著者

星山 栄成 高野 雅嗣 竹川 英宏 宍戸 宏行 永山 正雄 小野 一之 平田 幸一

出版者

一般社団法人 日本神経救急学会

雑誌

Journal of Japan Society of Neurological Emergencies & Critical Care (ISSN:24330485)

巻号頁・発行日

vol.31, no.2, pp.69-73, 2019-08-23 (Released:2019-08-24)

参考文献数

11

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A 42-year-old male patient was admitted to our hospital because of generalized convulsive status epilepticus (GCSE), disturbance of consciousness, and shock. He had cardiopulmonary arrest after arrival our hospital, but he was return of spontaneous circulation as soon as cardiopulmonary resuscitation. He had disseminated intravascular coagulation (DIC) and multiple organ dysfunction. From the time of admission, we managed about the patient's breathing, circulation, body temperature. We also administrated sodium valproate 400mg, levetiracetam 1,000mg daily, and continuous use of midazolam to status epilepticus. In addition, he underwent continuous renal replacement therapy because of acute renal failure. The electroencephalogram showed scattered delta waves. Brain MR images showed hyper-intense lesions at bilateral pallidum and thalami, which led to a diagnosis of hypoxic encephalopathy associated with long-term GCSE. On day 13, he started tracking our fingers with his eyes. On day 34, he was able to obey commands and he was transferred to the general ward. GCSE is known to exhibit various organ dysfunctions. In this case, there was a history of epilepsy and had developed on GCSE, but as a result of the clinical examination, it was considered epilepsy-related organ dysfunction because the cause of multiple organ dysfunction was not clear.

著者

続木 陽子 佐藤 勉 永山 正雄

出版者

一般社団法人 国立医療学会

雑誌

医療 (ISSN:00211699)

巻号頁・発行日

vol.43, no.10, pp.1085-1090, 1989-10-20 (Released:2011-10-19)

参考文献数

15

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優位側視床梗塞による健忘症候群の1例につき, 131I-IMP SPECTにより検討を加えた. 症例は73才女, 右利き. 傾眠と一過性の右上肢不全麻痺で発症した. 数日で意識清明化した後にも健忘症状が持続し, 14~16日後の神経心理学的検査で言語性短期記憶, 計算, 抽象的思考の障害を認めた. CTスキヤンにて左視床前核群, 背内側核, 前腹側核にわたる梗塞巣がみられた. SPECT所見では, 発症後18日目に左視床の他に左前頭葉と側頭葉に広汎な脳血流低下が示唆され, 発症後41日目には左前頭葉下部にのみ異常が残つた. 視床前・内側部の限局性病変が大脳皮質機能に影響し, これが症状の発現と関係した可能性が考えられた.