[Irreversible cerebral ischemia caused by febrile status epilepticus in Sturge-Weber syndrome type III].

Q4 Medicine No To Hattatsu Pub Date : 2017-03-01
Yuri Sakaguchi, Tomohide Goto, Sahoko Miyama
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Abstract

We report a 9-year-old girl with Sturge-Weber syndrome (SWS) type III, whose motor function deteriorated after an episode of febrile status epilepticus. The patient had leptomeningeal angiomas in the left temporal, occipital, and parietal lobes. Complex partial seizures, which started at 8 months, were controlled by antiepileptic medications. At 9 years of age, she developed irreversible ischemic lesions in the left temporal and occipital regions after the febrile status epilepticus and her motor function deteriorated. In addition to antiepileptic medications, aspirin therapy was started.SWS type III is a rare disorder characterized by leptomeningeal angiomatosis without facial nevus. In addition to the chronic ischemia in the affected cortex, epileptic seizures result in a phased progression of ischemia in SWS. Although the patient’s complex partial seizures had been well-controlled, a single episode of febrile status epilepticus resulted in permanent brain lesions. The impairment of appropriate hemodynamic response to status epilepticus, together with venous hypertension in the affected side in SWS may have caused the cerebral infarction in our case. Seizure control is crucial to improving the neurological prognosis of SWS.

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[Sturge-Weber综合征III型患者发热性癫痫持续状态所致不可逆脑缺血]。
我们报告一个患有斯特奇-韦伯综合征(SWS) III型的9岁女孩,其运动功能在发热癫痫持续状态发作后恶化。患者在左侧颞叶、枕叶和顶叶有脑膜血管瘤。8个月时开始的复杂部分性癫痫发作由抗癫痫药物控制。9岁时,患者出现发热性癫痫持续状态后,左颞和枕区出现不可逆的缺血性病变,运动功能恶化。除了抗癫痫药物外,还开始了阿司匹林治疗。SWS III型是一种罕见的疾病,其特征是无面部痣的小脑膜血管瘤病。除了受影响皮层的慢性缺血外,癫痫发作导致SWS缺血的阶段性进展。尽管患者复杂的部分性癫痫发作得到了很好的控制,但单次发热性癫痫持续状态导致永久性脑损伤。在我们的病例中,对癫痫持续状态的适当血流动力学反应的损害,以及SWS患侧静脉高压可能导致脑梗死。癫痫控制是改善SWS神经预后的关键。
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No To Hattatsu
No To Hattatsu Medicine-Pediatrics, Perinatology and Child Health
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