继发于电击脑损伤的癫痫:病例报告

Gabriella Telles Almeida, Camilla Nunes Proença Formoso, Daniel Antunes Pereira, Gilberto Canedo Martins Jr, A. M. da Silva Catharino
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摘要

导言:根据《2022 年电击事故年鉴》,巴西共报告了 853 起电击事故,其中 592 人死亡,死亡率比上一年下降了 12.2%。有三种情况可以解释电流通过造成的创伤开关,即电流通过造成的调节改变、电能转化为热能(即焦耳效应)以及电刺激加剧收缩造成的肌肉损伤。病例报告:一名 51 岁的男性患者在 15 年前因高压放电事故导致神经衰弱而接受门诊随访。事件发生后,他出现了传导性失语、右侧同侧偏盲、右侧肢体感觉减退、右上肢构音障碍以及局灶性癫痫发作,并逐渐演变为强直-阵挛发作。为控制癫痫发作,患者服用了卡马西平 200 毫克,每天 3 次,此后癫痫发作得到完全控制。结论:因此,必须强调的是,电击对中枢神经系统(CNS)造成的损害是多种多样的。不过,根据患者的临床表现、神经影像学检查结果和病史,这是一起继发于电击的癫痫。脑畸形显示脑组织中有一个巨大的疤痕,采用药物治疗控制癫痫发作也证实了这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epilepsy secondary to brain injury by electrocution: A case report
Introduction: According to the Yearbook of Accidents of Electrical Origin for the year 2022, 853 accidents due to electric shock were reported in Brazil, of which 592 died, a reduction of 12.2% in mortality compared to the previous year. Three conditions elucidate trauma switches caused by the passage of electric current, the regulatory alterations by the passage of electric current, the conversion of electrical energy into thermal, known as the Joule effect, and muscle damage by the electrical stimulus of exacerbated contractions. Case Report: A 51-year-old male patient was followed up on an outpatient basis due to a nervous breakdown caused by accident with a high-voltage electrical discharge 15 years ago. After the event, he evolved with conduction aphasia, homonymous hemianopia on the right, hypoesthesia on the right side of the body, dysmetria on the right upper limb, and epileptic seizures of focal onset, evolving into tonic-clonic seizures. For seizure control, carbamazepine 200 mg 3 times a day was administered, with complete seizure control since then. Conclusion: Therefore, it is important to emphasize that the damage caused by electrocution to the central nervous system (CNS) is varied. Still, due to the patient’s clinical presentation, his neuroimaging findings, and his history, this is epilepsy secondary to electrocution. Encephalomalacia demonstrates a large scar in the brain tissue, and its control of seizure episodes with the adopted pharmacotherapy also corroborates.
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