Tourette Syndrome and Complex Partial Epilepsy - A Case report

圖烈氏症候群在解部學上的異常，以及它和癲癇的關係仍未定論。本文是一位37歲病人正好患有上述兩種疾病的報告。他二、三個月大時開始有癲癇發作。發一次發作伴有發燒，症狀是全射性強直及間代性抽搐。成人後複雜性局部癲癇的情形如下：眼前發黑，頭昏，接著眼神困滯，無反應，有時會倒下來，有時會上廁所小便。圖烈氏症候群在三、四歲左右出現；症狀包括口吃，鬼臉，以鼻子啍氣，打嗝，和兩前臂同時外旋動作。腦波發現左額頭有銳波，但此銳波並未造成不自主動作或肌肉收縮。病人表現圖烈氏症候群的症狀時亦無伴隨異常腦波。腦部磁振攝影發現左額葉又顳葉萎縮，兩側基底核大小則無明顯差異(正常人左側比右側大)。本病例支持圖烈氏症候群和左側額葉，基底充又邊綠系統有關的理論，但不支持圖烈氏症候群的症狀是一種額葉癲癇發作的假說。

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並列摘要

Controversy exists over the patophysiology of Tourette syndrome (TS). The case reported is a 37-year-old unmarried man suffering from both TS and complex partial epilepsy (CPE). He began to have seizures at 2-3 months of age. The CPE featured dark vision, dizziness, followed by unresponsiveness, a blank stare, occasional loss of posture control, and occasional automatism consisting of going to the toilet to urinate. TS gradually began to develop when he was 3-4 years of age. The tics were character-ized by stereotypic stuttering, vocalization, hiccups, grimacing, snorting, and jerky supination of both forearms. EEG sharp waves with phase reversal at the left fronto-temporal region were present but they were not related to the tics. Magnetic resonance imaging revealed atrophy of the left temporal and frontal lobes, as well as absence of normal asymmetry of basal ganglia. This case supports the theory that TS is related to the left frontal lobe, limbic system, and basal ganglia, but contradicts the hypothesis that the tics are ictal events.

並列關鍵字

Tourette syndrome ； epilepsy

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Tourette Syndrome and Complex Partial Epilepsy - A Case report

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