隐匿性边缘叶脑炎临床缓解后持续性频繁亚临床发作及记忆障碍

Persistent frequent subclinical seizures and memory impairment after clinical remission in smoldering limbic encephalitis.

作者信息

Kanazawa Kyoko, Matsumoto Riki, Shimotake Akihiro, Kinoshita Masako, Otsuka Akiko, Watanabe Osamu, Tanaka Keiko, Takahashi Ryosuke, Ikeda Akio

机构信息

Department of Neurology.

Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto.

出版信息

Epileptic Disord. 2014 Sep;16(3):312-7. doi: 10.1684/epd.2014.0664.

DOI:10.1684/epd.2014.0664

PMID:25036726

Abstract

AIM

To delineate a possible correlation between clinical course and EEG abnormalities in non-infectious "smoldering" limbic encephalitis.

METHODS

Long-term clinical data, including video-EEG monitoring records, were analysed in two patients.

RESULTS

The two patients were positive for anti-voltage-gated potassium channel complex antibody and unspecified antineuronal antibody, respectively. The latter patient had small cell lung carcinoma. Both patients had memory impairment and clinical seizures. EEG showed frequent subclinical seizure patterns in the bilateral temporal regions. Subclinical seizure patterns and memory impairment persisted over one to two years after clinical seizure remission. Therapy (prednisolone and chemoradiation in the two patients, respectively) resulted in decreased occurrence of subclinical seizure patterns and memory improvement.

CONCLUSIONS

EEG seizure patterns may persist years after clinical seizure remission in "smoldering" limbic encephalitis and lead to memory impairment.

摘要

目的

明确非感染性“隐匿性”边缘叶脑炎的临床病程与脑电图异常之间可能存在的相关性。

方法

对两名患者的长期临床数据进行分析，包括视频脑电图监测记录。

结果

两名患者分别对抗电压门控钾通道复合物抗体和未明确的抗神经元抗体呈阳性。后一名患者患有小细胞肺癌。两名患者均有记忆障碍和临床癫痫发作。脑电图显示双侧颞叶频繁出现亚临床癫痫发作模式。亚临床癫痫发作模式和记忆障碍在临床癫痫发作缓解后持续一至两年。治疗（两名患者分别使用泼尼松龙和放化疗）使亚临床癫痫发作模式的发生率降低，记忆得到改善。