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The Prognostic Factors Affecting the Occurrence of Subsequent Unprovoked Seizure in Patients Who Present with Febrile Seizure after 6 Years of Age (6세 이후 열경련 환자의 비열성발작으로 진행되는 위험 인자)

  • Lee, Hyeon Ju;Kim, Seung Hyo
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.215-220
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    • 2018
  • Purpose: Few reports have described the prognostic factors affecting the occurrence of subsequent unprovoked seizure in patients who present with febrile seizure (FS) after 6 years of age. We investigated the prognostic factors affecting the development of unprovoked seizures after FS among patients from Jeju Island. Methods: We included patients who developed FS after 6 years of age, who presented to our outpatient clinic between January, 2011 and June, 2017. Clinical data were obtained through chart reviews and phone call interviews. We used logistic regression analysis to analyze the risk factors associated with the occurrence of subsequent unprovoked seizure. Results: Of the 895 patients who presented to our hospital due to their febrile seizure, 83 developed FS after 6 years of age. Among them, 3 patients were prescribed antiepileptic drugs before the onset of the unprovoked seizure, and 4 patients developed an unprovoked seizure before 6 years of age. Thus, overall, 76 patients were included in the study. 51 patients developed first FS before 6 years of age. In the remaining patients, the first FS developed after 6 years of age. The mean observational period since the last outpatient follow-up visit was 3.2 years (median 3.04 years, range: 1.42-4.71 years). Among them, 21% developed an unprovoked seizure. Logistic regression analysis showed that electroencephalographic (EEG) abnormalities served as an independent risk factor for a subsequent unprovoked seizure. Conclusion: EEG is the proper diagnostic tool to predict the risk of a subsequent unprovoked seizure in patients with FS after 6 years of age.

An Unusual Case of Todd's Paralysis Mimicking Large Cerebral Infarction after Open Heart Surgery (개심술 후 뇌경색과 비슷한 양상을 띠는 Todd 마비에 대한 치험 1예)

  • Park Han Gyu;Chang Won Ho;Roh Hak Jae;Youm Wook
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.237-240
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    • 2005
  • Improved operative, anesthetic, and cardiopulmonary bypass (CPB) techniques have significantly reduced postoperative complications; however, neurologic disorders remain a serious complication after open heart surgery. Possible explanations for neurologic complications are microembolism from CPB, decreased cerebral pefusion pressure due to intraoperative hypotension and unexpected metabolic changes. Amomg these, seizure has low incidence and Todd's paralysis after open heart surgery is extremely rare. Todd's paralysis is a complication of a seizure due to neuronal exhaustion mimicking large cerebral infarction after open heart surgery.

A Case of Nocturnal Paroxysmal Dystonia: Frontal Lobe Epilepsy and Parasomnias (FLEP) Scale, Polysomnography and Subtraction of Ictal-interictal SPECT Coregistered with MRI (SISCOM) Findings (야간발작성근육긴장이상 1예: 전두엽간질 및 사건수면척도, 수면다원검사, 발작기 및 발작간기 감산 SPECT 소견)

  • Kim, Woojun;Oh, Yun-Sang;Yoon, Bora;Kim, Yeong-In;Lee, Kwang-Soo;Kim, Joong-Seok
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.52-57
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    • 2008
  • Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.

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Epileptic Seizure Detection Using CNN Ensemble Models Based on Overlapping Segments of EEG Signals (뇌파의 중첩 분할에 기반한 CNN 앙상블 모델을 이용한 뇌전증 발작 검출)

  • Kim, Min-Ki
    • KIPS Transactions on Software and Data Engineering
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    • v.10 no.12
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    • pp.587-594
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    • 2021
  • As the diagnosis using encephalography(EEG) has been expanded, various studies have been actively performed for classifying EEG automatically. This paper proposes a CNN model that can effectively classify EEG signals acquired from healthy persons and patients with epilepsy. We segment the EEG signals into sub-signals with smaller dimension to augment the EEG data that is necessary to train the CNN model. Then the sub-signals are segmented again with overlap and they are used for training the CNN model. We also propose ensemble strategy in order to improve the classification accuracy. Experimental result using public Bonn dataset shows that the CNN can detect the epileptic seizure with the accuracy above 99.0%. It also shows that the ensemble method improves the accuracy of 3-class and 5-class EEG classification.

Retrograde Thalamocortical Diaschisis in Temporal Lobe Epilepsy (측두엽 간질에서의 역행성 시상피질 해리현상)

  • Yune, My-Jin;Lee, Jong-Doo;Ryu, Young-Hoon;Kim, Dong-Ik;Lee, Byung-In;Kim, Jai-Keun;Lee, Chang-Hoon;Park, Su-Mi;Kim, Dong-Joon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.469-475
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    • 1996
  • 목 적 : 측두엽 간질 환자의 발작간 뇌 스캔에서 관찰되는 측두엽 혈류 감소와 같은 쪽 시상 혈류 감소 소견의 빈도를 알아보고 이러한 소견이 간질 병소 국소화에 미치는 유용성에 대해 알아보고자 한다. 대상 및 방법 : Tc-99m-ECD를 이용하여 발작간 뇌 스캔을 시행한 67명의 측두엽 간질 환자에서 편측 측두엽과 같은 쪽 시상에 혈류 감소를 보인 12명의 환자를 대상으로 하였다. 간질 병소는 표면 뇌파 검사, 발작시 뇌파 검사, 심부 뇌파 검사, 자기 공명 영상 그리고 임상적 소견을 종합하여 국소화 하였다. 결 과 : 편측 측두엽과 같은 쪽 시상에 혈류 감소는 18%의 환자에서 관찰되었다. 7명의 환자는 왼쪽 측두엽과 시상에 혈류 감소를 보였다. 이들 7명중 4명은 자기공명영상 소견상 왼쪽 내측 측두엽 경화 소견을 보였다. 5명의 환자는 오른쪽 측두엽과 시상에 혈류 감소를 보였다. 이들 5명중 4 명은 자기공명영상 소견상 오른쪽 내측 측두엽 경화 소견을 보였다. 결 론 : 발작간 뇌 스캔상 관찰되는 편측 측두엽과 같은 쪽 시상의 혈류 감소 소견은 측두엽과 시상사이의 상호 연결에 의한 해리 현상으로 부분 발작의 병태 생리와 밀접한 연관이 있으리라 생각한다. 또한 이러한 소견은 간질 병소 국소화에 도움이 되리라 생각한다.

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Organic Acidopathies as Etiologic Diseases of Developmental Delay in Korean Childhood and Adolescent Age Group (한국인 소아청소년기 발달지연의 원인질환으로서의 유기산대사이상질환)

  • Lee, Jong Yoon;Lee, Ye Seung;Choi, Joong Wan;Bae, Eun Joo;Park, Won Il;Oh, Phil Soo;Lee, Hong Jin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.2
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    • pp.85-93
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    • 2012
  • Purpose: Developmental delay is caused by very diverse etiologic diseases. Most chronic disorders has some influence on development. Chronic or acute disorders of CNS are main etiologic diseases of developmental delay. Up to now, over 60 diseases are included in organic acidopathies and most of them causes acute or chronic recurrent CNS damage and developmental delay. We have done this study to find out the importance of organic acidopathies causing developmental delay in Korean childhood and adolescent patients. Method: Retrograde analysis for 738 patients with developmental delay whose clinical informations are available and have done urine organic acid analysis for 5 years period, between Jan. 1st 2007 to Dec. 31th 2011. Statistical analysis was done with Student's t test using SPSS. Result: Out of 738 patients, 340 patients (46.1%) showed abnormalities on urine organic acid analysis. The most frequent disease was mitochondrial respiratory chain disorders (MRCD) (253, 34.3%), followed by ketolytic defects(39, 5.3%), 3-hydroxyisobutyric aciduria (26, 3.5%), glutaric aciduria type II (8, 1.1%), pyruvate dehydrogenase deficiency (3, 0.4%), 3-methylglutaric aciduria (2, 0.3%), glutaric aciduria type I (2, 0.3%), ethylmalonic aciduria (1, 0.15%), methylmalonic aciduria (1, 0.15%), HMG-CoA lyase deficiency (1, 0.15%), 3-methylcrotonylglycinuria (1, 0.15%), fatty acid oxidation disorders(1, 0.15%) and FAOD (1, 0.15%). Conclusion: Mitochondrial disorders are most frequent etiologic disease on all age group, followed by ketolytic defects and various organic acidopathies. The number and diversities of organic acidopathies emphasize meticulous evaluation of basic routine laboratory examinations and organic acid analysis with initial sample on every developmental patient.

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A Case Report of Epileptic Children Diagnosed as Simple Partial Seizures, Infantile Spasms and Absence Seizures (단순부분발작, 영아연축 및 결신발작으로 진단받은 소아간질(小兒癎疾) 3례에 대한 증례보고(證例報告))

  • Kang, Kyoung Ha;Park, Eun Jung
    • The Journal of Pediatrics of Korean Medicine
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    • v.28 no.1
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    • pp.61-70
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    • 2014
  • Objectives The purpose of this study is to report three cases of epileptic children who were treated by oriental medicine. Methods Three epileptic children were treated by Gwakhyangjeonggi-san and Kuibiondam-tang. Two children had took combination therapy; anti-epilepsy drugs and oriental medicines and the other one took only oriental medicines. We measured frequency and intensity of seizure, and observed general conditions. Results The oriental medicine treatment is not only reducing seizures, but also improving general condition like digestion, constipation and reducing frequency of common cold and symptom of rhinitis. Conclusions Epilepsy in childhood is induced by various factor like Fung (風), Dam (痰), Sik (食), Kyung (驚). We administrated oriental medicine and prevented seizures.

A Case of Convulsive Seizure Development Induced by Clozapine (Clozapine 투여 후 경련성 발작을 보인 환자 1례)

  • Seo, Man Kil;Kim, Doh Kwan;Kim, Eyong
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.135-140
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    • 1999
  • The authors described a case of male schizophrenia who developed myoclonic jerk repeatedly and one episode of convulsive seizure during the treatment of clozapine. According to literatures and reported cases, myoclonic jerks induced in a small amount of clozapine may precede and predict the development of a convulsive seizure. Therefore clinicians have to pay attention to the development of a myoclonic jerk during the administration of clozapine. They may decrease the dosage of clozapine step by step at first in the convulsive state, and observe EEG changes of patients frequently.

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