高血糖性枕叶癫痫二例  

Occipital seizures induced by hyperglycemia

作　　者：崔韬[1] 李志梅[1] 陈超[1] 吕瑞娟[1] 王群[1] 邵晓秋[1] Cui Tao;Li Zhimei;Chen Chao;Lyu Ruijua;Wang Qun;Shao Xiaoqiu(Epilepsy Center,Deparment of Neuroogy,Bejing Tiantan Hospital,Capial Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心癫痫科,国家神经系统疾病临床医学研究中心,北京100070

出　　处：《脑与神经疾病杂志》2022年第8期476-480,共5页Journal of Brain and Nervous Diseases

基　　金：癫痫病临床医学研究北京市重点实验室-首都医科大学三博脑科医院资助(2021DXBL02)。

摘　　要：目的 非酮症高血糖(NKH)临床表现为枕叶癫痫发作的病历较少见,总结首都医科大学附属天坛医院神经内科的病历,对其临床特点、脑电图(EEG)表现及影像学改变进行分析。方法 分析了因癫痫住院的患者2例,对高血糖性枕叶癫痫病历的临床表现、EEG、磁共振(MRI)及正电子发射扫描(PET)改变进行了总结。结果 本文2例患者均表现为中等血糖升高及糖化血红蛋白(HbA1C)升高,临床及EEG均提示为枕叶癫痫,例1头颅MRI可见枕叶皮质下白质T或FLAIR低信号,例2头颅MRI未见特征性改变,1例患者PET检查提示右侧枕叶低代谢区。患者经胰岛素及补液治疗后恢复正常。结论 NKH患者可以表现枕叶癫痫,其EEG表现为枕叶癫痫波、影像学表现为T或FLAIR枕叶白质低信号,纠正高血糖、补液治疗后预后良好。Objective To investigate occipital lobe seizures caused by nonketotic hyperglycemia(NKH) are rare and not fully characterized.We describe clinic presentation,EEG,MRI anpositron emission tomography(PET)of two cases of NKH-related occipital lobe seizures with high hemoglobin A1 C(HbA1 C).Methods Two patients admitted becauseof NKH-related occipital lobe seizures were reviewed.All data of these patients including history,MRI,scalp video-electroencephalography(VEEG),and PET were analyzed retrospectively.Results Both patients were admitted for seizures and had moderate hyperglycemia and elevated HbA1 C.Both patients had a clinico-EEG seizure originating from the occipital region.The subcortical Tand FLAIR hypointensity was present in case 1.The MRI of case 2 is unremarkable.The PET of one patient showed hypointensity signal in right occipital region.Patient was treated with insulin and hydration and all the neurological symptoms including the seizures disappeared.Conclusions Occipital seizures can be caused by hyperglycemia and may be accompanied by special EEG pattern,or/and imaging findings of Tand FLAIR hypointensity.After treating with insulin and hydration,the seizure outcome is favorable in such patients.

关 键 词：非酮症性高血糖 枕叶癫痫发作 癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]