Seizure or syncope: lessons over time.
Seizure or syncope: lessons over time.
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癫痫发作或晕厥：随着时间的推移吸取教训。
DOI：
10.1016/j.jocn.2011.06.017
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Sheen,VolneyL
中科院分区：
文献类型：
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作者：
Sheen,VolneyL
一名25岁女性反复晕厥发作，首次出现全身强直阵挛（GTC）癫痫发作。她之前经历过两次持续数秒的昏厥，与减肥药和脱水有关。她在摔倒前有另一个类似的咒语，右后枕骨撕裂，并有目击的GTC癫痫发作。她的头皮脑电图（EEG）显示左颞叶变慢伴尖锐特征。T1加权和T2加权磁共振成像显示两个中度增强局灶性病变内的左额和颞区。这些发现提高了潜在癫痫病灶的可能性。然而，一个月后对该患者的重复影像学检查显示，这些发现和脑软化区消退，与创伤性政变对冲性损伤一致。重复脑电图正常。因此，意识丧失的原因是晕厥，随后头部受伤引起孤立性癫痫发作。了解癫痫发作的根本原因在决定治疗方面很重要。在这种情况下，患者未开始接受癫痫药物治疗，情况良好。
A 25-year-old woman with recurrent syncopal episodes presented with a first time generalized tonic clonic (GTC) seizure. She had experienced two prior fainting spells lasting seconds and associated with diet pills and dehydration. She had another similar spell prior to falling, sustaining a laceration to the right posterior occiput, and having a witnessed GTC seizure. Her scalp electroencephalography (EEG) showed left temporal slowing with sharp features. T1-weighted and T2-weighted MRI revealed two moderately enhancing focal lesions within the left frontal and temporal regions. These findings raised the possibility of an underlying seizure focus. Repeat imaging studies of this patient 1month later, however, demonstrated resolution of these findings and an area of encephalomalacia, consistent with a traumatic coup contrecoup injury. A repeat EEG was normal. Therefore, the cause of the loss of consciousness was due to syncope with the consequent head injury giving rise to an isolated seizure. Understanding the underlying cause of a seizure is important in dictating treatment. In this setting the patient was not initiated on seizure medication and has done well.