Pasini Elena, Provini Federica, Michelucci Roberto
IRCCS Instituto delle Scienze Neurologiche di Bologna, UOC Neurologia Ospedale Maggiore, Bologna, Italia.
IRCCS Instituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italia.
BMJ Case Rep. 2018 Aug 23;2018:bcr-2018-225238. doi: 10.1136/bcr-2018-225238.
A 61-year-old woman affected by nocturnal hypermotor seizures since the age of 2 years complained of epigastric discomfort and chocking sensation before seizure onset for the last 25 years. Telemetry unit monitoring revealed several focal seizures with left frontotemporal onset complicated with ictal asystole and apnoea. After pacemaker (PM) implantation, video-EEG monitoring coupled with extensive respiratory montage confirmed the presence of ictal central apnoea. Despite this huge ictal autonomic imbalance which is claimed to be a risk factor for sudden unexpected death in epilepsy, the patient had a 25-year history of similar seizures, questioning the need to perform PM implantation and assisted ventilation.
一名自2岁起就患有夜间运动性癫痫的61岁女性，在过去25年中，每次癫痫发作前都会出现上腹部不适和哽咽感。遥测单元监测显示有几次局灶性癫痫发作，起始于左侧额颞叶，并发发作期心搏停止和呼吸暂停。植入起搏器（PM）后，视频脑电图监测结合广泛的呼吸监测证实了发作期中枢性呼吸暂停的存在。尽管这种巨大的发作期自主神经失衡被认为是癫痫患者意外猝死的一个危险因素，但该患者有25年类似癫痫发作的病史，这让人质疑是否有必要植入起搏器和进行辅助通气。
