Sanada Yuki, Kajikawa Shunsuke, Kobayashi Katsuya, Kuzuya Akira, Matsumoto Riki, Ikeda Akio, Takahashi Ryosuke
Department of Neurology, Kyoto University Graduate School of Medicine.
Division of neurology, Kobe University Graduate School of Medicine.
Rinsho Shinkeigaku. 2021 Jun 29;61(6):385-391. doi: 10.5692/clinicalneurol.cn-001560. Epub 2021 May 20.
A 66 year-old right-handed female was admitted to our hospital presenting with recurrent episodes of catatonic symptoms consisting of stupor, waxy flexibility, and catalepsy lasting about 5-20 minutes. A brain MRI showed no significant abnormalities. An scalp-electroencephalography (EEG) concurrent with the symptoms showed ictal EEG activities arising from the left fronto-central area, which evolved into the bilateral frontal and bilateral parietal areas together. An F-fluorodeoxy glucose positron emission tomography (F-FDG-PET) 4 days after improvement of the symptoms showed hypermetabolism in the bilateral frontal and parietal lobes. Her catatonic symptoms are assumed to be due to non-convulsive status epilepticus (NCSE), namely ictal catatonia. The introduction of several anti-epileptic drugs improved the symptoms and normalized the EEG and FDG-PET findings. NCSE must be considered as one of the underlying state of catatonic symptoms because the treatment plan for acute and chronic state is different from that of catatonic syndrome due to psychiatric disorders.
一名66岁右利手女性因反复出现紧张症症状入院,症状包括木僵、蜡样屈曲和僵住,持续约5至20分钟。脑部MRI未显示明显异常。症状发作时同步进行的头皮脑电图(EEG)显示,发作期EEG活动起源于左侧额中央区,并同时扩展至双侧额叶和双侧顶叶。症状改善4天后进行的F-氟脱氧葡萄糖正电子发射断层扫描(F-FDG-PET)显示双侧额叶和顶叶代谢亢进。她的紧张症症状被认为是由非惊厥性癫痫持续状态(NCSE),即发作性紧张症引起的。使用几种抗癫痫药物后症状得到改善,EEG和FDG-PET结果恢复正常。必须将NCSE视为紧张症症状的潜在病因之一,因为急性和慢性状态的治疗方案与精神障碍所致紧张症综合征的治疗方案不同。