下血はじめ多彩な症状を呈した自律性てんかんと思われる症例

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A 42-year-old man was admitted to our internal medicine department with complaints of nausea, epigastralgia, melena, headache, slight fever, polydipsia and polyuria. He has cerebral palsy due to high fever in infantile period. At the age of 28,he suffered a head injury from a traffic accident, lost consciousness for a week and lost the sight of his left eye. Two weeks after the accident he began to drink twenty litres of water a day, but this gradually subsided.At the age of 30 he complained of anorexia, nausea, epigastralgia, melena and anemia for the first time. A G-I tract survey could not ascertain the site of bleeding. At the age of 32,39 and 41 he complained of similar symptoms, the duration of which was from several months to several years. Physical examination revealed a similar abdominal tenderness and headache in each episode. Laboratory examinations done by several institutes revealed no organic disease which could account for his compants. An EEG showed a non-characteristic pattern (e.g. slow α wave, bursts of slow waves simnilar to a spike-and-wave complex).Summarizing his symptoms and signs, we found that they occured paroxysmally and repeatedly and were fixed and stereotyped. We also found that there were intermittent periods when no complaints existed. Consequently, we diagnosed him to have autonomic epilepsy caused by his head injury, evebn though the EEG was not characteristic of the usual autonomic epilepsy (i.e. 6 & 14 waves). We feel this case is peculiar due to its beginning after head injury, its long duration of attacks and the accompanying melena.
日本心身医学会の論文
1980-06-01

下血はじめ多彩な症状を呈した自律性てんかんと思われる症例

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