Terao A, Tawara S, Takemoto Y, Nomura N, Araki S, Shirabe T
Folia Psychiatr Neurol Jpn. 1977;31(3):403-17. doi: 10.1111/j.1440-1819.1977.tb02627.x.
Two cases with partial seizure and periodic EEG pattern were reported. Case 1. A 74-year-old woman reveal typical periodic lateralized epileptiform discharges (PLED's) on the right hemisphere. The patient was semicomatous with mild jaundice and epilepsia partialis continua in the left lower limb. Postmortem examination revealed a main metastatic carcinoma of pancreas head origin in the right parietooccipital region. In the right hemisphere, the cortical structures were relatively preserved, but the white matter including the frontal lobe was swollen and its demyelinating changes were observed diffusely. The PLED's might result from an anatomical or functional severance of the cerebral cortex from normal connections with deeper structures. Case 2. A 61-year-old woman, with idiopathic hypoparathyroidism showed partial complex seizure. The EEG revealed an anterior temporal spike focus and slowing in the right hemisphere, corresponding with repetitive seizures of about one minute duration and with several minutes interval. An interictal periodic EEG pattern appeared in the right anterior and mid-temporal region. No cerebral abnormalities were found with other neurological examinations including brain scanning, carotisangiogram, and echoencephalogram. The periodic pattern was assumed as subclinical focal seizure discharges from the right anterior temporal deep structures.
报告了2例部分性癫痫发作及脑电图周期性模式的病例。病例1：一名74岁女性，右半球出现典型的周期性一侧性癫痫样放电（PLEDs）。患者呈半昏迷状态，有轻度黄疸，左下肢持续性部分性癫痫发作。尸检发现右顶枕区有起源于胰头的主要转移性癌。在右半球，皮质结构相对保存，但包括额叶在内的白质肿胀，且弥漫性观察到脱髓鞘改变。PLEDs可能是由于大脑皮质与深部结构的正常连接发生解剖学或功能性分离所致。病例2：一名61岁女性，患有特发性甲状旁腺功能减退症，表现为部分性复杂癫痫发作。脑电图显示右半球前颞叶有尖波灶及慢波，与持续约1分钟、间隔几分钟的重复性癫痫发作相对应。发作间期周期性脑电图模式出现在右前颞叶和颞中区。包括脑部扫描、颈动脉血管造影和脑回波描记术在内的其他神经学检查未发现脑部异常。该周期性模式被认为是来自右前颞叶深部结构的亚临床局灶性癫痫放电。
