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神经型布鲁氏菌病并发脑静脉窦血栓形成导致的癫痫发作失控。

Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis.

作者信息

Faraji Fardin, Didgar Farshid, Talaie-Zanjani Afsoon, Mohammadbeigi Abolfazl

机构信息

Department of Neurology, Arak University of Medical Sciences, Arak, Iran.

出版信息

J Neurosci Rural Pract. 2013 Jul;4(3):313-6. doi: 10.4103/0976-3147.118780.

Abstract

Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient's history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

摘要

脑静脉窦血栓形成是一种由脑静脉窦血栓形成引起的罕见中风形式。在本研究中,我们报告了一名患有静脉窦血栓形成和布鲁氏菌病的患者,尽管接受了高剂量抗癫痫药物治疗,但仍出现癫痫发作无法控制的情况。该病例为一名33岁女性,有复杂部分性癫痫得到控制的病史,此次出现头痛、乏力和癫痫发作无法控制达1个月。她发热,脑部CT扫描显示左后顶叶和颞叶有出血灶。磁共振成像和磁共振静脉造影也证实左横窦存在静脉窦血栓形成。此外,实验室评估确诊为布鲁氏菌病。在接受抗凝、抗布鲁氏菌病和抗癫痫药物治疗后,患者病情好转出院并遵医嘱。临床怀疑以及对患者病史的准确评估是布鲁氏菌病和脑静脉窦血栓形成诊断和治疗的最重要线索,尤其是对于既往癫痫发作得到控制但此次发作无法控制的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c898/3821421/68ea54e0d3a5/JNRP-4-313-g001.jpg

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