Sirbu Carmen Adella, Stefani Constantin, Mitrică Marian, Toma Gabriela Simona, Ranetti Aurelian Emil, Docu-Axelerad Any, Manole Aida Mihaela, Stefan Ion
Department of Neurology, 'Dr. Carol Davila' Central Military Emergency University Hospital, 010242 Bucharest, Romania.
Department No. 5, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Diagnostics (Basel). 2022 Aug 4;12(8):1888. doi: 10.3390/diagnostics12081888.
Some neurotropic viruses induce specific lesions in the deep structures, such as basal ganglia and thalamus. These anatomical structures play an important role in initiating and maintaining different types of epileptic seizures. We present the case of a 25-year-old male, transferred to our clinic one week after the onset of the symptomatology, with a recent history of traveling to Turkey and Egypt. At the moment of his hospital admission, his symptoms included altered consciousness, agitation, and seizures. Shortly after, his state worsened, requiring intubation. Viral tick-borne encephalitis diagnoses were favored by the CSF (cerebrospinal fluid) analysis, EEG (Electroencephalography), MRI (magnetic resonance imaging) images presenting symmetric hyper signal in the basal ganglia, and IgM antibodies for anti-tick-borne encephalitis. These lesions persisted for several weeks, and the patient's seizures were polymorphic, originally generalized onset motor, generalized onset non-motor, and focal myoclonic. The patient achieved his independence, seizures decreasing both in intensity and frequency; the MRI images became almost normal. The reduction in antiepileptic doses was not followed by seizure recurrence.
一些嗜神经性病毒会在深部结构，如基底神经节和丘脑诱发特定病变。这些解剖结构在引发和维持不同类型的癫痫发作中起重要作用。我们报告一例25岁男性病例，在症状出现一周后转至我院，近期有前往土耳其和埃及旅行史。入院时，他的症状包括意识改变、躁动和癫痫发作。不久后，他的病情恶化，需要插管。脑脊液（CSF）分析、脑电图（EEG）、磁共振成像（MRI）图像显示基底神经节对称高信号以及抗蜱传脑炎IgM抗体，这些结果支持蜱传病毒性脑炎的诊断。这些病变持续了数周，患者的癫痫发作形式多样，最初为全面性发作运动性、全面性发作非运动性和局灶性肌阵挛性发作。患者恢复了自理能力，癫痫发作的强度和频率均降低；MRI图像几乎恢复正常。减少抗癫痫药物剂量后未出现癫痫复发。
