脑淀粉样血管病相关性炎症所致的癫痫持续状态

Status epilepticus caused by cerebral amyloid angiopathy-related inflammation.

作者信息

Tolchin Benjamin, Fantaneanu Tadeau, Miller Michael, Helgager Jeffrey, Lee Jong Woo

机构信息

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States.

Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States.

出版信息

Epilepsy Behav Case Rep. 2016 Jun 4;6:19-22. doi: 10.1016/j.ebcr.2016.05.003. eCollection 2016.

DOI:10.1016/j.ebcr.2016.05.003

PMID:27408804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4925902/

Abstract

This report discusses a case of nonconvulsive status epilepticus, caused by cerebral amyloid angiopathy-related inflammation. Brain biopsy demonstrated cerebral amyloid angiopathy, with clinical and radiographic features indicative of a fluctuating inflammatory process. Immunomodulatory treatment with pulse steroids resulted in rapid and dramatic clinical and radiographic improvement. Cerebral amyloid angiopathy-related inflammation should be considered in the differential diagnosis of new-onset seizures after the age of 40, when associated with fluctuating multifocal T2 hyperintensities and petechial hemorrhages on gradient echo (GRE) or susceptibility-weighted (SWI) MRI sequences.

摘要

本报告讨论了一例由脑淀粉样血管病相关炎症引起的非惊厥性癫痫持续状态。脑活检显示为脑淀粉样血管病，其临床和影像学特征提示存在波动的炎症过程。脉冲类固醇免疫调节治疗导致临床和影像学迅速且显著改善。40岁以后新发癫痫发作，伴有梯度回波（GRE）或磁敏感加权（SWI）MRI序列上波动的多灶性T2高信号和瘀点出血时，在鉴别诊断中应考虑脑淀粉样血管病相关炎症。