Reis J J, Kaplan P W
Johns Hopkins Bayview Medical Center, Department of Neurology, Baltimore, MD 21224, USA.
Seizure. 1998 Aug;7(4):337-9. doi: 10.1016/s1059-1311(98)80029-0.
Non-traumatic stereotyped postictal purpura is rare. A 25-year-old woman presented with right facial, cheek and periorbital purpuric eruptions that occurred after secondarily generalized tonic-clonic seizures. The stereotyped, invariably right-sided facial skin eruption, which resolved in 48 hours, falsely raised concerns of spousal abuse. Possible pathophysiological mechanisms include: (a) valsalva-induced capillary hypertension with secondary purpura, (b) ictal corticolimbic stimulation of the autonomic nervous innervation of facial vasomotor structures, and (c) trigeminal-mediated local release of vasoactive substances. Although rare, such stereotyped patterns of purpura should be recognized to avoid incorrect attribution of spousal abuse.
非创伤性刻板性发作后紫癜很罕见。一名25岁女性在继发全面性强直阵挛发作后出现右侧面部、脸颊及眶周紫癜性皮疹。这种刻板性、总是出现在右侧面部的皮肤皮疹在48小时内消退，引发了对配偶虐待的错误担忧。可能的病理生理机制包括：(a) 瓦尔萨尔瓦动作诱发的毛细血管高血压伴继发性紫癜；(b) 发作期皮质边缘系统对面部血管运动结构自主神经支配的刺激；(c) 三叉神经介导的血管活性物质局部释放。尽管罕见，但应认识到这种刻板性紫癜模式以避免对配偶虐待的错误归因。
