PDF(Pubmed)
Abstract：
Focal seizures with subjective auditory phenomena, known as auditory seizures, are uncommon and can include simple to complex auditory hallucinations. We present a case of a 59-year-old man who presented with motor and non-motor seizures. He had a four-month history of hearing things resembling continuous metallic sounds, pennies dropping into a bank, persistent music after radio cessation, and the sound of a passing train. Brain MRI showed multiple serpiginous flow voids in the right temporal lobes, consistent with an arteriovenous malformation that was confirmed eventually with a diagnostic brain angiogram. The etiology of the seizures was related to a structural lesion in the setting of a right temporal arteriovenous malformation (AVM). Treatment with 2000mg of levetiracetam twice daily and 300mg of oxcarbazepine twice daily improved symptoms, and subsequent stereotactic radiosurgery ablation successfully treated the AVM. Post-treatment MRI showed reduced visibility of parasitized vessels, with controlled generalized seizures but partial control of auditory seizures.
摘要：
局灶性癫痫发作与主观听觉现象，被称为听觉癫痫,并不常见，可能包括简单到复杂的幻听。我们介绍了一例59岁的男子，他出现了运动性和非运动性癫痫发作。他有四个月的历史，可以听到类似连续金属声音的声音，便士掉进银行，广播停止后持续的音乐，还有火车经过的声音.脑部MRI显示右侧颞叶有多个血清素样血流空隙，与动静脉畸形一致，最终经诊断性脑血管造影证实。癫痫发作的病因与右颞动静脉畸形（AVM）的结构性病变有关。用2000mg左乙拉西坦每天两次和300mg奥卡西平每天两次治疗改善症状，随后的立体定向放射外科消融成功治疗了AVM。治疗后MRI显示寄生血管的能见度降低，有控制的全身性癫痫发作，但部分控制的听觉癫痫发作。
