• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.571-578
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• 2010

Purpose : To evaluate the efficacy and safety of levetiracetam adjunctive therapy for reducing the rate of seizure frequency in children with intractable pediatric epilepsy. Methods : We reviewed the medical records of 86 patients with intractable pediatric epilepsy who visited our hospital between March 1989 and February 2009. Levetiracetam was included in the previous anticonvulsant regimen for at least 6 months and the reduction in the rate of seizure frequency was determined in follow-up examinations. We analyzed demographic data, seizure types, antiepileptic drug history, levetiracetam dose, adverse effects of levetiracetam therapy, treatment outcome, electroencephalogram findings, etc. Results : More than 50% reduction in the seizure frequency was observed in 62 of the 86 (72.1%) patients; 44 patients (51.1%) became seizure free, while the seizure frequency increased in 5.8% patients. The associations between seizure reduction rate and age, associated diseases, seizure types, and seizure frequency before treatment were not significant. However, the duration of disease, dose of levetiracetam, duration and frequency of anticonvulsant administration before levetiracetam therapy were significantly correlated. Electroencephalogram findings and the cause of epilepsy showed partial correlation. Forty (46%) patients showed adverse symptoms; the symptoms in the order of their frequency were somnolence, hyperactivity, irritability, aggressiveness, tiredness, etc. Conclusion : The findings of our study provide the evidence that levetiracetam adjunctive therapy is efficacious and well tolerated in various refractory childhood epilepsy cases.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.221-226
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• 2018

Purpose: Febrile seizures (FSs) are the most common type of seizure in the first 5 years of life and are frequently associated with viral infections. Influenza infection is associated with a variety of neurological conditions, including FSs. The purpose of this study was to evaluate the clinical implications of influenza infection in FSs. Methods: In total, 388 children with FS were divided into two groups: FS with influenza infection (n=75) and FSs without influenza infection (n=313). Their medical records, including seizure type, frequency, duration, and familial history of FSs or epilepsy, were retrospectively reviewed and the clinical characteristics of the two groups were compared. Results: In total, 75 of the 388 children (19.3%) had FSs associated with influenza infection; such children were significantly older than those with FSs without influenza infection ($34.9{\pm}22.3$ months vs. $24.4{\pm}14.2$ months; P<0.001). The children who had more than two febrile seizures episodes were more prevalent in children with FS with influenza infection [40/75 (53.3%) vs. 92/313 (29.4%); P<0.01]. Children older than 60 months were more likely to have influenza infection compared to those aged less than 60 months [11/22 (50%) vs. 64/366 (17.5%); P=0.001]. Conclusion: Influenza infection may be associated with FSs in older children, and with recurrence of FSs. Its role in the development of afebrile seizures or subsequent epilepsy requires further investigation with long-term follow-up.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.106-110
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• 2010

Hippocampal sclerosis (HS) is one of the most common features of intractable temporal lobe epilepsy. Generally it can be identified through brain magnetic resonance imaging (MRI) with high degree of sensitivity and specificity. Typical brain MRI findings of HS are hippocampal atrophy with hyperintense signal confined to the lesion. On the other hand cortical dysplasia exhibits blurring of the gray-white matter junction and abnormal white matter signal intensity. We present a case where preoperative brain MRI strongly suggested the presence of diffuse cortical dysplasia in the left temporal lobe but postoperative pathology revealed the temporal lesion to be unremarkable except for hippocampal sclerosis.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1005-1014
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• 2009

Purpose:Epilepsy of child may cause high level of psychosocial difficulties for parents including stigmatization and stress and therefore worsen their quality of life (QOL). The purpose of this study was to evaluate the mediating effect of perceived stigma against epilepsy on QOL among parents with epileptic child. Methods:Two hundred and sixty parents of epileptic child recruited from five separated university hospital child neurology clinics specializing in epilepsy completed a demographic questionnaire, a medical questionnaire, a perceived stigma questionnaire and the Ro's Quality of Life Inventory, a popular tool for evaluating QOL of adults in Korea which is composed of 6 domains and 47 questions. Data was analyzed with SPSS 14.0 program using frequency analysis and descriptive analysis and with AMOS 7.0 program using Structural Equation Model (SEM) analysis. Results:The level of parents' QOL was relatively fair. SEM analysis on the quality of life level of parents showed that all variables (especially having religion, the monthly income, employment state, age of child, the leisure time, the perceived stigma level against epilepsy, and seizure frequency) directly affect the quality of life level of parents and that disease-related variables also affect the quality of life level of parents indirectly through the mediating factor (the perceived stigma), where the indirect effect is large with the existence of combined disabilities. The total effect on the quality of life level of parents is large with the existence of combined disabilities, the perceived stigma level, the leisure time, having religion, and the monthly income. Conclusion:The results of this study indicated that many factors including parents' perceived stigma may affect the quality of life of parents with epileptic children directly, and that some disease-related factors may affect indirectly through a mediating factor, the perceived stigma. Multidisciplinary collaboration would be imperative for their welfare.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.484-488
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• 2007

Purpose : The purpose of this study was to determine the incidence and potential predictors of weight gain in older children and teens treated with valproate (VPA) for epilepsy. Methods : Sixty-five subjects aged 8 to 17 years of age, who began VPA treatment between January 1, 2001, and December 31, 2004, and who had documented weight and height measurements at medication initiation and at least one follow-up visit were retrospectively identified. Exclusion criteria were follow-up <6 months, discontinuation of VPA within 6 months, and concurrent therapy with medication known to affect weight (such as topiramate, carbamazepin). Body mass index (BMI) was calculated at initiation and either discontinuation of VPA or last follow-up and stratified into four categories: group 1, underweight <5%; group 2, appropriate 5-85%; group 3, potentially overweight 85-95%; group 4, overweight >95%. Results : Twenty-eight subjects (77.8%) remained within their same category and eight (22.2%) moved up at least one category. Weight gain (increase in BMI difference) was observed in 72.2% of the 36 subjects treated with VPA. Three factors, neurocognitive status (P=0.017), seizure type (P=0.001) and duration of VPA treatment (P=0.035) were identified to be significant predictors of BMI difference. Conclusion : VPA induces weight gain in children and teens with epilepsy. These factors which are normal neurocognitive status, primary generalized type and duration of VPA treatment over the 12 months were predictors for an increase of weight gain. Therefore potential weight gain should be discussed with patients before the initiation of therapy and BMI should be monitored closely.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1251-1262
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• 2002

Purpose : The purpose of this study is to assess and compare the stress of mothers and fathers in families with epileptic children, and to assess contributing factors to their stress. Methods : We used a family stress survey with 35 questionnaires to obtain data concerning the parents' perceived stress. Data were analyzed with SPSS 8.0 program using Pearson correlation coefficient, oneway ANOVA, and multiple range test. Results : The parents' stress level seemed not so high and there was no significant difference in stress level between mothers and fathers. There was no significant correlation between most demographic variables of the parents and parents' stress level. But the time of bringing epileptic children correlates positively with the stress level. Oneway ANOVA showed the differences of parents' stress level according to the education institution, seizure type, number of antiepileptic drugs, and the combined disabilities of the sufferer. Conclusion : The results of present study indicate that the stress level in the families with epileptic children may be influenced by some treatment-related characteristics of epileptic children such as seizure type, number of antiepileptic drugs, combined disabilities and the raising method of hospital expenses.

• Clinical and Experimental Pediatrics
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• v.60 no.12
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• pp.408-412
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• 2017

Combined oxidative phosphorylation deficiency-17 (COXPD-17) is very rare and is caused by homozygous or compound heterozygous mutations in the ELAC2 gene on chromosome 17p12. The ELAC2 gene functions as a mitochondrial tRNA processing gene, and only 4 different pathogenic mutations have been reported in ELAC2-associated mitochondrial dysfunction involving oxidative phosphorylation. Affected patients show various clinical symptoms and prognosis, depending on the genotype. We report a novel mutation in the ELAC2 gene (c.95C>G [p.Pro32Arg], het), in an infant with COXPD-17 who presented with encephalopathy including central apnea and intractable epilepsy, and growth and developmental retardation. During hospitalization, consistently elevated serum lactic acid levels were noted, indicative of mitochondrial dysfunction. The patient suddenly died of shock of unknown cause at 5 months of age. This is the first case report of COXPD-17 in Korea and was diagnosed based on clinical characteristics and genetic analysis.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1019-1025
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• 2006

Motor delay, when present, is usually the first concern brought by the parents of children with developmental delay. Cerebral palsy that is the most common motor delay, is a nonspecific, descriptive term pertaining to disordered motor function that is evident in early infancy and is characterized by changes in muscle tone, muscle weakness, involuntary movements, ataxia, or a combination of these abnormalities. A wide range of causative disorders and risk factors have been identified for cerebral palsy, and broadly classified into 5 groups; perinatal brain injury, brain injury related to prematurity, developmental abnormalities, prenatal risk factors, and postnatal brain injury. Delay in attaining developmental milestones is the most distinctive presenting complaint in children with cerebral palsy. A detailed history and thorough physical and neurologic examinations are crucial in the diagnostic process. The clinician should be cautious about diagnostic pronouncement unless the findings are unequivocal. Several serial examinations and history review are necessary. All children with cerebral palsy should undergo a neuroimaging study, preferably MRI, because an abnormality is documented on head MRI(89%) and CT(77%). The high incidence rates for mental retardation, epilepsy, ophthalmologic defects, speech and language disorders and hearing impairment make it imperative that all children with cerebral palsy be screened for mental retardation, ophthalmologic and hearing impairments, and speech and language disorders; nutrition, growth, and swallowing also should be closely monitored.

• The Korean Journal of Physiology and Pharmacology
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• v.10 no.1
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• pp.13-17
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• 2006

Experimentally induced cortical disorganization exhibits many anatomical features which are characteristic of cortical malformations in children with early-onset epilepsy. We used an immunocytochemical technique and extracellular field potential recordings from the dorsal hippocampus to determine whether the excitability of the CA1 pyramidal cells was enhanced in rats with exnerimentallv induced hippocampal dysplasia. Compared with control rats, the MAM-treated rats displayed a decrease of paired pulse inhibition. When $GABA_A$ receptor antagonists were blocked with $10{\mu}M$ bicuculline the amplitude of the second population spike of the MAM-treated of rats was similar to that of the first population spike, as was in the control rats. The MAM-treated rats had fewer somatostatin and parvalbumin-immunoreactive neurons than the control rats. These results suggest that the enhanced neuronal responsiveness of the in vivo recording of the CA1 in this animal model may involve a reduction of CA1 inhibition.

• The Journal of Pediatrics of Korean Medicine
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• v.21 no.3
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• pp.189-203
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• 2007

Objectives The prognosis, recurrence rate and treatment of febrile seizure were studied through the research of recent western medicine and Chinese oriental medicine paper. Methods Recent western medicine paper of internal and external and chinese oriental medicine paper from 1999 to 2007 were investigated. Results and Conclusions The prognosis of febrile seizure was good in most cases, but children with febrile seizure who developed epilepsy range between 2 and 10%. The risk factors developed epilepsy including complex febrile seizure, focal and prolonged seizure, pre-existing neurodevelopmental abnormalities and recurrent febrile seizure. Recurrence rate of febrile seizure ranges between 30 and 50% was high. The risk factors can be predicted by their age at first febrile seizure happened, family medical history of febrile seizure and epilepsy, complex febrile seizure, and neurodevelopmental abnormalities. However, the most important factor of those is the age when they have first febrile seizure. Diazepam or Lorazepam was administrated for a child with prolonged seizure but only Diazepam was used for reducing recurrence of febrile seizurein febrile illness. However, there were some side effects such as lethargy, ataxia, and irritability. The study of chinese oriental medicine demonstrates that the acupuncture and venesection were used for seizure attack and reduced of recurrences and second attack. To reduce recurrence of febrile seizure, herbal medicine was also used for febrile illness or after seizure attack within a certain period of time, so reduce the recurrence, frequency of seizure and febrile illness. The most of herbs in prescription were used for removing heat and toxic meterials(淸熱解毒), extinguishing wind and to stopping the convulsion(熄風止痙)