以陌生感為表現的顳葉癲癇個案報告

A Case Report of Temporal Lobe Epilepsy with Manifestation of Jamais Vu

「夢樣狀態」描述心智狀態的短暫改變，意識會專注在闖入的感覺或知覺。夢樣狀態的症狀描述相當主觀，包括既視感、陌生感、情緒變化與幻覺。夢樣狀態常與顳葉癲癇相關，但也常發生於精神科疾病。這篇個案報告，描述一位十七歲男性，因頻繁出現的陌生感而感到困擾，長期診斷為顳葉癲癇，但症狀在抗癲癇藥物治療下未得到改善，且腦波圖未偵測到異常發現。考慮不典型病程的癲癇時，精神疾病診斷需要被鑑別。作者指出其癲癇症狀以精神疾病症狀表現，歸納心因性癲癇的可能因素。個案的心智狀態需要被關切，並需要精神科醫師評估與介入治療。

Dreamy state is a transient alteration of mental state in which consciousness is preoccupied with an intrusive sensation or perception. The phenomenology is heterogeneous and subjective and includes déjà vu, jamais vu, reminiscence of memories, emotional change, and hallucinations. Dreamy state is known to be related to temporal lobe epilepsy, but the abovementioned symptoms are usually noted in psychiatric disorders. Herein we report a case involving a 17-year-old male suffering from frequent sense of strangeness who was diagnosed as having temporal lobe epilepsy. His symptoms were resistant to anticonvulsants, and electroencephalography revealed no positive findings. Due to the atypical presentation of his epilepsy, his illness needs to be differentially diagnosed from possible mental disorder. This case report highlights the possibility that epilepsy can manifest with symptoms of mental disorder, and postulated possible factors of psychogenic non-epileptic seizure. The mental condition of this case suggested the need for further investigation and additional assessment by a psychiatrist.