A 29-year-old woman presents with recurrent episodes beginning with epigastric aura, progressing to lip smacking and impaired awareness lasting several minutes, followed by 20-minute postictal confusion. Vital signs: BP 128/82, HR 98, RR 16, Temp 37°C, SpO2 98%. Brain MRI demonstrates unilateral hippocampal atrophy with T2 hyperintensity. EEG shows no generalized spike-wave discharges. She takes no antiepileptic medications. Which underlying pathology best explains these findings?
- A)Psychogenic nonepileptic seizure
- B)Acute disseminated encephalomyelitis
- C)Multiple sclerosis
- D)Todd paralysis
- E)Mesial temporal sclerosisGABARITO
Explicação
This patient has focal impaired awareness seizures arising from the temporal lobe, and hippocampal atrophy strongly indicates mesial temporal sclerosis. The hallmark pathologic substrate is hippocampal neuronal loss and gliosis, a common cause of refractory te... Ver explicação completa e trilha adaptativa →