Wong Jen-jou, Huda Saif, Wieshmann Udo Carl
Department of Psychiatry, Mersey Care NHS Trust, Liverpool, UK.
BMJ Case Rep. 2012 Sep 11;2012:bcr2012006546. doi: 10.1136/bcr-2012-006546.
A 33-year-old right-handed lady was referred to the psychiatry and neurology services by her general practitioner. Previously, she was under psychiatric care for bipolar affective disorder. Recently, her mood had deteriorated prompting the re-referral to the psychiatrists. In addition she had strange attacks. These strange attacks seemed to her like 'sensory overload' or that the 'brain just stops'. Other sensations throughout the attacks included feeling like she is in a 'fish bowl' and surrounding sights and sounds were distorted. She could not speak. After the attack she was hot and flustered, suffered memory loss and was tearful. Both the psychiatrist and the neurologist considered the possibility of these attacks being psychiatric in aetiology. However, the alternative possibility of a coexistence to epilepsy and depression was investigated and MRI demonstrated an epidermoid tumour with the supratentorial portion displacing the left temporal lobe.
一位33岁的右利手女性患者由她的全科医生转介至精神科和神经科。此前，她因双相情感障碍接受精神科治疗。近期，她的情绪恶化，促使其再次转诊至精神科医生处。此外，她还出现了奇怪的发作。对她来说，这些奇怪的发作感觉像是“感觉超载”或者“大脑突然停止运转”。发作期间的其他感觉包括感觉自己像是在一个“鱼缸”里，周围的景象和声音都变扭曲了。她无法说话。发作过后，她感到燥热、慌乱，出现记忆丧失，并且 tearful（此处英文有误，根据语境推测可能是“tearful”，意为“泪流满面”）。精神科医生和神经科医生都认为这些发作可能是精神源性病因。然而，他们也对癫痫与抑郁症并存的可能性进行了调查，磁共振成像（MRI）显示有一个表皮样肿瘤，幕上部分移位压迫左侧颞叶。
