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一名年轻男孩患垂体柄阻断综合征并伴有局灶性皮质发育异常

Pituitary stalk interruption syndrome with coexistent focal cortical dysplasia in a young boy.

作者信息

Alaqili Ameena Khaled, Jadah Raafat Hammad Seroor, Alkhayyat Haya Mohammed

机构信息

Bahrain Defence Force Royal Medical Services, Riffa, Bahrain

Paediatrics, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain.

出版信息

BMJ Case Rep. 2025 Jan 14;18(1):e262020. doi: 10.1136/bcr-2024-262020.

Abstract

This case report provides details of the first documented case of pituitary stalk interruption syndrome (PSIS) with coexistent focal cortical dysplasia (FCD) in a young boy. The child's initial presentation was an afebrile, generalised tonic-clonic seizure associated with postictal drowsiness. During his first episode, the physical examination revealed a short, obese child with a micropenis and left cryptorchidism. The neurological examination was normal, suggesting possible endocrine pathology. At that time, laboratory investigations showed a normal complete blood count; electrolyte levels were normal, while the thyroid function test revealed abnormal findings indicative of secondary hypothyroidism. Based on his clinical presentation, physical examination and laboratory investigations, a brain MRI scan was performed, which showed PSIS with diffuse FCD. Subsequently, anterior pituitary gland hormone levels were measured, revealing panhypopituitarism. This discovery is novel in the literature, offers potential new insights into the pathophysiology of PSIS and emphasises the importance of considering structural brain abnormalities in PSIS patients with seizures, thereby opening new avenues for future research on their neurological consequences.

摘要

本病例报告详细介绍了一名小男孩中首例有记录的垂体柄中断综合征(PSIS)合并局灶性皮质发育异常(FCD)的病例。患儿最初表现为无发热的全身性强直阵挛发作,并伴有发作后嗜睡。在其首次发作期间,体格检查发现患儿身材矮小、肥胖,有小阴茎和左侧隐睾。神经系统检查正常,提示可能存在内分泌病理情况。当时,实验室检查显示全血细胞计数正常;电解质水平正常,而甲状腺功能检查显示异常结果,提示继发性甲状腺功能减退。根据其临床表现、体格检查和实验室检查结果,进行了脑部磁共振成像扫描,结果显示为PSIS合并弥漫性FCD。随后,检测了垂体前叶激素水平,结果显示全垂体功能减退。这一发现是文献中的新内容,为PSIS的病理生理学提供了潜在的新见解,并强调了在有癫痫发作的PSIS患者中考虑脑部结构异常的重要性,从而为未来关于其神经学后果的研究开辟了新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6efc/11751600/9bdf3e8dd27e/bcr-18-1-g001.jpg

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