重症肌无力患者癫痫的治疗：真的比看上去更难吗？

Treatment of epilepsy in patients with myasthenia gravis: Is really harder than it looks?

作者信息

Lorenzoni Paulo José, Ducci Renata Dal-Prá, Tensini Tallulah Spina, Dalledone Giuliano, Kay Claudia Suemi Kamoi, de Paola Luciano, Werneck Lineu Cesar, Scola Rosana Herminia, Silvado Carlos

机构信息

Division of Neurology, Department of Internal Medicine, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.

出版信息

J Clin Neurosci. 2017 Oct;44:353-356. doi: 10.1016/j.jocn.2017.06.067. Epub 2017 Jul 29.

DOI:10.1016/j.jocn.2017.06.067

PMID:28765064

Abstract

The relationship between myasthenia gravis (MG) and epilepsy has been rarely reported. As consequence, there are no specific guidelines for the management of these conditions when they mutually occur. We reported on three patients in whom epilepsy and MG are coexisting, but in different clinical settings. Two patients were treated with antiepileptic drugs which improved their symptoms. One patient has controlled the seizures after a successful anterior temporal lobectomy with no appreciable consequences to her MG. We discuss the difficulties in the management of epilepsy in patients with MG. In addition, we report on the first epileptic surgery in a MG patient, indicating that this surgical procedure as a safe option for the treatment of intractable epilepsy in patients with MG.

摘要

重症肌无力（MG）与癫痫之间的关系鲜有报道。因此，当这两种疾病同时出现时，尚无针对其治疗的具体指南。我们报告了三例癫痫与MG共存但临床情况不同的患者。两名患者接受抗癫痫药物治疗后症状改善。一名患者在成功进行前颞叶切除术后癫痫发作得到控制，且对其MG无明显影响。我们讨论了MG患者癫痫治疗中的困难。此外，我们报告了首例MG患者的癫痫手术，表明该手术是治疗MG患者顽固性癫痫的一种安全选择。