一名患有巨大蛛网膜囊肿的中年患者出现迟发性持续性部分性癫痫。
Late onset epilepsia partialis continua in a middle-aged patient with huge arachnoid cyst.
作者信息
Nasr Mohammad Javad, Zohrevand Amir Hossein, Alizadeh Khatir Ali
机构信息
Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
出版信息
Caspian J Intern Med. 2021;12(Suppl 2):S464-S466. doi: 10.22088/cjim.12.0.464.
BACKGROUND
Arachnoid cysts are congenital or acquired cerebrospinal fluid (CSF) filled intra arachnoidal lesions, included 1% of all infantile intracranial masses and were discovered incidentally in MRI or CT-scan. The vast majority of these lesions are generally asymptomatic but some patients with arachnoid cyst have headache, dizziness, seizure (or epilepsy), vestibular symptoms and cognitive impairment.
CASE PRESENTATION
We present a case of a 43-year-old woman who has late onset epilepsia partialis continua and had right spastic cerebral palsy due to huge arachnoid cyst. Surprisingly without any history of seizure, her first seizure presents with sustained seizures (epilepsia partialis continua) and occur in the middle age for the first time.
CONCLUSION
Most arachnoid cysts are asymptomatic and may not produce any symptoms throughout life. In our case, the late onset epilepsia partialis continua in the 5 decade of life with probably a large arachnoid cyst without any history of seizure before that is unusual. Conservative approaches usually made for the management of arachnoid cysts as patients with these cysts usually maintain the vital neurological functions.
背景
蛛网膜囊肿是先天性或后天性充满脑脊液（CSF）的蛛网膜内病变，占所有小儿颅内肿块的1%，通常在MRI或CT扫描时偶然发现。这些病变绝大多数通常无症状，但一些蛛网膜囊肿患者会出现头痛、头晕、癫痫发作（或癫痫）、前庭症状和认知障碍。
病例介绍
我们报告一例43岁女性患者，因巨大蛛网膜囊肿出现迟发性持续性部分性癫痫，并有右侧痉挛性脑瘫。令人惊讶的是，她没有任何癫痫发作史，首次发作表现为持续性发作（持续性部分性癫痫），且首次发作发生在中年。
结论
大多数蛛网膜囊肿无症状，可能终生不产生任何症状。在我们的病例中，50岁出现迟发性持续性部分性癫痫，且之前可能有一个大的蛛网膜囊肿但无任何癫痫发作史，这种情况并不常见。由于患有这些囊肿的患者通常保持重要的神经功能，蛛网膜囊肿的治疗通常采用保守方法。
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