Riley T L, Friedman J M
JAMA. 1981 Mar 27;245(12):1243-4.
A 75-year-old man had development of left hemiparesis after a cerebral infarction. Nine months later, he was admitted to the hospital after generalized tonic clonic convulsion. In the hospital, he had clonic movement on the left side of the body. Even after acceptable control of orthostatic hypotension, rising from supine to standing position evoked slow waves over the right hemisphere on the EEG tracing. This example of focal seizures with orthostatic hypotension shows that previously compromised cerebral tissue or vessels may be vulnerable to changes in blood pressure. We suggest that convulsive movements associated with hypotension or syncope result from cortical mechanisms rather than brainstem tonic release mechanisms.
一名75岁男性在脑梗死发生后出现左侧偏瘫。九个月后，他在全身强直阵挛性惊厥发作后入院。在医院里，他身体左侧出现阵挛运动。即使体位性低血压得到了可接受的控制，从仰卧位起身站立时，脑电图记录显示右半球出现慢波。这个伴有体位性低血压的局灶性癫痫发作的例子表明，先前受损的脑组织或血管可能对血压变化很敏感。我们认为，与低血压或晕厥相关的惊厥运动是由皮质机制而非脑干强直释放机制引起的。
