老年自主神经性癫痫二例

目的探讨老年自主神经性癫痫发病机制和临床特点。方法分析2例老年自主神经性癫痫患者临床资料,结合影像学、脑电图结果探讨其临床特点和发病机制。结果 2例患者分别为67岁、60岁,均有高血压和(或)糖尿病病史,表现为发作性自主神经症状,头颅MRI检查可见颅内多发缺血灶(例1无明确边缘系统损害),无癫痫既往史及家族史,首诊均出现误诊,长程脑电图检查发现痫性放电,抗癫痫治疗有效。结论老年人自主神经性癫痫发病机制复杂,临床表现形式多样,动脉粥样硬化性脑梗死是其常见因素之一,影像学往往不能发现癫痫病灶,长程脑电图检查可提高诊断准确性。

Two cases of elderly patients with autonomic epilepsy

Objective To investigate the elderly autonomic epilepsy pathogenesis and clinical features Methods The clinical data of 2 cases of elderly patients with autonomic epilepsy were analysed,and clinical features and pathogenesis were investigated combinating with imaging and EEG results.Results Two cases of elderly patients were 67 years old and 60 years old,underwent high blood pressure and(or) a history of diabetes,performance for episodic autonomic symptoms,brain MRI examination showed multiple intracranial ischemic lesions(the limbic system of 1 case was not clearly damaged),They had no past history and family history of epilepsy,suffered from misdiagnosis on the first visit,epileptic discharges were found by long-term EEG,antiepileptic treatment was effective.Conclusion The pathogenesis of elderly autonomic epilepsy is complex and the clinical manifestations diversed,atherosclerotic cerebral infarction is one of the common factors.Imaging often can not find the epileptic lesion,and long-term EEG may improve diagnostic accuracy.