Ming X, Kaplan P W
Division of Pediatric Neurology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.
Epilepsia. 1998 Jun;39(6):664-8. doi: 10.1111/j.1528-1157.1998.tb01436.x.
Eyelid myoclonic jerks have been described in fixation-off-sensitive (FOS) epilepsy, but their relationship to nonconvulsive status epilepticus (NCSE) or to catamenial exacerbations is little reported.
We describe a woman of normal intelligence with catamenial periods of prolonged NCSE who exhibited various intra- and interseizure thresholds of polyspike suppression when her eyes were open, with particular visual inputs and with antiepileptic drug (AED) treatment.
In one episode, on the first day of the woman's menstrual period, bursts of bilateral synchronous polyspike activity were briefly suppressed with visual fixation but were more lastingly suppressed after administration of lorazepam (LZP). During another period of NCSE, the SE was completely suppressed by visual fixation on objects and patterned checkerboard screens and by ocular convergence, was incompletely suppressed when her eyes were open in a dark room and when her eyes were open without visual fixation, but was not suppressed by mental activation alone.
FOS polyspike bursts with eyelid myoclonic jerks may exhibit catamenial exacerbations, varying from completely suppressible with visual fixation to nonsuppressible during NCSE. These findings suggest an interplay between humoral factors, AEDs, and seizure threshold in this condition.
眼睑肌阵挛性抽搐已在固定脱逸敏感（FOS）癫痫中有所描述，但它们与非惊厥性癫痫持续状态（NCSE）或经期发作加剧之间的关系鲜有报道。
我们描述了一名智力正常的女性，她患有经期延长的NCSE，在睁眼、特定视觉输入和抗癫痫药物（AED）治疗时，表现出多棘波抑制的不同发作期内和发作间期阈值。
在一次发作中，在该女性月经周期的第一天，双侧同步多棘波活动的爆发在视觉固定时短暂受到抑制，但在给予劳拉西泮（LZP）后受到更持久的抑制。在另一个NCSE时期，癫痫持续状态通过注视物体和有图案的棋盘屏幕以及眼球会聚完全得到抑制，在暗室中睁眼且无视觉固定时部分受到抑制，但仅通过精神活动不能抑制。
伴有眼睑肌阵挛性抽搐的FOS多棘波爆发可能表现为经期发作加剧，从可通过视觉固定完全抑制到在NCSE期间不可抑制。这些发现提示在这种情况下体液因素、AED和发作阈值之间存在相互作用。
