• 제목/요약/키워드: Brain, epilepsy

검색결과 211건 처리시간 0.029초

간질과 산소 라디칼 (Epilepsy and Oxygen Free Radicals)

  • 김원섭
    • Clinical and Experimental Pediatrics
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    • 제48권9호
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    • pp.920-923
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    • 2005
  • Epilepsy is a neurological disorder from many molecular and biochemical responses. In the underlying mechanism, free radicals play an important role in seizure initiation and seizure-induced brain damage. Excessive production of oxygen free radicals and other radical species have been implicated in the development of seizures under pathological conditions and linked to seizure-induced neurodegeneration.

Effect of Vagus Nerve Stimulation in Post-Traumatic Epilepsy and Failed Epilepsy Surgery : Preliminary Report

  • Lee, Hai-Ong;Koh, Eun-Jeong;Oh, Young-Min;Park, Seung-Soo;Kwon, Ki-Hun;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • 제44권4호
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    • pp.196-198
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    • 2008
  • Objective : Vagus nerve stimulation (VNS) has been used in epilepsy patients refractory to standard medical treatments and unsuitable candidates for resective or disconnective surgery. In this study, we investigated the efficacy of VNS to patients who had refractory result to epilepsy surgery and patients with post-traumatic epilepsy. Methods : We analyzed the effect of VNS in 11 patients who had undergone previous epilepsy surgery and patients with intractable post-traumatic epilepsy associated with brain injury. All patients underwent VNS implantation between October 2005 and December 2006. Results : We evaluated seizure frequency before and after implantation of VNS and maximum follow up period was 24 months. In the first 6 months, 11 patients showed an average of 74.3% seizure reduction. After 12 months, 10 patients showed 85.2% seizure reduction. Eighteen months after implantation, 9 patients showed 92.4% seizure reduction and 7 patients showed 97.2% seizure reduction after 24 months. Six patients were seizure-free at this time. Conclusion : We conclude that the VNS is a helpful treatment modality in patients with surgically refractory epilepsy and in patients with post-traumatic epilepsy due to severe brain injury.

Multimodal neuroimaging in presurgical evaluation of childhood epilepsy

  • Jung, Da-Eun;Lee, Joon-Soo
    • Clinical and Experimental Pediatrics
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    • 제53권8호
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    • pp.779-785
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    • 2010
  • In pre-surgical evaluation of pediatric epilepsy, the combined use of multiple imaging modalities for precise localization of the epileptogenic focus is a worthwhile endeavor. Advanced neuroimaging by high field Magnetic resonance imaging (MRI), diffusion tensor images, and MR spectroscopy have the potential to identify subtle lesions. $^{18}F$-FDG positron emission tomography and single photon emission tomography provide visualization of metabolic alterations of the brain in the ictal and interictal states. These techniques may have localizing value for patients which exhibit normal MRI scans. Functional MRI is helpful for non-invasively identifying areas of eloquent cortex. These advances are improving our ability to noninvasively detect epileptogenic foci which have gone undetected in the past and whose accurate localization is crucial for a favorable outcome following surgical resection.

임상실제에서의 수면과 간질 (Sleep and Epilepsy in Clinical Practice "fears, rages, deliria, leaps out of bed and seizures during the night" - Hippocrates)

  • 김장성
    • 수면정신생리
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    • 제5권1호
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    • pp.18-33
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    • 1998
  • Sleep and Epilepsy either represent the opposite and independent spectrum of episodic manifestations from brain or closely interact with each other. Sleep or sleep deprivation may provoke epileptic seizures or activate epileptiform discharges in epilepsy patients whereas epilepsy may alter the sleep structure. Sleep stages are also known to influence pathophysiology of seizures in terms of ictogenesis. In this review, the impact of sleep on epilepsy as well as that of epilepsy on sleep are presented. Additionally the interaction between sleep and epilepsy will be discussed. This review will also comment on the differential diagnosis between nocturnal or sleep-related epilepsy and various sleep disorders. Finally, clinical application of the above perspectives of sleep and epilepsy will be suggested for the purpose of a better management of epilepsies.

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뇌성마비아의 간질 발생에 대한 임상연구 (Clinical study in children with cerebral palsy associated with or without epilepsy)

  • 안용주;정혜전;윤석;조의현;정사준
    • Clinical and Experimental Pediatrics
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    • 제49권5호
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    • pp.529-532
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    • 2006
  • 목 적 : 뇌성마비는 뇌의 여러 가지 원인에 의해 뇌에 발생한 비진행성 손상으로, 이러한 뇌성마비를 가진 환아의 간질 발생 빈도는 15-90%로 다양하게 나타난다. 이렇게 뇌성마비와 간질이 중복 되서 나타나는 경우에 심각한 중복 장애를 남길 수 있다. 따라서 뇌성마비아 중 간질의 발생아와 비발생아의 특징을 비교하여 장기적인 진료 및 예후의 지표를 삼고자 하였다. 방 법 : 1995년부터 2004년까지 9년간 경희의료원 소아과 외래에서 뇌성마비로 진단받고 추적관찰이 가능하였던 93명을 대상으로 조사하였으며, 이들의 뇌성마비를 분류하고, 간질의 형태와 발병 당시의 나이, 뇌영상소견과 뇌파 소견을 비교하였다. 결 과 : 뇌성마비에서의 간질의 유병률은 93명 중 43명으로 46.2%이었으며, 발작의 초 발 연령은 평균 21.5개월로 1세 미만에서 발생한 경우가 21례(48.8%)로 가장 많았고, 1세 미만에서는 영아 연축과 근간대성 발작의 빈도가 의미 있게 높았으며, 전체적으로는 강직성-간대성 발작이 44.2%로 가장 많이 나타났다. 뇌영상소견에서 가장 많이 동반된 이상은 뇌 피질 위축으로 간질 발생군과 비간질 발생군에서 각각 22례(23.6%)와 12례(12.1%)였으며, 뇌파 소견에서는 간질 발생아의 전례에서 이상 소견을 보였다. 결 론 : 뇌성마비아에서 간질이 동반된 경우 어린 나이에 발생하는 경우가 많았으며, 간질의 형태로는 전신성 간대성-강직성 발작이 가장 많았다. 또한 뇌 영상검사와 뇌파검사에서 뇌성마비아 중 간질 발생아와 비간질 발생아에서 의미 있는 빈도 차이를 보여 조기 진단에 도움을 줄 것으로 생각된다.

Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes

  • Lee, Yun-Jin;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • 제56권7호
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    • pp.275-281
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    • 2013
  • Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in seizure semiology have also been reported. Motor manifestations are prominent in infants and young children, but they become less obvious with increasing age. Further, automatisms tend to become increasingly complex with age. However, in childhood and especially in adolescence, the clinical manifestations are similar to those of the adult population. Selective amygdalohippocampectomy can lead to excellent postoperative seizure outcome in adults, but favorable results have been seen in children as well. Anterior temporal lobectomy may prove to be a more successful surgery than amygdalohippocampectomy in children with intractable TLE. The presence of a focal brain lesion on magnetic resonance imaging is one of the most reliable independent predictors of a good postoperative seizure outcome. Seizure-free status is the most important predictor of improved psychosocial outcome with advanced quality of life and a lower proportion of disability among adults and children. Since the brain is more plastic during infancy and early childhood, recovery is promoted. In contrast, long epilepsy duration is an important risk factor for surgically refractory seizures. Therefore, patients with medically intractable TLE should undergo surgery as early as possible.

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

  • Kim, Si Eun;Park, Kang Min
    • Annals of Clinical Neurophysiology
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    • 제19권1호
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    • pp.20-27
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    • 2017
  • Background: We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy. Methods: Thirty patients with epilepsy of unknown cause as well as age- and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled epilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we investigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images. Results: The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-controlled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050). Conclusions: We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.

THE GENETICALLY EPILEPSY-PRONE RAT: A MODEL FOR STUDIES OF THE EPILEPSIES

  • Jobe, Phillip-C.
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 1993년도 제2회 신약개발 연구발표회 초록집
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    • pp.54-54
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    • 1993
  • Two strains of genetically epilepsy-prone rats (GEPRs) have been derived from Sprague Dawley stock. One strain, known by the acronym GEPR-9, has a more pronounced epileptic condition than the other strain, known by the acronym GEPR-3. Only a small fraction of commercially available Sprague Dawley rats exhibits evidence of epilepsy. GEPRS are similar to most humans with epilepsy in that their general behaviors appear normal . GEPRS also share other traits with their non-epileptic counterparts. They are susceptible to forebrain and brainstem seizures produced by convulsant drugs and electrical currents. Because GEPRs and normal rats share these seizure non-epileptic brain rather than to an understanding of epilepsy. However, humans wi th epilepsy, the GEPR and other mammal inn models of genetic epilepsy are distinctive because they are characterized by seizure predisposition.

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Computational electroencephalography analysis for characterizing brain networks

  • Sunwoo, Jun-Sang;Cha, Kwang Su;Jung, Ki-Young
    • Annals of Clinical Neurophysiology
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    • 제22권2호
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    • pp.82-91
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    • 2020
  • Electroencephalography (EEG) produces time-series data of neural oscillations in the brain, and is one of the most commonly used methods for investigating both normal brain functions and brain disorders. Quantitative EEG analysis enables identification of frequencies and brain activity that are activated or impaired. With studies on the structural and functional networks of the brain, the concept of the brain as a complex network has been fundamental to understand normal brain functions and the pathophysiology of various neurological disorders. Functional connectivity is a measure of neural synchrony in the brain network that refers to the statistical interdependency between neural oscillations over time. In this review, we first discuss the basic methods of EEG analysis, including preprocessing, spectral analysis, and functional-connectivity and graph-theory measures. We then review previous EEG studies of brain network characterization in several neurological disorders, including epilepsy, Alzheimer's disease, dementia with Lewy bodies, and idiopathic rapid eye movement sleep behavior disorder. Identifying the EEG-based network characteristics might improve the understanding of disease processes and aid the development of novel therapeutic approaches for various neurological disorders.