Kurauchi Yoshinori, Yasaka Masahiro, Tokunaga Keisuke, Saito Masaki, Shimohama Shun, Okada Yasushi
Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center.
Brain Nerve. 2017 Apr;69(4):489-492. doi: 10.11477/mf.1416200769.
We report the case of a 67-year-old woman with non-convulsive status epilepticus (NCSE) due to hyponatremia. She had a history of psychogenic polydipsia but not epilepsy. She was admitted to our hospital with dysbulia. On admission, she was confused and disoriented (Glasgow Coma Scale: 6, E1V1M4). Magnetic resonance imaging of the brain showed no abnormalities. Laboratory test showed hyponatremia (Na level: 115 mEq/L). The electroencephalography (EEG) showed a generalized slow wave of 5 Hz during recording. The slow wave was promptly suppressed by diazepam and levetiracetam administered intravenously and orally, respectively. After the hyponatremia was treated the seizures stopped and did not reoccur, even after cessation of the anticonvulsant drugs. The patient was discharged with no neurological deficits. Few reports have described this condition. Here we discuss the diagnosis and treatment of NCSE due to hyponatremia. (Received May 31, 2016; Accepted December 12, 2016; Published April 1, 2017).
我们报告了一例因低钠血症导致非惊厥性癫痫持续状态(NCSE)的67岁女性病例。她有精神性烦渴病史,但无癫痫病史。她因吞咽困难入住我院。入院时,她意识模糊、定向障碍(格拉斯哥昏迷量表评分:6分,E1V1M4)。脑部磁共振成像未显示异常。实验室检查显示低钠血症(钠水平:115 mEq/L)。脑电图(EEG)记录期间显示5 Hz的广泛性慢波。静脉注射地西泮和口服左乙拉西坦后,慢波迅速被抑制。低钠血症得到治疗后,癫痫发作停止,即使在停用抗惊厥药物后也未复发。患者出院时无神经功能缺损。很少有报告描述这种情况。在此我们讨论低钠血症所致NCSE的诊断和治疗。(2016年5月31日收到;2016年12月12日接受;2017年4月1日发表)