促肾上腺皮质激素治疗学龄期男孩时出现局灶性癫痫发作：病例报告。
Focal seizures during adrenocorticotropic hormone therapy in a school-aged boy: a case report.
机构信息
Department of Pediatrics, Hirakata Municipal Hospital, Hirakata, Osaka, Japan.
Department of Pediatrics, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
出版信息
J Med Case Rep. 2022 May 24;16(1):200. doi: 10.1186/s13256-022-03429-0.
BACKGROUND
Adrenocorticotropic hormone therapy for infantile spasms, including West syndrome, has been previously reported to induce seizures. We present the findings for a school-aged child with epilepsy who developed new focal seizures during adrenocorticotropic hormone therapy.
CASE PRESENTATION
The Japanese patient had posttraumatic epilepsy and developed intractable focal seizures at the age of 13 years. Adrenocorticotropic hormone therapy was administered when the patient was 14 years of age. On day 10 of treatment, he developed new focal seizures, which were characterized by left arm contractions followed by movements of touching things with his right hand and writhing and rocking his body left and right and back and forth as automatisms. The focal seizures clustered for 40 minutes and disappeared after suppository administration of 10 mg diazepam. These focal seizures did not reoccur after more than 2 years of follow-up.
CONCLUSION
Adrenocorticotropic hormone-induced seizures can occur in children older than previously reported, and can occur in children with intractable seizures other than epileptic spasms.
背景
促肾上腺皮质激素治疗婴儿痉挛症（包括 West 综合征）以前曾有报道会诱发癫痫发作。我们报告了一例患有癫痫的学龄儿童在接受促肾上腺皮质激素治疗期间出现新的局灶性癫痫发作的情况。
病例介绍
这位日本患者有外伤性癫痫，13 岁时出现难治性局灶性癫痫发作。当患者 14 岁时，给予了促肾上腺皮质激素治疗。在治疗的第 10 天，他出现了新的局灶性癫痫发作，表现为左臂抽搐，随后右手触摸东西，身体左右扭动、前后摇晃，呈自动症。局灶性癫痫发作持续了 40 分钟，在直肠给予 10mg 地西泮后消失。在超过 2 年的随访中，这些局灶性癫痫发作没有再发作。
结论
促肾上腺皮质激素诱发的癫痫发作可发生在年龄大于以往报道的儿童中，也可发生在除癫痫痉挛以外的难治性癫痫儿童中。
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