| 수소 자기 공명 분광 영상으로 확인된 후두엽성 중첩성 복합 부분 간질에 의한 뇌신경 세포의 손상 |
| 서범천, 김옥준, 김현숙*, 최철희, 김서현, 이병인 |
| 연세대학교 의과대학 신경과학 교실, 진단방사선과학 교실 |
| Neuronal damage confirmed by 1H-MRS in occipital lobe complex partial status epilepticus |
| Bum Chun Suh, M.D., Ok Joon Kim, M.D., Hyun Sook Kim, M.D.*, Chul Hee Choi, M.D., Seo Hyun Kim, M.D., Byung In Lee, M.D. |
| Department of Neurology, Yonsei University, College of Medicine
Shinchon-dong Seodaemun-ku C.P.O Box 8044 Seoul, 120-752, Korea |
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| Abstract |
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A 74-year old woman presented with partial and secondarily generalized status epilepticus lasted for 11 days. Initially her seizures consisted of only unformed visual hallucination, which progressed to formed hallucinations, and then memory disturbance and GTCs. During the period of recurrent formed visual hallucinations, T2-weighted brain MRI revealed high signal intensities in the left occipital lobe. After intravenous phenytoin loading, she did not develop any further GTCs but visual hallucinations persisted. Follow-up MRI performed after complete recovery of seizures showed complete recovery of the previous focal lesions, however, 1H-MRS showed a significant decrease of NAA in the recovered area. These features suggested the neuronal loss in the area of seizure focus, despite the complete recovery of transient focal abnormalities in MRI. This case provides a supportive evidence of neuronal damage even in focal status epilepticus, which stress the importance of early treatment and EEG confirmation of the complete seizure control after the disappearance of clinically obvious seizures.
Key words : Occipital complex partial status epilepticus, Neuronal damage, 1H-MRS |
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