後頭に限局せる発作波とその臨床症状—視覚性発作重積症例を中心に

ON THE PSYCHICAL SYMPTOMS IN THE EPILEPTIC DISCHARGES LOCALIZED TO THE OCCIPITAL REGION: ONE CASE OF STATUS EPILEPTICUS OF VISUAL SEIZURE AND OTHER TWO CASES OF THE VISUAL EPILEPSY

はじめに

　てんかんの感覚性発作のうち，いわゆる視覚性発作といわれるものの焦点は後頭葉であると考えられている。しかし，その発作中の脳波を自然の状態で観察する機会は少なく，多くの場合は閃光刺激をはじめとする各種賦活法によつて誘発している。また，後頭に発作波が始発しても，それが終始その部に限局しておらず，結局は全汎化して全身痙攣をおこす例も少なくない。

　われわれは，数日間にわたり一側後頭部に限局した発作波が，いわば発作重積のごとく反復出現し，それに一致して複雑な幻視，錯視を訴えながら発作波の全汎化や全身痙攣を示さなかつた稀な1例を経験した。そこで，その症例を中心とし，後頭部に限局性発作波を呈した2例を対比させて記述し考察したいと考えた。

A case of the status epilepticus of the visual seizure was reported. Though the seizure dis-charges occured repeatedly at intervals of several minutes, they always localized in the right occipital region and never generalized. During this seizure, the patient complained not only the "sensory hallucinations" but also the "psychical hallucina-tions" in sense of Penfield and Jasper, including the autoscopy. Other two cases. whose seisure dis-charges were also localized in the unilateral occi-pital region, were reported.

The authors dicussed the ictal symptoms of the so-called visual epilepsy through three cases des-cribed above and concluded that the occipital sei-zure can induce the psychical seizures known as a manifestation of the temporal seizures.

It must be emphasized that there is an intimate relationship between the occipital foci and the temporal foci of epileptics.