脳磁図による電流源解析を行ったLandau-Kleffner症候群の2症例  [in Japanese] Magnetoencephalographic Study of Landau-Kleffner Syndrome : Report of Two Cases  [in Japanese]

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Abstract

Landau-Kleffner症候群 (LKS) の病態解明を目的として、その2症例の脳磁図を記録し、発作間欠時棘波の等価電流双極子 (equivalent current dipole; ECD) 解析を行った。その結果、ほぼ極期に相当し、全失語を呈した症例1では、ECDは左側の前頭葉後下方および側頭葉上面・弁蓋部の言語領域および聴覚領近傍に優位に集積し、一方、極期からかなり経過しているが、感覚性失語の遷延した重度の失語像を呈した症例2では、両側前頭葉優位、多焦点性であった。今回の検討から、LKSにおける棘波活動は、言語領域および聴覚領に及んでいることが示唆され、これらの領域が失語の責任病巣と考えられた。しかし、一方で、症例2のごとく、脳波および脳磁図上のてんかん性所見と臨床上の失語像が必ずしも一致しない症例が存在し、縦断的な観察が必要であることも留意すべきであると考えられた。

Magnetoencephalography (MEG) and equivalent current dipole (ECD) analysis of interictal spikes on MEG were performed in 2 right-handed boys with Landau-Kleffner syndrome (LKS). Age at MEG recording was 6 years 6 months in case 1 and 14 years 3 months in case 2. Case 1 developed speech impairment progressing to mutism from age 4 years and 11 months. The estimated ECDs were localized in the periand intrasylvian region in the lower and posterior frontal lobe and superior temporal gyrus with left side predominance. The location suggested that epileptic activity may involve the language area and the auditory cortex, resulting in his aphasic deficit. In contrast, in case 2 who showed persistent severe aphasia from 8 years of age, ECDs scattered widely and multifocally, mainly in the bilateral frontal area. The difference between the two cases is possibly due to the age-related course of the syndrome. This study indicates that MEG may be valuable in identifying the resposible cortical area for aphasic disorder in LKS. However there may be cases like case 2 whose epileptic findings on MEG and EEG are not necessarily concordant with his aphasic manifestation. Longitudinal evaluation is required to draw a definite conclusion.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 15(2), 140-145, 1997-06-30

    JAPAN EPILEPSY SOCIETY

References:  10

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008972592
  • NII NACSIS-CAT ID (NCID)
    AN10043823
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09120890
  • Data Source
    CJP  CJPref  J-STAGE 
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