視覚性発作の1例

A CASE OF VISUAL SEIZURE

　癲癇に現われる種々な感覚性発作の中，視覚性発作（visual seizure）または視覚性前兆（visualaura）については，すでに古くから成書にも記載され，それが後頭葉視覚領に関係をもつことが知られている。またPenfield, Jasper等はvisualauraを持つ癲癇患者で，開頭時に大脳皮質電気刺激を行い，刺激部位と誘発発作の様相について詳細な報告を行つている。しかしこのような自発性発作を脳波所見との連関において検索したものは少いようである。

　私共は一過性に典型的な視覚性発作を示した一癲癇患者において，その自発発作の様相と脳波の関係についてPenfield等の実験に相当する知見を得たので報告する。

Concerning the visual seizure in a case with epilepsy, a relation between clinical findings and electroencephalographic changes was studied.

The patient was a 20-years-old woman who had history of some inflammatory disease of brain in her infancy. At age of 11, she began to have the seizures, characterized by typical generalized convulsion (grand mal).

Afterwards, she was given some anticon-vulsant drugs. In the course on decreasing the doses, some types of seizures with visual sensations, never observed till that time, appeared. Accordingly the seizure pattern of EEG was studied with following results: 1) When elemental visual sensations, so called "visual seizure or visual aura", appear-ed in the right visual field, the EEG showed seizure discharges only in the left occipital region.

2) But, when these sensations produced some of visual hallucinations, so called a type of the psychical seizure, the seizure discharges were not localized in the left occipital region but extended to the temporal and parietal region prominently in the left hemisphere.

The above observation were discussed in contrast with Penfield & Jasper's and other reports.