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患者男,32岁。因发作性左上肢抽搐3次,进行性加剧1月余入院。1年前患脑膜炎在外院治愈,出院1个月后出现左上肢抽搐,近1个月来每日抽搐10～20次,每次10～20分钟,发作时意识丧失,伴全身抽搐,两眼向左斜视,口吐白沫,左手活动不灵,门诊怀疑脑右半球占位病变而收入院。查体:左上肢肌力Ⅱ级,左上肢Hoffmann氏征阳性,其余无阳性发现。脑电图示右额区呈痫样放电。CT扫描右额区呈等密度结节病灶,其周围呈明显低密度改变(为脑水肿所致),增强CT扫描病灶呈结节状强化。
Male patient, 32 years old. Due to episodes of upper left limb twitching 3 times, progressive more than 1 month admitted to hospital. One year ago, meningitis was cured in the hospital. One month after discharge, left upper extremity convulsions occurred. Twitch was performed 10 to 20 times a day in the past month, with each episode of 10 to 20 minutes. Loss of consciousness during seizures and generalized convulsions, Eyes strabismus, spit foam at the mouth, left hand movement is not working, clinics suspect the right hemisphere lesions occupy the income hospital. Physical examination: left upper limb muscle strength Ⅱ grade, left upper extremity Hoffmann’s sign positive, the rest without positive findings. EEG shows the right frontal area was epileptiform discharge. CT scan of the right frontal region showed equal density of nodular lesions, the surrounding showed a significant density change (caused by cerebral edema), enhanced CT scan showed nodular enhancement.