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一名新发难治性癫痫持续状态(NORSE)患者出现可逆性胼胝体压部病变。

Reversible splenial lesion in a patient with new-onset refractory status epilepticus (NORSE).

作者信息

Mizutani Akane Unno, Shindo Akihiro, Arikawa Shigeo, Shimada Takuya, Matsuura Keita, Ikejiri Kaoru, Suzuki Kei, Imai Hiroshi, Tomimoto Hidekazu

机构信息

Department of Neurology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.

Mie University Hospital, Emergency and Critical Care Center, Tsu, Mie, Japan.

出版信息

eNeurologicalSci. 2019 Dec 24;18:100220. doi: 10.1016/j.ensci.2019.100220. eCollection 2020 Mar.

Abstract

New-onset refractory status epilepticus (NORSE) is a rare neurological emergency condition with poor prognosis. A 30-year-old male suddenly had tonic-clonic convulsions seven days after a preceding fever and diarrhea. MRI showed a reversible splenial lesion, and he developed refractory multifocal and generalized seizures in spite of anticonvulsant medication. He was diagnosed with NORSE and received a combination treatment with immunotherapy and targeted temperature management (TTM), which effectively decreased his seizures. This case suggests that even for patients with reversible splenial lesions, NORSE should be considered, and that treatment with immunotherapy and TTM may be effective.

摘要

新发难治性癫痫持续状态(NORSE)是一种预后较差的罕见神经系统急症。一名30岁男性在先前发热和腹泻7天后突然出现强直阵挛性惊厥。磁共振成像(MRI)显示可逆性胼胝体压部病变,尽管使用了抗惊厥药物,他仍出现难治性多灶性和全身性癫痫发作。他被诊断为NORSE,并接受了免疫治疗和靶向体温管理(TTM)的联合治疗,这有效地减少了他的癫痫发作。该病例表明,即使对于有可逆性胼胝体压部病变的患者,也应考虑NORSE,并且免疫治疗和TTM可能有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9815/6938895/b7108f441427/gr1.jpg

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