以视幻觉为表现的非惊厥性癫痫持续状态一例  

A case of nonconvulsive status epilepticus characterized by visual hallucinations

作　　者：王肖肖 祁秀峰[1] 赵俊杰 张亚楠 许蕾 Wang Xiaoxiao;Qi Xiufeng;Zhao Junjie;Zhang Yanan;Xu Lei(Department of Neurology,the First Hospital of Handan,Hebei 056002,China)

机构地区：[1]邯郸市第一医院神经内四科,河北056002 [2]河北医科大学第二医院

出　　处：《脑与神经疾病杂志》2024年第11期686-690,共5页Journal of Brain and Nervous Diseases

基　　金：邯郸市科学技术研究与发展计划项目(23422083279)。

摘　　要：目的非惊厥性癫痫持续状态(NCSE)临床表现多样,无特异性。明确诊断需临床表现和脑电图(EEG)相结合。当患者出现意识障碍、精神行为异常等症状时,应考虑到此病。本文报道1例癫痫非惊厥性持续状态患者临床、EEG特点及治疗,以便临床早发现,及时用药。方法收集该患者临床资料包括性别、年龄、病因、临床表现、头颅MR、发作期及发作间期视频EEG(VEEG)资料、治疗及效果。结果视幻觉是短暂的、刻板的、生动的。在NCSE期间进行神经心理测试显示,存在认知功能下降。头颅MRI示右侧颞顶叶软化灶,NCSE视频EEG可记录到清醒背景脑电,右侧后颞持续尖性慢波(7~8Hz),60s后频率增快至11~12Hz,波幅增高,全导尖波、棘波节律,随后全导尖慢复合波持续约120s恢复背景脑电。结论生动形象的视幻觉,常与急性精神病或精神错乱相混淆。因此,我们要提高对以视幻觉为表现NCSE的认识,以避免误诊,防止不适当的治疗,并及时治疗,改善预后。Objective The clinical manifestations of nonconvulsive status epilepticus(NCSE)are diverse,non-specific.Definite diagnosis requires the combination of clinical manifestations and electroencephalogram(EEG).When the patient has symptoms such as consciousness disorders and mental behavior abnormalities,this disease should be taken into account.The purpose of this paper is to report the clinical and EEG characteristics of a patient with NCSE,so as to be diagnosed early and use drugs in time.Methods Clinical data of the patient were collected,including gender,age,etiology,clinical manifestations,findings of magnetic resonance imaging,video EEG data,treatment and prognosis.Results Visual hallucinations are transient,stereotypical,and vivid.europsychological tests performed during NCSE showed a decline in cognitive function.MRI shows focus of right temporo-parietal,and EEG records epileptic activity starting from the right temporal region.Conclusion Vivid visual hallucinations are often confused with acute psychosis or insanity.Therefore,We aim to increase awareness of NCSE characterized by visual hallucinations to avoid misdiagnoses,prevent inappropriate treatment,enable timely treatment,and improve outcomes.

关 键 词：癫痫 视幻觉 非惊厥性癫痫持续状态 脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]