Status Epilepticus as an Initial Manifestation of Neurosyphilis: A Case Report

神經性梅毒以癲癇重積狀態為表現－一病案報告

李建勳(Chien-Hsun Li) ； 蘇哲能(Che-Long Su) ； 林威辰(Wei-Chen Lin) ； 林瑞泰(Ruey-Tay Lin)

《The Kaohsiung Journal of Medical Sciences》 22卷8期 (2006/08) Pp. 404-409

摘要

癲癇發作和局部神經功能缺損可能是神經性梅毒的併發症，但是以癲癇重積狀態為初始症狀表現仍是相當罕見的。我們提出一位四十歲男性個案，起始表現有急性表達性語言困難，伴隨著持續性癲癇狀態以及嚴重的系統性內科併發症。經由廣泛的實驗室評估，確定神經性梅毒及糖尿病的診斷。腦部磁振照影顯現出非特異性炎症反應的變化。由於神經性梅毒的多樣化臨床表現，我們再次強調面對任何中樞神經系統疾病，特別是癲癇重積狀態，神經性梅毒都應列入鑑別診斷。

關鍵字

中樞神經系統疾病 ； 神經性梅毒 ； 癲癇重積狀態

並列摘要

Seizures and focal neurologic deficits may be the complications of neurosyphilis, but status epilepticus as a presenting picture of neurosyphilis is rare. We describe a 41-year-old man with an acute onset of expressive dysphasia, followed by persistent seizure state and severe complications of systemic medical problems. An extensive laboratory evaluation confirmed the diagnosis of neurosyphilis and diabetes mellitus. Brain magnetic resonance imaging showed edematous change in the left cingulate gyrus, left temporal lobe, and peri-Rolandic area, which suggested an inflammatory process. Due to varied clinical manifestations of neurosyphilis, we underscore the importance of considering neurosyphilis among the possible causes of status epilepticus and any central nervous system diseases.

並列關鍵字

CNS disease ； neurosyphilis ； status epilepticus