難治性複雑部分発作を呈した島回部psammomatous meningiomaの1手術例

Insular Psammomatous Meningioma Presenting Intractable Complex Partial Seizures

Ⅰ．はじめに

　てんかん症例において，発作が島回部より起始する場合，多彩な臨床症状を呈するために症候のみでの焦点診断は困難なことが多い．特に複雑部分発作が発作症状の主体である場合には，側頭葉てんかんとの鑑別に苦慮する場合がある⁹⁾．今回われわれは，側頭葉てんかんと同様な複雑部分発作を呈した島回部に主座をおく髄膜腫（deep sylvian meningioma）の1例を経験したので，文献的考察を加え報告する．

　We describe a 30-year-old female with intractable symptomatic epilepsy caused by an insular calcified mass, which was histologically proved as psammomatous meningioma. Seizures were described as consciousness impairment, motionless stare and automatism. After total removal of the tumor with a neuronavigation system and motor evoked potential (MEP) monitoring, seizures completely disappeared without neurological deficit. We emphasize that insular meningioma presents complex partial seizures which mimic medial temporal lobe epilepsy and seizures are controlled by total resection of the tumor.