PDF(Pubmed)
Abstract：
BACKGROUND: Convulsive-like movements are rare in basilar artery occlusive cerebral infarction (BAOCI). These manifestations may easily be mistaken for epileptic seizures caused by compromised anterior circulation or by cortical lesions. Delayed diagnosis of this condition affects its subsequent treatment and prognosis. Therefore, it is critical to recognize this type of phenomenon in the early stage.
METHODS: A 55-year-old male patient presented with unconsciousness, rigidity, and a paroxysmal twitch in both lower limbs. These conditions lasted for nearly 2 h and resembled status epilepticus. After the initial conditions subsided, hemiplegia occurred and then subsided rapidly. The family refused thrombolytic therapy because the symptoms were similar to Todd paralysis after epilepsy. However, magnetic resonance imaging showed left pontine infarction. No abnormality was observed in a video electroencephalogram during the interictal period. Digital subtraction angiography revealed that the basilar artery was occluded and that the posterior communicating arteries were patent. Fortunately, the patient received a good prognosis after antiplatelet therapy, lipid regulation, balloon dilatation of the basilar artery, and rehabilitation.
CONCLUSIONS: Convulsive-like movements may be an early sign of basilar artery occlusive brainstem infarction. It is important to identify this phenomenon in a timely manner.
METHODS: A 55-year-old male patient presented with unconsciousness, rigidity, and a paroxysmal twitch in both lower limbs. These conditions lasted for nearly 2 h and resembled status epilepticus. After the initial conditions subsided, hemiplegia occurred and then subsided rapidly. The family refused thrombolytic therapy because the symptoms were similar to Todd paralysis after epilepsy. However, magnetic resonance imaging showed left pontine infarction. No abnormality was observed in a video electroencephalogram during the interictal period. Digital subtraction angiography revealed that the basilar artery was occluded and that the posterior communicating arteries were patent. Fortunately, the patient received a good prognosis after antiplatelet therapy, lipid regulation, balloon dilatation of the basilar artery, and rehabilitation.
CONCLUSIONS: Convulsive-like movements may be an early sign of basilar artery occlusive brainstem infarction. It is important to identify this phenomenon in a timely manner.
摘要：
背景：基底动脉闭塞性脑梗死（BAOCI）很少发生惊厥样运动。这些表现很容易被误认为是前循环受损或皮质病变引起的癫痫发作。这种情况的延迟诊断会影响其后续治疗和预后。因此,在早期阶段认识到这种现象至关重要。
方法：一名55岁的男性患者表现为无意识，刚性,双下肢阵发性抽搐.这些情况持续了近2小时，类似于癫痫持续状态。在初始条件平息之后,偏瘫发生后迅速消退。该家庭拒绝溶栓治疗，因为症状与癫痫后的托德瘫痪相似。然而,磁共振成像显示左脑桥梗死。在发作间期，视频脑电图未观察到异常。数字减影血管造影显示基底动脉闭塞，后交通动脉通畅。幸运的是,患者抗血小板治疗后预后良好,脂质调节，基底动脉的球囊扩张,和康复。
结论：惊厥样运动可能是基底动脉闭塞性脑干梗死的早期征兆。及时识别这种现象很重要。
方法：一名55岁的男性患者表现为无意识，刚性,双下肢阵发性抽搐.这些情况持续了近2小时，类似于癫痫持续状态。在初始条件平息之后,偏瘫发生后迅速消退。该家庭拒绝溶栓治疗，因为症状与癫痫后的托德瘫痪相似。然而,磁共振成像显示左脑桥梗死。在发作间期，视频脑电图未观察到异常。数字减影血管造影显示基底动脉闭塞，后交通动脉通畅。幸运的是,患者抗血小板治疗后预后良好,脂质调节，基底动脉的球囊扩张,和康复。
结论：惊厥样运动可能是基底动脉闭塞性脑干梗死的早期征兆。及时识别这种现象很重要。
