【摘要】 <正> 有少数癫痫患者和个别健康人可以通过视觉、听觉、触觉等生理性或物理性刺激诱导癫痫发作,临床上将它们统称为反射性癫痫或诱发性癫痫,文献中已屡有记载。但有关棋类或纸牌游戏诱发的癫痫则在世界医学文献上均未见有报导。作者陈在1957年开始注意到一种与弈棋有关的反射性癫痫。作者秦在1962年又发现一种与纸牌游戏有关的反射性癫痫。兹合并就六年(1957年8月到1963年3月)来发现的四例这类病人作一报导并就其诱发机制加以探讨。更多还原

【Abstract】 Attacks of epilepsy induced by watching or playing of chess or card games have never been reported so far in the literature.The author, Chen,first observed in 1957 a case of reflex epilepsy induced by watching chess game,and in 1962,another author,Chin,observed another case induced by playing of cards.The present communication reports four cases of chess and card epilepsy observed in The First Teaching Hospital of The Shanghai First Medical College between August 1957 and March 1963. All four patients were of male sex.Onset of seizures began at the ages of 20.21,14 and 13 respectively.Case 1 and 3 showed the character- istic pictures of myoclonic epileptic attacks and grand mal.Case 2 and 4 showed the typical manifestations of adversive seizures.Case 2 had “acute meningitis” and case 4 had “head injury” in the past.Though there were no well defined localized abnormality in their electroencephalo- grams,nor any positive findings on neurological and roentgenological investigations in these two cases,their clinical manifestations could still be attributed to the presence of a certain regional pathological change in the brain.The diagnosis of genuine epilepsy in these two cases seemed unlikely.With regard to case 1 and case 3 the diagnosis was considered to be genuine epilepsy on basis of the form of attacks and the electro- encephalographic characteristics. Chess game (Hsiang-cbi) provoked epileptic seizures in all four cases,and card game provoked attacks in two of them (Case 1 and 2).Case 1,who admitted himself a poor hand in the chess game,preferred to be a spec- tator rather than a participant.In spite of his being an unconcerned spectator,he would almost always have grand mal attacks,if he looked at the game too long.Epileptic attacks would be induced in case 2,3 and 4 when they played the chess,Case 1,after the first attack induced by chess game had noticed ten years later that card game lasting longer than 2 hours could provoke a kind of myoclonic epileptic attacks as well. Card game induced(?)an adversive seizure in case 2.Thus,besides the epileptic attacks induced by chess games in all four cases,there were also epilepsies induced by card game in two of them. Paroxysmal bursts of sharp waves or spikes of high voltage occurred on hyperventilation in the electroencephalograms of all four cases. Playing chess (only case 1 acting as a spectator) resulted in all except case 2 in more frequent bursts of abnormal discharges of high voltages as well as in actual clinical seizures in two of them. Possible mechanisms of the pathogenesis of the epileptic seizures induced by chess and card games were discussed.The authors present these cases with the hope that discovery of these two new patterns of reflex epilepsy might cast some light on the pathogenetic mechanism of epilepsy and further elucidate the reflex theory of its pathogenesis.更多还原