Kobayashi Yoshiyuki, Ishikawa Nobutsune, Tani Hiroo, Fujii Yuji, Kobayashi Masao
Department of Pediatrics, Hiroshima University Hospital, Hiroshima, Japan.
Neuropediatrics. 2017 Apr;48(2):119-122. doi: 10.1055/s-0037-1598111. Epub 2017 Jan 23.
Eating epilepsy (EE) is a rare form of reflex epilepsy in which seizures are induced by eating. It is known that most patients with eating seizures, in fact, suffer from symptomatic temporal lobe epilepsy (TLE), whereas only a few patients with epileptic spasms induced by eating (E-ES) have been reported. The patient was an 8-year-old girl whose magnetic resonance imaging (MRI) of the head detected dysgenesis of the corpus callosum, cerebellar hypogenesis, marked cerebral asymmetry, broad polymicrogyria, periventricular heterotopia, and closed lip-type schizencephaly. She experienced E-ES as the second form of recurrent seizures after the first recurrence of spontaneous ES. After E-ES occurred, the EEG findings in the right hemisphere, predominantly over the right centrotemporal region, were clearly exacerbated, although the interictal EEG originally showed left-side-dominant asymmetric hypsarrhythmia. The ictal EEG of the E-ES showed diffuse large triphasic (negative-positive-negative) potentials, predominantly over the right centrotemporoparietal region. This is a unique case because the E-ES were recurrent ES, although the previous ES were spontaneous, which may provide insight into the mechanism of E-ES.
饮食性癫痫(EE)是一种罕见的反射性癫痫,其发作由进食诱发。已知大多数有饮食性发作的患者实际上患有症状性颞叶癫痫(TLE),而仅有少数由进食诱发癫痫性痉挛(E-ES)的患者被报道。该患者为一名8岁女孩,其头部磁共振成像(MRI)检测到胼胝体发育不全、小脑发育不全、明显的大脑不对称、广泛多小脑回、脑室周围异位和闭合唇型脑裂畸形。她在首次自发性癫痫性痉挛复发后,经历了E-ES作为复发性发作的第二种形式。E-ES发作后,尽管发作间期脑电图最初显示左侧为主的不对称高度失律,但右半球(主要是右侧中央颞区)的脑电图结果明显加重。E-ES的发作期脑电图显示弥漫性大三相(负-正-负)电位,主要分布在右侧中央颞顶区。这是一个独特的病例,因为E-ES是复发性癫痫性痉挛,尽管之前的癫痫性痉挛是自发性的,这可能为E-ES的机制提供见解。