:A Consideration on the Generalized Cortico-reticular Epilepsy

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We described a 6-year-old boy with Lennox- Gastaut syndrome, who developed complex partial seizures, improved by surgical treatment of a porencephalic cyst. At the age of 3 years, he began to have an impairment of consciousness. An EEG showed sporadic left temporal spikes and diffuse bilateral clusters of the fast activities. Despite of the treatment with the various antiepileptic drugs, he gradually developed recurrent seizures. Atypical absences and tonic spasms with concomitant diffuse slow spike-and-wave discharges in the interictal EEG were frequently observed every day at 4 years and 2 months of age. At that time it was considered the disease had progressed to the Lennox- Gastaut syndrome. A computerized tomographic scan showed a porencephalic cyst in the left anterior temporal region. The craniotomy and the evacuation of the fluid in the cyst were performed at 4 years and 6 months of age. The cerebral surface was found to be markedly bulged and 20 ml of xanthochromic fluid was obtained from the intracerebral cyst. He had no seizures for 1 year since 3 days after the operation and the EEG findings has also improved.<BR>It is considered that the treatment for the cortical lesion interrupted an abnormal interaction of the cortex and the subcortical reticular system. We therefore conclude that Lennox- Gastaut syndrome should be regarded as an generalized cortico-reticular epilepsy.
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