Epileptic nystagmus as a prominent symptom in status epilepticus: a report of 3 cases
10.3760/cma.j.issn.1671-8925.2014.08.016
- VernacularTitle:以癫痫性眼震为主的癫痫持续状态三例报道
- Author:
Liying WANG
1
;
Zhengwei WANG
;
Yunlong YUE
;
Wenhong LIU
Author Information
1. 首都医科大学附属北京世纪坛医院功能神经外科
- Keywords:
Epileptic nystagmus;
Status epilepticus;
Video-electroencephalogram;
Diffusion weighted magnetic resonance imaging
- From:
Chinese Journal of Neuromedicine
2014;13(8):825-828
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the typical clinical and imaging characteristics of epileptic nystagmus (EN) to provide a reference for better diagnosis and treatment of EN.Methods Three patients with EN,admitted to our hospital from 2008 to 2010,were chosen; the clinical presentations and ictal epileptiform discharges by magnetic resonance imaging (MRI) or transcranial cerebral Doppler (TCD) were studied retrospectively.Results All patients showed a binocular syntropy horizontal nystagmus and conjugate eye deviation on onset.Among all the three,two had head deviation,one visual hallucination and one vertigo; during onset,altered mental state and/or impaired consciousness were noted.The ictal EEG revealed that the 11-14 Hz spike waves mainly originated from the temporal-parietal-occipital border area was opposed to the direction of the nystagrnus (one left and two right).Diffusion-weighted imaging (DWI) abnormal high signal and high signal of fluid-attenuated inversion recovery sequences were located at left parietal-occipital region (n=1),right temporal-parietal-occipital region (n=1) and right occipital-temporal region (n=1) in the 1.5 T MRI.TCD indicated an elevated flow velocity in the ipsilateral middle/posterior cerebral artery during status epilepticus.Conclusions The epileptic nystagrnus as a prominent symptom in status epilepticus is a rare type of status epilepticus.Video-EEG is the key method in the diagnosis of the disease.The direction of the nystagrnus usually is contralateral to the brain lesion and/or the ictal discharges.The frequent seizures induce DWI abnormality.Epileptogenic zone is localized to the temporal-parietal-occipital region.
