• Proceedings of the Korean Society of Veterinary Clinics Conference
• /
• 2009.04a
• /
• pp.151-156
• /
• 2009

발작은 대뇌겉질의 기능장애 (Cerebral cortical dysfunction)의 결과 나타나며, 다양한 임상증상을 야기하여, 임상가로 하여금 나타나는 증상이 발작인지 혼동 스럽게 한다. 그러므로, "나타나는 증상"이 진성 발작인지를 알아보기 위한 초기의 노력이 필요하다. 이는 대개 동물 보호자에게 다양하고 신중한 질문과 병력청취를 통해서 얻어진다. 일단 "발작"에 대한 진단이 이루어 지면, 동물의 품고에 기초한 감별진단 목록이 형성되어야 한다. 어린 개체 (1년이하)의 경우 감염성 병력에 의한 발작이 많고, 반면 노령성 개체 (5년 이상)의 경우 대사성 기능장애나 두개내의 종양에 의해 발작이 일어난다. 중년령의 개체(1년에서 5년사이)에서는 특발성 발작이 호발한다.

• The Korean Journal of Nuclear Medicine
• /
• v.29 no.1
• /
• pp.9-14
• /
• 1995

뇌졸증환자의 뇌 SPECT 소견상 나타나는 소뇌교차해리현상(crossed cerebellar diaschisis)은 잘 알려진 현상이다. 한편 간질 환자의 발작시 뇌 SPECT에서 반대편 소뇌에 혈류증가를 보이는 역교차해리현상(reverse type of crossed cerebellar diashisis)은 드물게 보고되었었다. 따라서 본 저자들은 발작시 뇌 SPECT에서 역교차해리현상의 빈도 및 간질병소를 찾는데 있어서의 유용성에 대해 알아보고자 하였다. 복합부분발작환자 중 임상적, 뇌파검사상 및 SPECT 소견등에서 간질병소가 일치하는 12명의 환자를 대상으로 하였다. 환자 모두에서 시행한 발작시 스캔은 발작중 혹은 환자가 aura를 호소할때 $^{99m}Tc$-HMPAO 15-20mCi를 정맥주입 후 시행하였으며 발작간 스캔은 11명의 환자에서 발작시 스캔 후 적어도 3일 간격을 두고 시행하였다. 간질병소는 우측측두엽이 6예, 좌측측두엽이 4예, 우측후두엽이 1예, 좌측전두엽이 1예 등이었다. 발작시 스캔상 간질병소 및 반대편 소뇌에 혈류가 증가하는 역해리현상은 모두 8명(75%)의 환자에서 나타났으며 특히 2명의 환자에서는 간질병소보다 반대편 소뇌의 동위원소 섭취가 더욱 뚜렸했다. 역해리현상을 보였던 환자의 발작간 스캔소견에서는 발작시 증가되었었던 소뇌의 동위원소 섭취가 7예에서 정상화되었고 나머지 1예에서는 감소되었다. 따라서 소뇌의 역교차해리현상은 발작시 뇌 SPECT의 자주 볼 수 있는 현상으로 간질병소의 편측화에 도움을 줄 수 있을 것으로 생각된다.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.4
• /
• pp.463-468
• /
• 1996

본 연구는 간질 병소의 국소화에 있어 발작기 및 발작간 뇌스캔의 정확도를 알아보고 발작기 뇌 스캔에서 나타나는 간질 확산이 정확한 간질 병소를 국소화 하는데 어떠한 영향을 미치는가에 대하여 알아보고자 하였다. 15명의 복잡 부분 발작 환자를 대상으로 하였으며, 간질 병소의 최종적인 국소화는 두피 및 발작 뇌파, 피질 뇌파, 자기 공명 영상, 임상양상 및 병리 소견을 종합한 근거로 하였다. 발작기 뇌스캔은 뇌파상 발작 중 또는 환자가 aura를 호소할 때 Tc-99m HMPAO 20mCi(740 MBq)를 정맥주입후 시행하였으며 발작간 뇌스캔은 발작기 뇌스캔 후 3일 이내 임상적으로 발작 증상이 없는 기간에 시행하였다. 간질 병소는 우측 측두엽이 8예, 좌측 측두엽이 6예, 측두엽 이외의 기원이 1예 였다. 발작기 뇌스캔상, 모두 11예(73.3 %)에서 단발성 또는 다발성 섭취 증가가 간질 병소 및 간질확산 부위에서 관찰되었으며, 간질 병소에만 국한된 섭취 증가는 4예(26.7%)에 불과 하였다. 발작간 뇌스캔에는 모두 11예(73.3 %)에서 간질 병소에만 섭취가 감소되었다. 자기 공명 영상에서는 8예(53.3 %)에서 hippocampal sclerosis를 포함한 간질 병소가 확인되었다. 본 연구로 복잡 부분 발작 환자에서, 간질 확산이 발작기 뇌 스캔 중 자주 관찰됨을 알 수 있었으며, 이러한 간질 확산에 따른 다발성 방사능 섭취가 발작기 뇌스캔상, 간질 병소의 국소화에있어 한계가 있음을 결론 내릴 수 있었다.

• Clinical and Experimental Pediatrics
• /
• v.51 no.12
• /
• pp.1346-1349
• /
• 2008

Reflex seizures induced by micturition are rare, and there have been few reports on ictal electroencephalogram (EEG) findings. Here, we report a 7-year-old boy with secondarily generalized partial seizures induced by micturition. The seizures occurred every time he urinated. A few seconds after micturition begun, he toppled down with hand automatism followed by a secondarily generalized tonic posture and loss of consciousness. Ictal video-EEG recording during urination was performed. An ictal EEG demonstrated a polyspike wave discharge onset from the left frontotemporal region, with rapid spread to the right frontotemporal region. He was treated with the antiepileptic drug valproate sodium, which improved seizure control. He remained seizure-free until the last followup for a period of 2 years.

• Clinical and Experimental Pediatrics
• /
• v.45 no.12
• /
• pp.1559-1570
• /
• 2002

Purpose : There has been no exact answer to the question of when to discontinue antiepileptic drugs(AEDs) in children with well-controlled epilepsy for a long period. This study is about the risk factors of relapse after withdrawal of AEDs in seizure(Sz)-free patients to show a guideline for discontinuation of AEDs. Methods : One hundred and sixty-nine children were diagnosed as epileptic at the Pediatric Dept. of Kyung-Hee Univ. between 1993 to 1998, in whom AEDs had been withdrawn after at least two years of Sz-free period. Univariate analysis using Kaplan-Meier survival analysis and multivariate analysis using Cox-proportional hazard model were performed for sixteen risk factors. Results : Forty-nine of the 169 patients(28.9%) had recurrence of Szs. The mean follow-up after withdrawal of AEDs was 4.1 years, mean treatment period was 4.1 years, and the mean Sz-free period was 3.3 years. Factors associated with an increased risk of relapse were young age at onset, symptomatic Sz, Sz type in West and Lennox-Gastaut syndrome, neurologic deficit, longer Sz-controlling period, shorter total treatment period, number of AEDs used(more than one drug), age at withdrawal of AEDs, and Sz-free period less than two years in univariate analysis using Kaplan-Meier mothod. From multivariate analysis, the factors indicating a significantly higher relapse risk were pre-treatment period after first Sz attack, Sz-controlling period, Sz-free period, number of AEDs used, neurologic abnormalities. Conclusion : For epileptic children who were Sz-free for more than two years, and were more than six-years-old, the discontinuation of AEDs should be considered positively, according to age of onset, Sz type, age at withdrawal of AEDs, total treatment period, Sz-controlling period, number of AEDs used, etiology, neurologic deficit, and the wishes of the patients and the their parents.

• Proceedings of the Korean Institute of Intelligent Systems Conference
• /
• 2002.05a
• /
• pp.73-76
• /
• 2002

간질은 대뇌 신경세포의 순간적인 제어되지 않는 과도한 전기방출로 인하여, 발작적으로 몸의 경련이나, 기타 신경증상 등이 몸으로 표출되는 현상으로 이것이 반복되어 나타나는 현상이다. 간질 진단에 필수적으로 사용되는 뇌파에 혼합된 미지의 성분들로부터 각각의 독립적인 성분으로 분리하는 독립성분분석(ICA)을 적용하여 간질 발작파를 분리하고, 발생위치를 추정하였다. 본 연구에서는 부분발작 환자를 대상으로 간질 발작파가 나타나는 뇌파 신호(18개 채널)에 독립성분분석을 적용하여 18개의 독립성분으로 분리하였다. 또한 발작파(예파(sharp), 극파(spike), 예파와 서파를 동반한 극서파(sharp and slow complexes))가 나오는 간질 발작파의 유형을 분리하였다. 2차원 topological map을 이용하여 발작파의 발생위치를 나타내어 간질 진단에 독립성분분석이 적용될 수 있음을 나타내었다.

• 건강소식
• /
• v.32 no.4 s.353
• /
• pp.6-13
• /
• 2008

환절기만 되면 발작적 호흡곤란 때문에 고생을 하는 사람이 있다. 이들은 곤히 잠든 새벽녘에 천식발작을 일으켜 숨이 차서 밤을 꼬박 새우기도 한다. 천식은 기관지가 정상인보다 민감해서 작은 자극에도 쉽게 반응을 하기 때문에 생기는 병이다. 숨을 쉴 때 휘파람을 불 듯‘휘휘’소리가 나는 천명, 호흡곤란, 기침이 천식의 3대 증상이다. 발작이 일어나면 숨을 제대로 못 쉬기 때문에 안색이 창백해지고 입술이 파랗게 되는 등 고통이 심하지만 발작이 끝나면 거짓말처럼 깨끗이 낫는 게 특징이다.

• Sim-seong Yeon-gu
• /
• v.37 no.1
• /
• pp.1-30
• /
• 2022

This text is an attempt to understand the psychological meaning of panic attacks occurring in the young people in their early twenties who play music. A panic attack is a type of anxiety neurosis known to occur primarily in their twenties and is characterized by extreme fear and terror accompanied by various symptoms in the autonomic nervous system. Situations with occurring panic attacks were examined in three cases combined with panic attacks and mood swings, suicidal ideation, and self-mutilating behaviors, and the psychological meaning of panic attacks was reviewed for each case. In the first case, panic attacks make one think or reflect with consciousness for someone who wants to remain unconscious. In the second case, for one who hesitates to move forward in life and finds oneself in conflict, panic attacks open the inner mind and allow one to come in touch with one's deeper mind, thereby opening possibilities to transcend the conflict. In the third case, one experience the instinct and impulse of desiring to realize the unconsciousness as panic attacks and thereafter consciously realize the impulse as well. Their panic attacks, which all seem to have different meanings, are likely a powerful approach of the unconsciousness to urge a renewal from the consciousness level of the youth period.

• Clinical and Experimental Pediatrics
• /
• v.51 no.4
• /
• pp.420-425
• /
• 2008

Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.10 no.8
• /
• pp.1471-1477
• /
• 2006

Electrocorticogram (ECoG) was recorded in one young adult suffering from medically refractory partial seizures a few weeks before resection. ECoG of intractable focal epilepsy was analyzed usins AR model, wavelet analysis and cross-correlation analysis. The cross-correlation of the epileptic discharges was calculated between the electrodes in every unit of time, to get the phase shift. A contour map of the phase shift and the sequential two-dimensional phase shift maps were utilized to localize the epileptic foci and to study their propagation process. More than two epileptogenic foci were localized and two kinds of propagating process were shown. These investigations suggest that epileptic phenomena can be caused by at least two kinds of mechanisms in one patient.