髄膜脳炎に続発したてんかんの検討 An Analysis of Epilepsies Following Meningo-encephalitis
髄膜脳炎を既往歴に持つ147人のてんかん例を分析した. 147例の内で, 複雑部分発作と脳波上の側頭部焦点を持つ43症例をTLE群, TLE群を除いた局在関連てんかんの60症例をnon-TLE群, 22例の症候性潜因性全般てんかんをSGE群とし, この3群を比較した. その結果, (1) 髄膜脳炎によってもたらされた病巣の大きさは, TLE群, non-TLE群, SGE群の順に大きい, (2) TLE群, non-TLE群, SGE群の順に髄膜脳炎からてんかん発作発症までの潜伏期間が長い, (3) 辺縁系関連前兆の内, elaboratesensationはTLE群とnon-TLE群で頻度がほぼ同じなのに対して, crudesensationはTLE群で多い. (4) TLE群では, non-TLE群と比較して幻覚・妄想状態の発現率が高いなどの諸点が明らかになった.
We analysed 147 patients with epilepsy following meningo-encephalitis. Among them, there were forty three cases with temporal lobe epilepsy (TLE group), sixty cases with non-TLE localization-related epilepsy (non-TLE group), and twenty two cases with symptomatic generalized epilepsy (SGE group) who were selected and compared. The latent period between the onset of meningo-encephalitis and the onset of epilepsy was the longest in the TLE-group and the shortest in the SGE -group. The high incidence of crude limbic sensation and the low incidence of elaborate limbic sensations were salient features of the TLE caused by meningo -encephalitis. Episodes of delusory-hallucinatory experiences were reported more frequently in the TLE-group than in the non-TLE-group. The low incidence of mental retardation as well as hemiparesis in the TLE-group, together with radiological findings, suggested a confined nature of the brain damage. We speculated that extended damage to the brain lead to a symptomatic generalized epilepsy while a confined one was associated with TLE. We postulated also that temporal lobe epilepsy occurring as a sequel to the meningoencephalitis was mostly of the medial type and reconfirmed the prevailing view that epileptic psychosis was closely related to temporal lobe epilepsy.
- てんかん研究 = Journal of the Japan Epilepsy Society
てんかん研究 = Journal of the Japan Epilepsy Society 14(2), 109-115, 1996-06-30