Rehabilitation Center, Jichi Medical University, Japan.
Division of Neurology, Department of Medicine, Jichi Medical University, Japan.
Intern Med. 2021 Apr 1;60(7):1089-1094. doi: 10.2169/internalmedicine.5175-20. Epub 2020 Oct 28.
A 43-year-old man with a preceding infection was transferred to our hospital for febrile status epilepticus (SE). Although treatment for SE was immediately initiated, it failed. Therefore, continuous anesthetics treatment with mechanical ventilation was initiated. No epileptic discharge was found on an electroencephalogram. However, total aphasia and right hemiplegia due to left hemispheric swelling were noted on day 5. His aphasia and hemiplegia did not improve. The mechanism underlying the hemispheric involvement remains unclear. The initial diagnosis should be made with care in patients with febrile SE; furthermore, intensive treatment should be administered in the acute phase.
一位 43 岁的男性患者,既往有感染史,因发热性癫痫持续状态(SE)转入我院。尽管立即开始了 SE 的治疗,但治疗失败。因此,开始进行持续麻醉治疗并机械通气。脑电图未发现癫痫放电。然而,在第 5 天,患者出现因左半球肿胀导致的完全失语和右侧偏瘫。他的失语和偏瘫没有改善。半球受累的机制尚不清楚。在发热性 SE 患者中,初始诊断应谨慎进行;此外,在急性期应给予强化治疗。