雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 28, Issue 3 （March 1976）

Brain and Nerve 脳と神経 28巻3号（1976年3月発行）

Japanese English

原著

遅発性てんかん患者の連続脳血管撮影所見の検討 SERIAL CEREBRAL ANGIOGRAPHIC STUDIES IN 23 CASES OF LATE ONSET EPILEPSY 外賀昭 ¹ , 森本一良 ² , 池田宏也 ² , 岩田吉一 ² , 赤木功一 ³ Akira Gega ¹ , Kazuyoshi Morimoto ² , Hiroya Ikeda ² , Yoshikazu Iwata ² , Tsuguto Akagi ³ ¹奈良県立医科大学脳神経外科 ²大阪大学医学部脳神経外科 ³国立大阪病院脳神経外科 ¹Department of Neurosurgery, Nara Medical University ²Department of Neurosurgery, Osaka University Medical School ³Department of Neurosurgery, Osaka National Hospital pp.293-300

発行日 1976年3月1日 Published Date 1976/3/1

DOI https://doi.org/10.11477/mf.1406203858

PDF(9649KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　20歳以上になつて発症したけいれん発作は症候性てんかんとして検索され，脳腫瘍，脳動静脈奇型らGrossLesionが見つけ出される事は日常経験されるところである。

　しかしながら，中にはけいれん発作のみで他に随伴症状もなく原因のはつきりとしない症例もあつてUnkno—wn Originとして外来にてFollow Upされている場合もある。

　従来よりGross Lesionが否定された場合の原因の一つとして脳血管閉塞症^1,8,11,15）が挙げられている。脳血管撮影によつて，Waddigton^16,17），およびVermess^14）は中大脳動脈末梢枝の閉塞とけいれん発作との関係を明らかにしているがその他の小さな脳血管の異常および病変についてSystemicな報告を見ない。このような事からUnknown Originとして外来にてFollow Upされている患者も含め，連続脳血管撮影を行い，このような遅発性てんかん患者について再検討を試みた。

It has been generally experienced in each clinic that there are some cases with complaint of con-vulsive attack at the age over twenties without any predictive symptoms. Of course, gross lesions such as brain tumor, arteriovenous malformation had been found among them, but in some cases no satisfactory diagnosis could be made for the cause of those late onset epilepsy.

In this time, these cases whom have remained as unknown origin have been studied by serial cerebral angiography to detect more precise and small lesions.

Thus, small cerebral vascular lesion (SCVL) had been angiographically demonstrated in 12 cases out of 23 cases with late onset epilepsy.

In addition to the angiographic findings, clinical and EEGcal features are summarized as below.

1. The cases with SCVL have initial attack which is highest at the twenties, secoundarily at forties.

2. The mode and type of convulsive attack show nonfocal, generalized convulsion in 9 cases out of 12 cases with SCVL, and 3 cases focal con-vulsion.

3. There is no typical epileptic pattern like spike and wave. Ten cases with SCVL show small sharp spike and one shows big sharp spike, and the other one high voltage slow wave.

4. SCVL found by serial cerebral angiography :

(A) coiled & irregular capillary network…………1

(B) occlusion of small branch of cerebral artery… 2

(D) small cerebral angioma……………………… 3

(E) cerebral capillary telangiectasis…………… 2

(F) no abnormal finding………………………… 11

5. These findings are able to classify to pathogenic relations as below.

(1) ischemic & steal pattern………………… B, C.

(2) hemorrhagic & destructive pattern…C, D, E.

(3) hyperemic & hot pattern………………… A, E. It would be suggested that SCVL could be found among these patients of late onset epilepsy remained as unknown origin. Among these with SCVL, other drugs beside anticonvulsants and surgical theraphy would be needed.