興味ある脳波展開を示した片側巨脳症の1例  [in Japanese] A Case of Hemimegalencephaly with Characteristic Evolvement of EEG  [in Japanese]

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Abstract

難治てんかんを伴う片側巨脳症の患者で、脳波上てんかん性異常波は健側に出現し、患側半球の機能的切除により発作抑制に成功した興味ある1例を経験したので報告する。臨床発作は患側半球起始を示唆する発作型であった。経時的に追跡した発作間欠期脳波の所見では、てんかん性異常波が患側から健側へ移行していく様子が観察された。本症例は、片側巨脳症の外科的治療においては、発作症候学・画像・継続的脳波所見を含めた総合的判断の重要性を示す貴重な症例と考えられた。また、てんかん性異常波の健側への移行に関して、鏡焦点の可能性を含めて考察を加えた。

A Case of Hemimegalencephaly with Characteristic Evolvement of EEG Ritsuko Shigetomo, Hiroyuki Shimizu, Taketoshi Maehara, Nobuyoshi Kaito, Akira Yagishita, Masaya Oda, Nobutaka Arai, Kazuhiko Komiya, Hiroshi Tanaka, Fumio Hayakawa We report a case of hemimegalencephaly whose serial EEGs disclosed very interesting features.The patient's seizures started immediately after birth. Scalp EEG first showed epileptic discharges in the right affected brain. However, over the time course of three years with intransigent seizures, interictal epileptic discharges gradu-ally shifted from the right hemisphere to the contralateral“healthy”brain. At the age of 3 years and 4 months, she underwent a right functional hemispherectomy. After the operation, her seizures completely ceased, with the exception of slight myoclonic jerks in the morning.We speculate that a mirror focus may have been formed in the opposite hemisphere by incessant electric stimulation from the affected hemisphere. This case undescores the importance of a comprehensive diagnosis which encompasses scalp EEG, semiology, and image diagnosis for the selection criteria of epilepsy surgery.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 15(3), 204-209, 1997-10-31

    JAPAN EPILEPSY SOCIETY

References:  11

Codes

  • NII Article ID (NAID)
    10008555880
  • NII NACSIS-CAT ID (NCID)
    AN10043823
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    09120890
  • Data Source
    CJP  J-STAGE 
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