阵发性同义偏盲(HH)是癫痫的罕见表现。我们证明了罕见的阵发性HH病例,该病例是通过磁共振(MR)动脉自旋标记(ASL)诊断的。一名82岁的女性在颅脑外伤后16天突然出现孤立的视野异常,没有惊厥性癫痫。入院时获得的扩散加权和MR-ASL显示右颞枕皮质的高强度和高灌注。怀疑非惊厥性癫痫持续状态。患者口服左乙拉西坦治疗,症状在3天内消失。单纯性部分性癫痫患者应考虑阵发性HH,和MR-ASL成像可能有助于这些患者的鉴别诊断。
Paroxysmal homonymous hemianopsia (HH) is uncommon presentation of epilepsy. We demonstrate a rare
case of paroxysmal HH that was diagnosed by magnetic resonance (MR) arterial spin-labeling (ASL). A 82-year-old woman presented with abrupt onset of isolated visual field abnormality without convulsive epilepsy at 16 days after a traumatic head injury. Diffusion weighted and MR-ASL obtained on admission revealed hyperintensity and hyperperfusion in the right temporo-occipital cortex. Nonconvulsive status epilepticus was suspected. The patient was treated with oral levetiracetam and the symptoms resolved in 3 days. Paroxysmal HH should be considered in patients who present with simple partial epilepsy, and MR-ASL imaging may assist in the differential diagnosis of these patients.