手による自己誘発性光原性てんかん

A CASE OF PHOTOGENIC EPILEPSY WITH SELF-INDUCED ATTACKS BY WAVING HAND

はしがき

　視覚，聴覚，触覚等の知覚性刺激によつて癲癇発作が誘発されることは古くから知られており，このうち視覚性の癲癇として1881年Gowers^1）．が明るい光により発作を誘発した症例を報告している。

　本症には発作誘発の視覚刺激として強い陽の光は勿論，木の間を洩れる光，雪や海面に反射する光等によるもの，即ちBickford^2）の記載している日常の光の強さによつて癲癇発作が誘発される所謂photogenic epilepsyと，最近脳波検査室において盛んに用いられているflicker刺激により癲癇発作或は発作波のみが人工的に誘発されるものとあり，患者の光に対する被興奮性の差異により発作誘発に対する光刺激量に相当の閾値差があるようである。

A child of photogenic epilepsy with waving his hand before his eyes toward the lightwas reported.

The patient was 11 years old boy with. idiocy, grand mal and petit mal, and photo-genic epilepsy from 7 years and 8 months of age. All kind of anticonvulsant drugs did not show any effect to photogenic epilepsy for 2 years. But photogenic epilepsy has dis-appeared, since the caudal resection of the pancreas was performed 3 years ago.

EEG during awake and sleep showed preo-peratively diffuse bilateral synchronous spike and wave, 3 cps slow high voltage activity in all areas without any focal sign. In pos-toperative EEG, these seizure discharges dis-appeared for one year, but in examinations on the 2nd year after operation the discharge as well as preoperative EEG appeared again. And then the seizure discharges could not be induced by the photic stimulation in a few examinations, but with the color filters of bitter orange and grey. When the anti-convulsant drugs was discontinued for the EEG examinations, grand mal and petit mal appeared again, but photogenic epilepsy did not reappeared. I thought that the pathoge-nesis of grand mal and petit mal differed from photogenic epilepsy.