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例1 男性,36岁,农民。右侧面部及下磨牙呈发作性电刺样疼痛7年,每月发作2～3次,每次发作持续约10min左右缓解,多在劳累或吃硬食物时发作。曾服扑尔敏,去痛片,安定,肌注鲁米那钠约54天未再发作,后又因精神刺激再次犯病,且呈进行性加重,可持续1～2天。 曾在外地诊断“牙髓炎”及“三叉神经痛”,先后拔除两颗后磨牙,理疗及局部封闭,中药等治疗均无效,1992年4月6日来我院检查。血压17.5/12kPa,查体无阳性体征。脑电检查于过度换气诱发试验5～8s至90s时各导联出现同步的暴发的短程3～4次/s 250～300μv的尖慢综合波,右枕区显著。CT检查正常。诊断牙痛性癲痫,给苯妥英钠0.1每日3次,5天后症状明显减轻,又将药量增加至0.2每日3次,2个月症状完全消失,以后逐渐减量至停药至今未再发作。
Example 1 Male, 36 years old, farmer. The right side of the face and the lower molars were episodes of electro-acupuncture pain for 7 years, 2 to 3 episodes per month, each attack lasted about 10min or so, more in the exertion or eating hard food attack. Served chlorpheniramine, to painkillers, stability, intramuscular injection of sodium Lumi Na about 54 days without recurrence, and then re-convulsions due to mental stimulation, and was progressive increase, sustainable 1 to 2 days. In the field of diagnosis of “pulpitis” and “trigeminal neuralgia”, has removed two molars, physical therapy and partial closure, Chinese medicine and other treatment are invalid, April 6, 1992 to our hospital. Blood pressure 17.5 / 12kPa, physical examination no positive signs. EEG examination induced hyperventilation induced test 5 ~ 8s to 90s when the lead appeared synchronized outbreaks of short-range 3 ~ 4 times / s 250 ~ 300μv sharp slow wave, right occipital significant. CT examination is normal. Diagnosis of toothalamic epilepsy, to phenytoin 0.1 3 times a day, 5 days after the symptoms were significantly reduced, and then the dose increased to 0.2 3 times a day, 2 months the symptoms disappeared, and then gradually tapering until the withdrawal has not yet attack.