Matsumoto Yoshiyasu, Akamatsu Yosuke, Ogasawara Yasushi, Aso Kenta, Oshida Sotaro, Kashimura Hiroshi
Department of Neurosurgery, Iwate Prefectural Chubu Hospital, 17-10 Murasakino, Kitakami, Iwate 024-8507, Japan.
Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
Radiol Case Rep. 2020 Apr 5;15(6):668-671. doi: 10.1016/j.radcr.2020.03.005. eCollection 2020 Jun.
Paroxysmal homonymous hemianopsia (HH) is uncommon presentation of epilepsy. We demonstrate a rare case of paroxysmal HH that was diagnosed by magnetic resonance (MR) arterial spin-labeling (ASL). A 82-year-old woman presented with abrupt onset of isolated visual field abnormality without convulsive epilepsy at 16 days after a traumatic head injury. Diffusion weighted and MR-ASL obtained on admission revealed hyperintensity and hyperperfusion in the right temporo-occipital cortex. Nonconvulsive status epilepticus was suspected. The patient was treated with oral levetiracetam and the symptoms resolved in 3 days. Paroxysmal HH should be considered in patients who present with simple partial epilepsy, and MR-ASL imaging may assist in the differential diagnosis of these patients.
阵发性同向性偏盲（HH）是癫痫的一种不常见表现。我们展示了一例罕见的阵发性HH病例，该病例通过磁共振（MR）动脉自旋标记（ASL）得以确诊。一名82岁女性在头部外伤后16天出现孤立性视野异常且无惊厥性癫痫发作。入院时进行的扩散加权成像和MR-ASL显示右侧颞枕叶皮质高信号和高灌注。怀疑为非惊厥性癫痫持续状态。该患者接受口服左乙拉西坦治疗，症状在3天内缓解。对于表现为单纯部分性癫痫的患者应考虑阵发性HH，MR-ASL成像可能有助于这些患者的鉴别诊断。
