青少年肌阵挛性癫痫孤立单侧脑电图1例报告

Merve Aktan Suzgun, V. Demirbilek
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摘要

青少年肌阵挛性癫痫(JME)具有明确的临床和电生理特征。另一方面,大量病例系列表明,在JME中,局灶性和不对称放电可能伴随着广泛的癫痫样活动。尽管已知这些非全身性电生理学发现并不排除该综合征的诊断,但一些发现可能会在鉴别诊断中造成混乱。在本病例报告中,讨论了一例JME,其脑电图表现为孤立的单侧癫痫样活动,没有典型的全身性放电。目前的病例临床表现为双侧上肢不自主的急动。根据家庭录像,已经确定这些动作是单/双侧肌阵挛搏动。肌阵挛病因的研究排除了代谢、毒性和结构问题。在对癫痫过程进行的电生理检查中,观察到癫痫样放电局限于孤立的右半球。JME主要是由于患者的临床表现而被考虑的,并且在抗癫痫治疗的4年随访中实现了有效的癫痫控制。该病例的特点是在4年的随访期间存在孤立的单侧癫痫样活动的电生理记录。需要强调的是,在文献中没有普遍性棘波慢波或多发性棘波缓波的情况下,没有一例JME被诊断为孤立的单侧癫痫样活动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Isolated Unilateral EEG Findings in Juvenile Myoclonic Epilepsy: A Case Report
Juvenile myoclonic epilepsy (JME) has well-defined clinical and electrophysiological features. On the other hand, large case series have shown that focal and asymmetrical discharges may accompany generalized epileptiform activities in JME. Although it is known that these non-generalized electrophysiological findings do not exclude the diagnosis of this syndrome, some findings may create confusion in the differential diagnosis. In this case report, a case of JME with electroencephalographic findings characterized by isolated unilateral epileptiform activities without typical generalized discharges was discussed. The current case clinically presented with involuntary jerk movements in the bilateral upper extremities. It has been determined that these movements are uni/bilateral myoclonic beats based on home video recordings. Metabolic, toxic and structural problems were excluded in the investigations for the etiology of myoclonus. In the electrophysiological examination performed for epileptic processes, epileptiform discharges localized to the isolated right hemisphere were observed. JME was considered primarily due to clinical findings in the patient, and effective seizure control was achieved in a 4-year follow-up under anti-seizure treatment. The peculiarity of the case is the presence of electrophysiology recordings of isolated unilateral epileptiform activity during the 4-year follow-up period. It should be emphasized that there is no case of JME diagnosed with isolated unilateral epileptiform activity in the absence of generalized spike-slow waves or multiple spike-slow waves in the literature.
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