以癫癎为主要症状的慢性病程的病毒性脑炎  

On guard against viral encephalitis in chronic course presenting as epilepsy

作　　者：苏彧[1] 刘玉玺[1] 张建斌[1] 陈玉平[1] 杜晓萍[1] 

机构地区：[1]山西医科大学癫癎研究所,山西太原030001

出　　处：《临床神经电生理学杂志》2009年第1期21-24,共4页Journal of Clinical Electroneurophysiology

摘　　要：目的：探讨以癫癎为主要首发症状且表现为慢性病程的病毒性脑炎的临床特点、诊断和治疗转归。方法：总结4例患者的临床表现、脑电图（EEG）、脑脊液（CSF）、影像学表现和病理检查及治疗转归等临床资料。结果：4例患者均以癫癎为首发和主要症状，病情虽呈进行性加重，但均表现为慢性病程及高级皮层功能受损，其中2例有颅内压轻度增高，4例中仅1例有影像学改变。患者的EEG检查均表现为α指数显著减少的慢波背景。其中2例患者曾手术治疗并对脑组织进行了病理检查，发现脑组织为炎性改变。所有患者单纯应用抗癫癎药物治疗效果不佳，经足量抗病毒治疗后病情好转或痊愈。结论：对癫癎病程在半年以内和（或）合并有其它脑皮层功能减退的症状，EEG有与年龄不相称的慢波优势活动者，在充分排除了其它相关疾病的情况下，应考虑有慢性病毒性脑炎之可能。Objective：To etplre the clinical characteristics, diagnose and therapy of viral encephalitis chronic course presenting as epilepsy. Methods： The symptom, EEG,CSF, MRI,pathology and therapy of 4 patients was examined respectively. Results： The four patients presented the symptom of epilepsy in aggravating chronic course. The first symptom of the 4 patients was the damage of higher cortical function. Two of them slightly increased intracranial pressure of CSF, and one had image change. The EEG background of the 4 patients all presented as slow wave rhythm. The pathological findings of 2 patients were demonstrated as encephalitis. Simple treatment of AEDs could not effectively control their epileptic seizures, but there was a cosiderable effect after using enough drugs of anti-virus. Conclusion： If other reletive diseases are excluded, the patient could be consideved to suffer from viral encephalitis in chronic course which presents the symptom of intractable epilepsy with a degradation of cortical function and abnormal EEG background.

关 键 词：病毒性脑炎 癫癎发作 脑电图(EEG) 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R512.3[医药卫生—临床医学]