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An Autopsied Case of Dementia with Lewy Bodies Presenting with Hemispheric Cerebral Cortical Atrophy with Selective Neuronal Necrosis after Status Epilepticus Yasushi Iwasaki 1,2 , Keiko Mori 2 , Masumi Ito 2 , Maya Mimuro 1 , Mari Yoshida 1 1Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University 2Department of Neurology, Oyamada Memorial Spa Hospital Keyword: dementia with Lewy bodies , status epilepticus , selective neuronal necrosis , diaschisis , prolonged disturbance of consciousness pp.1069-1074
Published Date 2012/9/1
DOI https://doi.org/10.11477/mf.1416101298
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Abstract

 We report on a 72-year-old-Japanese man with dementia with Lewy bodies (DLB) who presented with hemispheric cerebral cortical atrophy with selective neuronal necrosis after status epilepticus. His disease manifested with psychiatric symptoms, such as a "hot feeling" in the abdomen, at the age of 68 years. He was found to have hypochondriasis and anxiety disorder and was treated in the Department of Psychiatry. Parkinsonism gradually developed approximately 1 year later. Approximately 3 years after the onset of psychiatric symptoms, he suddenly experienced left hemiclonic seizures with consciousness disturbance, and he was admitted to our hospital. Status epilepticus occurred for several hours. His convulsive seizures were controlled by the administration of antiepileptic drugs (diazepam, phenytoin); however, he later showed prolonged disturbance of consciousness and left spastic hemiparesis. Gastrostomy was performed, but the patient died of aspiration pneumonia approximately 9 months after the onset of status epilepticus. Pathological examination showed widespread neuron loss with gliosis involving the entire right cerebral cortex, particularly in the frontotemporal lobe and hippocampus, and with patchy involvement of the contralateral cerebellum, especially in the cortex and dentate nucleus. These findings seemed to be consistent with a chronic stage of selective neuronal necrosis and secondary cerebellar degeneration due to diaschisis of the cerebral cortical involvement. Evidence of limbic-type DLB was also observed.  We believe that selective neuronal necrosis associated with status epilepticus is an interesting neuro-pathological finding.

(Received: December 9, 2011, Accepted: April 6, 2012)


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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