Terzano M G, Parrino L, Mazzucchi A, Moretti G
Epilepsia. 1986 Jul-Aug;27(4):446-57. doi: 10.1111/j.1528-1157.1986.tb03566.x.
The histories of seven patients over the age of 60 years are reported. They all suffered from recurrent and prolonged episodes of confusional state associated with psychic and neurologic manifestations. All episodes were accompanied by the occurrence of periodic lateralized epileptiform discharges (PLEDs) on the EEG, which became normal when the ictal episodes subsided either spontaneously or after administration of diazepam i.v. Although PLEDs may correspond to severe hemispheric lesions, serial computed tomography (CT) scan and laboratory investigations detected significant abnormalities in only one case, that of a patient with a progressive dementing outcome. In the other six patients, follow-up neuropsychological controls indicated moderate impairment of higher cortical functions according to the hemisphere involved by PLEDs. Administration of carbamazepine (CBZ) proved rather effective in preventing the recurrence of the ictal episodes. For its clinical, EEG, and prognostic features, this condition may represent a peculiar nonconvulsive status epilepticus in the elderly.
报告了7例60岁以上患者的病史。他们均患有与精神和神经表现相关的反复且持续时间较长的意识模糊状态发作。所有发作均伴有脑电图上周期性一侧性癫痫样放电（PLEDs）的出现，当发作性事件自发缓解或静脉注射地西泮后缓解时，脑电图恢复正常。尽管PLEDs可能与严重的半球病变相对应，但连续计算机断层扫描（CT）和实验室检查仅在1例患者中发现了明显异常，该患者有进行性痴呆结局。在其他6例患者中，随访神经心理学检查表明，根据PLEDs所累及的半球，高级皮质功能有中度损害。卡马西平（CBZ）给药在预防发作性事件复发方面相当有效。就其临床、脑电图和预后特征而言，这种情况可能代表老年人一种特殊的非惊厥性癫痫持续状态。
