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6岁女孩,服L-赖氨酸1/4包(2.5g)后半小时,突然恶心、呕吐三次,非喷射性,随之抽搐,双目凝视,右侧肢体抽动,左侧强直,历时10分钟自行停止,如此反复发作三次。查体神志不清,面唇微绀,两瞳偏大,光反应迟钝,四肢肌张力高,腱反射活跃,病理征阳性,立即给镇静止痉,抽搐停止,次日神清,活动如常儿,脑电图仍双侧弥漫性θ节律,伴高波幅(>300mv)δ波,左侧为甚。追问病史,近二月每日口服L-赖氨酸1/4包,超过规定剂量5倍,遂嘱停服,随访二年,未再有痫性发作。赖氨酸致痫机理有待进一步探讨。
Six-year-old girl, half an hour after taking L-lysine 1/4 pack (2.5g), suddenly nausea, vomiting three times, non-jet, followed by convulsions, binocular gaze, right limb twitch, left ankylosis, 10 minutes to stop on their own, so repeated attack three times. Examination of unconsciousness, face micro-cyanosis, two pupil is too large, slow light reaction, limb muscle tension, tendon reflex active, positive pathological signs of sedation, convulsions, convulsions stopped the next day clear, activity as usual , EEG still bilateral diffuse θ rhythm, with high amplitude (> 300mv) δ wave, the left is even. Asked history, nearly February daily oral L-lysine 1/4 package, 5 times the prescribed dose, then ordered to stop taking, followed up for two years, no further seizures. Lysine induced epilepsy mechanism to be further explored.