Peri-ictal headache due to epileptiform activity in a disconnected hemisphere

被引：5

作者：

Vydrova, Rosa ^{[1
]}

Krsek, Pavel ^{[1
]}

Kyncl, Martin ^{[2
]}

Jahodova, Alena ^{[1
]}

Dvorak, Josef ^{[3
]}

Komarek, Vladimir ^{[1
]}

Delalande, Olivier ^{[4
]}

Tichy, Michal ^{[3
]}

机构：

[1] Charles Univ Prague, Univ Hosp Motol, Fac Med 2, Dept Pediat Neurol, CZ-15006 Prague 5, Czech Republic

[2] Charles Univ Prague, Univ Hosp Motol, Fac Med 2, Dept Radiol, CZ-15006 Prague 5, Czech Republic

[3] Charles Univ Prague, Univ Hosp Motol, Fac Med 2, Dept Neurosurg, CZ-15006 Prague 5, Czech Republic

[4] Fdn Ophtalmol Adolphe Rothschild, Paris, France

来源：

EPILEPTIC DISORDERS | 2014年 / 16卷 / 02期

关键词：

peri-ictal headache; hemispherotomy; AED withdrawal; SPREADING DEPRESSION;

D O I：

10.1684/epd.2014.0653

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

A 4-year-old girl with intractable epilepsy due to left-side hemispheric cortical dysplasia underwent a hemispherotomy. She was seizure-free after the surgery. EEG showed persistent abundant epileptiform activity over the left (disconnected) hemisphere, including ictal patterns that neither generalised nor had clinical correlates. Antiepileptic medication was completely withdrawn four years following the surgery. One week after the withdrawal, she developed episodes of intense left-sided hemicranias (ipsilateral to the surgery) with vomiting and photophobia that did not resemble her habitual seizures and were unresponsive to non-steroidal anti-inflammatory drugs. Video-EEG showed association of the headache attacks with ictal patterns over the disconnected hemisphere. Brain MRI revealed increased signal changes in the left hemisphere. Attacks responded promptly to i.v. midazolam and carbamazepine at a low dose. Mechanisms underlying peri-ictal headache originating in the disconnected hemisphere are discussed. [Published with video sequences]

引用

页码：213 / 217

页数：5

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