非けいれん性てんかん重積状態を初発症状とした前頭葉てんかんの1小児例  [in Japanese] Nonconvulsive status epilepticus as an initial symptom in a boy with frontal lobe epilepsy  [in Japanese]

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Author(s)

    • 岡 明 Oka Akira
    • 杏林大学医学部小児科学教室|東京大学医学部小児科学教室 Department of Pediatrics, Kyorin University School of Medicine|Department of Pediatrics, the University of Tokyo

Abstract

 非けいれん性てんかん重積状態 (nonconvulsive status epilepticus ; NCSE) を初発症状とした前頭葉てんかんの1例を経験した. 症例は11歳男児で既往歴はない. 5時間持続する見当識障害と異常行動を主訴に受診し, 脳波での持続的なてんかん性放電によりNCSEと診断した. diazepamの投与により, 脳波所見の改善と共に反応性の低下や見当識障害が改善した. 以降, 神経後遺症や発作の再発はない. NCSEは全身性急性疾患や難治性てんかんに合併し, 予後不良な病態と考えられてきたが, 部分発作重積状態や欠神発作重積状態では予後良好な症例が存在する. 特にNCSEを初発症状とするてんかん症例では合併症による障害がなければ, 予後が良好な可能性が高いことが示唆された.

  An 11-year-old boy, who had no remarkable past history, exhibited disorientation and abnormal behavior lasting for several hours. Continuous ictal discharges on his EEG lead to the diagnosis of nonconvulsive status epilepticus (NCSE). The administration of diazepam instantly resulted in the cessation of ictal discharges, associated with clinical recovery. Interictal spikes distributed in frontal lobes are sporadically seen, suggesting frontal lobe as an epileptic focus. After starting medication, he showed excellent clinical course without recurrence of seizure or neurological sequelae. Although NCSE is generally suggestive of poor prognosis, some subtypes of NCSE, such as partial status epilepticus and absence status epilepticus, are not always associated with adverse outcome. The present case suggests that epileptic patients who present NCSE at onset and lack interictal neurological impairments might have good outcome.

Journal

  • NO TO HATTATSU

    NO TO HATTATSU 46(4), 301-306, 2014

    The Japanese Society of Child Neurology

Keywords

Codes

  • NII Article ID (NAID)
    130004728680
  • Text Lang
    JPN
  • ISSN
    0029-0831
  • Data Source
    J-STAGE 
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