감마니이프 방사선 수술 후 발생한 지속성 부분 간질 1예
A Case of Epilepsia Partialis Continua after Gamma Knife Radiosurgery
이일형, 김현숙, 김옥준, 안정용, 김원찬,
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이일형 ( Lee Il-Hyung )
포천중문의과대학 분당차병원 신경과
김현숙 ( Kim Hyun-Sook )
포천중문의과대학 분당차병원 신경과
김옥준 ( Kim Ok-Jun )
포천중문의과대학 분당차병원 신경과
안정용 ( Ahn Jung-Yong )
포천중문의과대학교 분당차병원 신경외과학교실
김원찬 ( Kim Won-Chan )
포천중문의과대학 분당차병원 신경과
KMID : 0877220050090020172
Abstract
The gamma knife radiosurgery (GKS) is a safe and effective neurosurgical approach in the treatment of arteriovenous malformation (AVM). Seizures after GKS are rarely reported, but epilepsia partialis continua (EPC) has not been reported yet. We report a patient with EPC accompanied with cerebral edema after GKS in AVM. A 50-year-old man was admitted for EPC, dysarthria and monoparesis 20 days after GKS due to AVM. Brain MRI showed increased cerebral edema around AVM in the left premotor area. Symptoms were relieved by IV dexamethasone and antiepileptic drugs (AEDs). 15 weeks later, EPC recurred and aphasia and right hemiplegia were rapidly aggravated. The follow up brain MRI showed markedly increased cerebral edema compared with previous MRI. EPC was well controlled by AEDs, but aphasia and hemiplegia were not responsive to IV dexamethasone until trying oral prednisolon. We think that cerebral edema induced by EPC, as a complication of GKR, might aggravate hemiparesis.
키워드
Arteriovenous malformation;Gamma knife radiosurgery;Epilpsia partialis continua
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