Yanagisawa Kiichi, Saito Takuya, Ishii Tatsuhito, Sato Keishiro, Homma Kazunari, Kondo Yoshiyuki
Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.
NMC Case Rep J. 2024 Dec 25;11:407-411. doi: 10.2176/jns-nmc.2024-0181. eCollection 2024.
We report a case of persistent consciousness disturbance due to non-convulsive status epilepticus (NCSE) following a successful mechanical thrombectomy (MT). A 98-year-old female with atrial fibrillation presented with impaired consciousness and right hemiparesis 6 hrs after her last known well state. Magnetic resonance angiography revealed occlusion of the left internal carotid artery, necessitating MT to achieve complete recanalisation. Following admission, her consciousness showed no signs of improvement, and electroencephalography (EEG) revealed NCSE as the underlying cause. Levetiracetam treatment led to improvement in both clinical symptoms and EEG findings. This case highlights the importance of prompt diagnosis and management of NCSE in patients with ischaemic stroke who have persistent consciousness disturbance even after MT.
我们报告了一例成功进行机械取栓术(MT)后因非惊厥性癫痫持续状态(NCSE)导致的持续性意识障碍病例。一名98岁的房颤女性在最后一次已知状态良好6小时后出现意识障碍和右侧偏瘫。磁共振血管造影显示左侧颈内动脉闭塞,需要进行MT以实现完全再通。入院后,她的意识没有改善迹象,脑电图(EEG)显示NCSE是根本原因。左乙拉西坦治疗使临床症状和EEG结果均得到改善。该病例强调了对于即使在MT后仍有持续性意识障碍的缺血性中风患者,及时诊断和处理NCSE的重要性。