てんかん性痙攣重積にたこつぼ型心筋症を併発した1例

Symptomatic Seizure Associated with Takotsubo Cardiomyopathy: A Case Report

Ⅰ．はじめに

　たこつぼ型心筋症は左室心尖部のバルーン状拡張と心基部の過収縮により左室がたこつぼのような形態をとる疾患である⁴⁾．一般に自然に軽快し予後はよいが，なかには呼吸不全や心破裂を起こし致命的になることもある．今回われわれは脳梗塞後の症候性てんかんにたこつぼ型心筋症を併発した1例を経験したため報告する．

　A 68-year-old woman was admitted for symptomatic seizure. She had a history of cerebral infarction in the right fronto-temporal lobes, and was medicated for the symptomatic seizure with valproic acid. Her electrocardiogram（EEG）showed ST-segment elevation in leads II, III, aVF, and V2-V6. Emergency coronary angiography showed normal coronary arteries, however, left ventriculography showed apical ballooning in the systolic phase. She had no chest pain or dyspnea, and takotsubo cardiomyopathy was diagnosed due to ECG abnormality. The majority of the takotusbo cardiomyopathy patients recover rapidly, but in some the condition proves fatal. Seizure-associated takotsubo cardiomyopathy may cause sudden unexplained death in epilepsy（SUDEP), and EEG measurements should be carefully checked for seizure patients.