
Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
J Feline Med Surg. 2012 Dec;14(12):932-7. doi: 10.1177/1098612X12454419. Epub 2012 Jul 11.
A 14-year-old male domestic shorthair cat presented with an acute onset of aggressive behaviour, fear and hypersalivation. Neurological examination revealed bilateral mydriasis and left-sided facial twitching and hemiparesis. Magnetic resonance imaging (MRI) showed moderate bilateral symmetrical T2-hyperintensity along the entire hippocampus and bilateral asymmetric T2-hyperintensity in the pyriform lobes. Marked bilateral contrast enhancement of the hippocampus was evident on post-contrast T1-weighted images. The partial complex seizures were refractory to medical treatment and the cat was euthanased 4 days after admission. The clinical and MRI findings were consistent with feline hippocampal necrosis (FHN). On histopathology, neuronal necrosis and astrocytosis were present in the hippocampi and pyriform lobes. In addition, an oligodendroglioma was detected in the right pyriform lobe. Contrary to previous reports of FHN in which no underlying cause could be identified, we believe that in this case the seizure focus arose from a neoplastic lesion within the right pyriform lobe. This unique case report represents the so-called 'dual pathology' of temporal lobe epilepsy in humans, in which an extrahippocampal lesion within the temporal lobe results in hippocampal sclerosis.
一只14岁的雄性家养短毛猫出现攻击行为、恐惧和流涎增多的急性发作。神经学检查发现双侧瞳孔散大、左侧面部抽搐和偏瘫。磁共振成像（MRI）显示双侧海马体沿全长呈中度对称性T2高信号，梨状叶双侧不对称T2高信号。增强后T1加权图像上可见海马体明显的双侧对比增强。部分复杂性癫痫发作对药物治疗无效，该猫在入院4天后实施安乐死。临床和MRI表现与猫海马坏死（FHN）一致。组织病理学检查显示，海马体和梨状叶存在神经元坏死和星形细胞增生。此外，在右侧梨状叶检测到一个少突胶质细胞瘤。与之前报道的无法确定潜在病因的FHN病例不同，我们认为在该病例中，癫痫病灶源于右侧梨状叶内的肿瘤性病变。这一独特的病例报告代表了人类颞叶癫痫中所谓的“双重病理”，即颞叶内海马体外病变导致海马硬化。
