WordNet

showing favoritism
being or affecting only a part; not total; "a partial description of the suspect"; "partial collapse"; "a partial eclipse"; "a partial monopoly"; "partial immunity"
remaining in force or being carried on without letup; "the act provided a continuing annual appropriation"; "the continuing struggle to put food on the table"

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(また『part』)『一部分の』,部分的な;不完全な / 不公平な,偏った / 《補語にのみ用いて》(…が)特に好きで《+『to』+『名』》

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/10/03 18:44:14」(JST)

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Epilepsia partialis continua (also called Kojevnikov's epilepsia) is a rare^[1] type of brain disorder in which a patient experiences recurrent motor epileptic seizures that are focal (hands and face), and recur every few seconds or minutes for extended periods (days or years).

Presentation

During these seizures, there is repetitive focal myoclonus or Jacksonian march. After a seizure has subsided, Todd's phenomenon may be observed, which includes transient unilateral weakness.

Causes

There are numerous causes for this kind of seizure and they differ depending somewhat on the age at which the seizures begin. Epilepsy most often occurs at the extremes of life – in childhood or in very old age – but can develop at any time throughout one's life. Epilepsy really begins at conception or the completion of one's genome, because from then on all the things that affect the brain may have the potential to cause seizure to begin.

Although these seizures are usually due to large, acute brain lesions resulting from strokes in adults and focal cortical inflammatory processes in children (Rasmussen's encephalitis), possibly caused by chronic viral infections, edema, or autoimmune processes.

They are very medication and therapy-resistant, and the primary therapeutic goal is to stop secondary generalization. There are also many other reasons why these seizures occur. For example, they could be due to genetics, infections, problems with brain development. Commonly the cause is unknown.

Genetic background determines such features as height, eye color, and potential to develop certain diseases like diabetes, but it also determines all the chemicals and structures that make up the brain, therefore playing a role in epilepsia partialis continua. The chemicals and structures that make up the brain have similarities across different people, but they vary in certain enzymes and receptors. These variations are not usually enough to cause a problem, but occasionally they do. For example, if a person has a mutation in a gene that creates the sodium channel (a part of the neuron required for firing) it makes it easier for neuronal firing to get out of control.

An infection of the brain (encephalitis) can also be a contributing factor. Although this sort of infection is uncommon it can be due to a virus, bacterium, or (very rarely) fungus. If a seizure happens during the infection itself, the person most likely doesn't have epilepsy, but has "symptomatic seizures" or seizures occurring because of a known injury to the brain. Once the infection is stopped the seizures will stop. Another more common infection is "meningitis", infection of the membranes surrounding the brain. Since this infection does not directly involve the brain it might not appear as a possible cause of epilepsy, but has been shown that meningitis can cause epilepsy, which would give rise to the possibility of developing epilepsy partialis continua. These infections are most likely to result in epilepsy when they occur at an early age.

Problems with brain development can also be a factor. The brain undergoes a complicated process during development in which neurons are born and must travel to the surface of the brain. Here they wind up carefully placed in six distinct layers of the cerebral cortex. Throughout the brain the placement of these neurons are normally quite precise. If this system doesn't work exactly right, neurons can develop outside their appropriate areas. If this happens then the firing or circuitry of the brain is not right, and an abnormal, epileptic circuit can result.

Treatment

Identification of the underlying cause plays an important role in treatment. Brain abscesses or tumors can be- at least temporarily or partially, if not fully and permanently- surgically treated and chemotherapy and/or radiotherapy given to the patient. If seizures do continue, various anticonvulsant medication regimens that can be tolerated by the patient can be tested and if need be, administered, either orally, or in emergency conditions such as status epilepticus after tonic-clonic (grand mal) seizures, intravenously. If stroke or other similar, transient disorders occur (cerebrovascular accident, or transient ischemic attack, TIA), then neurological imaging of the affected lobes or hemispheres of the brain can be performed (CT, MRI, PET, etc.) and, if not absolutely contraindicated, antithrombolytic therapy might be given if it can be tolerated due to the seizures; if a hemorrhagic stroke has occurred and surgery can be performed to cauterize the vessel or otherwise stop the bleeding, it will be attempted if it can be done safely.^[2]

References

^ Bien CG, Elger CE (March 2008). "Epilepsia partialis continua: semiology and differential diagnoses". Epileptic Disord 10 (1): 3–7. doi:10.1684/epd.2008.0161. PMID 18367424. http://www.john-libbey-eurotext.fr/medline.md?issn=1294-9361&vol=10&iss=1&page=3.
^ Sinha S, Satishchandra P (April 2007). "Epilepsia Partialis Continua over last 14 years: experience from a tertiary care center from south India". Epilepsy Res. 74 (1): 55–9. doi:10.1016/j.eplepsyres.2006.12.003. PMID 17292588. http://linkinghub.elsevier.com/retrieve/pii/S0920-1211(07)00002-2.

UpToDate Contents

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1. 局在関連（部分）てんかん：原因および臨床的特徴 localization related partial epilepsy causes and clinical features
2. 成人におけるてんかん重積状態 status epilepticus in adults
3. 小児におけるてんかん重積状態の臨床的特徴および合併症 clinical features and complications of status epilepticus in children
4. ミオクローヌスの分類および評価 classification and evaluation of myoclonus
5. 小児における運動過多な運動障害 hyperkinetic movement disorders in children

English Journal

Intravenous levetiracetam treatment in status epilepticus: A prospective study.

Atmaca MM1, Orhan EK2, Bebek N2, Gurses C2.
Epilepsy research.Epilepsy Res.2015 Aug;114:13-22. doi: 10.1016/j.eplepsyres.2015.04.003. Epub 2015 Apr 17.
OBJECTIVE: To assess the efficacy of intravenous (IV) levetiracetam (LEV) in the treatment of status epilepticus (SE) and treatment outcomes.METHODS: This study was conducted on patients, who were classified according to the clinical characteristics of their seizures, in the emergency department, ne
PMID 26088881

Epilepsia partialis continua responsive to neocortical electrical stimulation.

Valentin A1,2,3, Ughratdar I4, Cheserem B4, Morris R5, Selway R4, Alarcon G1,2,3.
Epilepsia.Epilepsia.2015 Jul 15. doi: 10.1111/epi.13067. [Epub ahead of print]
Epilepsia partialis continua (EPC), defined as a syndrome of continuous focal jerking, is a rare form of focal status epilepticus that usually affects a distal limb, and when prolonged, can produce long-lasting deficits in limb function. Substantial electrophysiologic evidence links the origin of EP
PMID 26174165

Etiology, clinical course and response to the treatment of status epilepticus in children: A 16-year single-center experience based on 602 episodes of status epilepticus.

Kravljanac R1, Djuric M2, Jankovic B2, Pekmezovic T3.
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.Eur J Paediatr Neurol.2015 Jun 19. pii: S1090-3798(15)00104-X. doi: 10.1016/j.ejpn.2015.05.007. [Epub ahead of print]
OBJECTIVE: evaluation of etiology, clinical course and response to the treatment of status epilepticus (SE) in children, with particular investigation of superrefractory SE.MATERIALS AND METHODS: The retrospective study included children with convulsive SE aged 0.2-18 years, treated from 1995 to 201
PMID 26143956

Japanese Journal

Nationwide survey (incidence, clinical course, prognosis) of Rasmussen's encephalitis

MUTO Ayako,OGUNI Hirokazu,TAKAHASHI Yukitoshi,SHIRASAKA Yukiyoshi,SAWAISHI Yukio,YANO Tamami,HOSHIDA Toru,OSAKA Hitoshi,NAKASU Satoru,AKASAKA Noriyuki,SUGAI Kenji,MIYAMOTO Akie,TAKAHASHI Satoru,SUZUKI Motomasa,OHMORI Iori,NABATAME Shin,OSAWA Makiko
Brain & development 32(6), 445-453, 2010-06-01
NAID 10027491620

接続性部分てんかん患者の脳磁図によるjerk-lockd back average

橋詰智保,佐藤綾子,渡司博幸 [他]
臨床検査 53(5), 643-647, 2009-05
NAID 40016687637

Related Pictures

★リンクテーブル★

リンク元	「てんかん重積状態」「持続性部分てんかん」「コジェヴニコフてんかん」「EPC」
関連記事	「partial」「epilepsia」