Neurological Surgery 脳神経外科41巻5号

2013年05月発行

症例

脳梁離断術によりてんかん焦点が顕在化した多発結節を伴う結節性硬化症の1例

著者： 佐藤圭亮¹ 岩崎真樹¹ 植松貢² 中里信和³ 冨永悌二¹

所属機関： ¹東北大学大学院神経外科学分野 ²東北大学大学院小児病態学分野 ³東北大学大学院てんかん学分野

ページ範囲：P.421 - P.428

Ⅰ．はじめに

　結節性硬化症（tuberous sclerosis）は高頻度にてんかんを合併し，その多くは薬物治療に抵抗性である．しかし，結節が多発している場合はてんかん焦点の同定が困難なため，外科治療が適応できないことも多い．てんかん原性結節の同定にはMRIに加えて，脳磁図（MEG）やFDG-PETなどが用いられるが，特に乳幼児期のてんかんは，全般性の脳波異常や局在所見に乏しいてんかん発作症状を呈する傾向が強く，てんかん焦点の同定は一般に困難である^3,9,16)．

　今回われわれは，多発結節を伴う結節性硬化症の小児に対して脳梁離断術を行ったところ，てんかん焦点が明らかになり，二期的にてんかん原性結節を切除して発作の寛解を得た1例を経験したので報告する．

参考文献

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