PARTIALLY SUCCESSFUL TREATMENT OF RASMUSSENS ENCEPHALITIS WITH ZIDOVUDINE - SYMPTOMATIC IMPROVEMENT FOLLOWED BY INVOLVEMENT OF THE CONTRALATERAL HEMISPHERE
PARTIALLY SUCCESSFUL TREATMENT OF RASMUSSENS ENCEPHALITIS WITH ZIDOVUDINE - SYMPTOMATIC IMPROVEMENT FOLLOWED BY INVOLVEMENT OF THE CONTRALATERAL HEMISPHERE
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DOI：
10.1111/j.1528-1157.1994.tb02443.x
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发表时间：
1994-03-01
期刊：
影响因子：
5.6
通讯作者：
SMITH, DB
中科院分区：
文献类型：
--
作者：
DETOLEDO, JC;SMITH, DB
1例18岁女性，有4年的拉斯穆森脑炎（RE）病史，表现为进行性失语、右侧轻偏瘫和几乎连续的难治性简单部分性癫痫发作，经常继发全身性发作，采用齐多夫定（AZT）治疗。癫痫发作对任何主要的抗癫痫药物（AEDs）都没有反应，这些药物被给予了高水平和毒性水平，或者ACTH。服用AZT 62天，因粒细胞减少而停药。在AZT开始治疗的6周内，癫痫发作停止，神经功能恶化被阻止了21个月。随后，部分躯体运动性癫痫发作，影响到以前未涉及的左半身。尝试了2周的AZT重复疗程，但持续发热和胃肠道（GI）副作用排除了AZT治疗的继续。在未经治疗的RE中尚未报告癫痫发作的自发持续缓解。在这种情况下，癫痫控制和神经系统恶化的停止比使用AZT持续了19个月。由于该患者对AZT有明显反应，因此似乎有必要进行旨在评估抗病毒药物的长期缓解/治愈特性的临床研究，特别是在语言优势半球受累的患者中。
An 18-year-old woman with a 4-year history of Rasmussen's encephalitis (RE) manifested by progressive aphasia, right hemiparesis, and nearly continuous intractable simple partial seizures that frequently secondarily generalized was treated with zidovudine (AZT). Seizures had not responded to any of the major antiepileptic drugs (AEDs) administered to high and toxic levels, or to ACTH. AZT was given for 62 days and discontinued because of granulocytopenia. Within 6 weeks of AZT initiation, seizure stopped and neurologic deterioration was arrested for similar to 21 months. Subsequently, partial somatomotor seizures developed, affecting the previously uninvolved left hemibody. A 2-week repeat course of AZT was attempted, but unremitting fever and gastrointestinal (GI) side effects precluded continuation of AZT treatment. Spontaneous, sustained remission of seizures has not been reported in untreated RE. Seizure control and arrest of neurologic deterioration in this case outlasted use of AZT by 19 months. Because of the apparent response of this patient to AZT, clinical studies designed to assess long-term palliative/curative properties of antiviral agents, particularly in patients with involvement of the hemisphere dominant for language, appear warranted.