早期乳児てんかん性脳症後のWest症候群に合併した右股関節脱臼の1例

Hip Dislocation Complicated by West Syndrome Following Early Infantile Epileptic Encephalopathy. Case Report

　難治性てんかんに伴う股関節脱臼の治療は困難である．早期乳児てんかん性脳症を発症し，生後7カ月でWest症候群に移行した1例を経験した．痙攣コントロール中，右股関節亜脱臼が高位脱臼に進行し，3歳4カ月時にハムストリング近位全切離を含む股関節周囲筋解離術で整復した．後療法は，開排装具，外転装具を着用し，4歳7カ月現在，右股関節は安定し，疼痛は消失した．股関節整復後はてんかん症状に改善もみられた．

　Treatment of hip dislocation in patients with intractable epilepsy is difficult.　We report a case of West syndrome in a 7-month-old infant after early infantile epileptic encephalopathy.　During treatment of the epilepsy, right hip subluxation progressed to severe dislocation.　We performed surgical reduction of the right hip joint and soft-tissue release, including total hamstring release, when the patient was 3 years 4 months old, and the outcome was good.　We performed hip bracing until the patient was 4 years 7 months old, and the frequency of the epileptic seizures has decreased.