腹膜灌流により脳波上興味ある経過を示した尿毒症の一例

抄録

Serial electroencephalographic examinations were performed during the course of intermittent peritoneal dialysis in a 10 year old uremicpatient who had no family or past history of epilepsy.
At the height of uremia with maximal biochemical deviation, EEG showed marked slow wave dysrhythmia and occasional bursts of bilaterally synchronous high voltage slow waves, which gradually improved to show normal basic rhythm in the course of treatment. However, with clinical and electro-encephalographic improvement, bilaterally synchronous atypical spike and wave complexes appeared in all leads.
Marked slowing of EEG at the height of uremia may reflect a primary cortical involvenment and bilaterally synchronous high voltage slow wave bursts may reflect involvement of brain stem mechanisms of presumed reticularorigin. Later development of bilaterally synchronous atypical spike and wave complexes with improvement of cortical background activity is consistent with the known pathology of uremia in which brain stem reticular formation is particularly involved together with cerebral cortex.
The above finding is one of evidences to support the concept that origination of bilaterally synchronous spike and wave complex will require the involvement of cortico-reticular system.