Uncontrollable Epilepsyの原因となったEctopic Gray Matterの一治験例

A CASE OF ECTOPIC GRAY MATTER AS A CAUSE OF EPILEPTOGENIC FOCUS

はじめに

　Ectopic gray matter （以下EGMと略す）は，He—teroric gray matter,Ectopic cerebral cortexなどの色々な名称で呼ばれ，多くは重大な脳回異常に伴なつて出現するため，これが臨床的に問題となることは少ない。ところが，頑固なてんかんのみを主症状とするものにこのEGMが原因するものがあり，そのような症例が二，三病理の方面から報告されている^7）11）。我々は最近，後者に相当するEGMを手術により確認診断し治療の対象としえた症例を経験したが，生存中に診断がついたというだけでなく，脳の直流電位の測定が非常に役立つなど，興味深い点を有するのでここにその症例を報告したい。

This 35-year-old woman was admmited to our hospital with a history of uncontrollable epilepsy of non-focal type lasting 30 years. Neurological and neuroradiological examination showed no pe-culiar finding with the exeption of moderate asym-metrical dilation of lateral ventricle (The left ven-tricle was larger than the right one). EEG demon-strated focal negative spike in the left precentral area. DC potential of the brain suggested left precentral subcortical mass because of positive change of the stationary potential.

Left frontal craniotomy revealed subcortical-ectopic gray matter which was removed as exten-sive as possible. Postoperatratively the epilepsy became controlable.

Histological examination showed the ganglion cells in white matter with random disposition and low differentiation. No tumor cell, however, could be detectable.

This is a intersting case, because the diagnosis of ectopic gray matter was obtained during the life time and DC potential was suggestive of this disease.