使用动脉自旋标记磁共振成像识别伴有言语迟缓的非惊厥性癫痫持续状态。
Identification of non-convulsive status epilepticus with bradylalia using arterial spin-labeling magnetic resonance imaging.
作者信息
Yamamoto Shuzo, Mutoh Tatsushi, Tatewaki Yasuko, Tsurutani Hisanobu, Watabe Noriaki, Saito Hiroshi, Yasui Nobuyuki, Taki Yasuyuki
机构信息
Department of Nuclear Medicine and Radiology Institute of Development, Aging and Cancer Tohoku University Aoba-kuSendai Japan.
Department of Neurosurgery Sendai East Neurosurgical Hospital Miyagino-ku, Sendai Japan.
出版信息
Acute Med Surg. 2018 Sep 23;6(1):73-77. doi: 10.1002/ams2.369. eCollection 2019 Jan.
CASE
Non-convulsive status epilepticus (NCSE) is among the differential diagnoses of decreased consciousness, but often presents a diagnostic challenge. A 65-year-old woman was admitted to our emergency department with bradylalia. No abnormal finding was detected by computed tomography or magnetic resonance imaging. Subsequently, acquired arterial spin-labeling images showed hyperperfusion in the right hemisphere.
OUTCOME
After the examination, the patient began experiencing left hemifacial seizures, which were relieved by diazepam; however, she was still agitated. Ictal confusion due to NCSE was suspected. Electroencephalography revealed periodic, generalized epileptiform activities with brief seizures of facial muscles by intermittent photic stimulation. Another supportive case of NCSE detected by arterial spin-labeling from a 56-year-old right-handed man has also been presented.
CONCLUSION
Arterial spin-labeling magnetic resonance perfusion imaging provides valuable information regarding cerebral perfusion status in NCSE patients in emergency/acute settings.
病例
非惊厥性癫痫持续状态（NCSE）是意识减退的鉴别诊断之一，但常常带来诊断挑战。一名65岁女性因言语缓慢入住我院急诊科。计算机断层扫描或磁共振成像未发现异常。随后，动脉自旋标记成像显示右半球血流灌注增加。
结果
检查后，患者开始出现左侧面部癫痫发作，地西泮可缓解；然而，她仍烦躁不安。怀疑是NCSE所致的发作期意识模糊。脑电图显示有周期性、全身性癫痫样活动，间歇性光刺激可诱发面部肌肉短暂发作。还介绍了另一例通过动脉自旋标记检测到的NCSE支持病例，患者为一名56岁右利手男性。
结论
动脉自旋标记磁共振灌注成像可为急诊/急性期NCSE患者的脑灌注状态提供有价值的信息。
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