• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.299-307
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• 2024

Cerebral cavernous malformation (CCM) is a vascular anomaly commonly found in children and young adults. Common clinical presentations of pediatric patients with CCMs include headache, focal neurological deficits, and seizures. Approximately 40% of pediatric patients are asymptomatic. Understanding the natural history of CCM is crucial and hemorrhagic rates are higher in patients with an initial hemorrhagic presentation, whereas it is low in asymptomatic patients. There is a phenomenon known as temporal clustering in which a higher frequency of symptomatic hemorrhages occurs within a few years following the initial hemorrhagic event. Surgical resection remains the mainstay of treatment for pediatric CCMs. Excision of a hemosiderin-laden rim is controversial regarding its impact on epilepsy outcomes. Stereotactic radiosurgery is an alternative treatment, especially for deep-seated CCMs, but its true efficacy needs to be verified in a clinical trial.

• 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.

• 대한한방소아과학회지
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• 제17권2호
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• pp.27-35
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• 2003

특발성(特發性) 간질(癎疾)을 진단받고 지속적인 경련(痙攣)을 주소(主訴)로 내원한 환아(患兒)의 치료에 소양인(少陽人) 형방도적산(荊防導赤散) 가미방(加味方)과 철치료(鍼治療)를 병행하여 경련과 제반증상을 완화하는데 양호(良好)한 효과를 보았다. 비록 현재 경련이 나타나지 않고 있지만, 아직 증상이 남아 있는 상태이고 치료과정이 길지 않았으므로, 향후 지속적인 경과관찰이 필요하리라 사료된다.

• Clinical and Experimental Pediatrics
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• 제62권7호
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• pp.259-260
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• 2019

• Journal of Korean Neurosurgical Society
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• 제60권3호
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• pp.294-300
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• 2017

Hypothalamic hamartoma (HH) is a benign indolent lesion despite the presentation of refractory epilepsy. Behavioral disturbances and endocrine problems are additional critical symptoms that arise along with HHs. Due to its nature of generating epileptiform discharge and spreading to cortical region, various management strategies have been proposed and combined. Surgical approaches with open craniotomy or endoscopy, stereotactic approaches with radiosurgery and gamma knife surgery or radiofrequency thermos-coagulation, and laser ablation have been introduced. Topographical dimension and the surgeon's preference are key factors for treatment modalities. Endoscopic disconnection has been one of the most favorable options performed in treating HHs. Here we discuss presurgical evaluation, patient selection, surgical procedures, and complications.

• 대한한방소아과학회지
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• 제34권3호
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• pp.37-54
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• 2020

Objectives The purpose of this study is to analyze the treatment and treatment's effect for seizures disease in children by reviewing Korean clinical studies. Methods 13 articles which were published from August, 2002 to August, 2016 were obtained from the National discovery for science leader (NDSL), Research information sharing service (RISS), Google Scholar, and Oriental medicine advanced searching integrated system (OASIS) by using keyword 'Seizure', 'Convulsion', and 'Epilepsy'. Results Most of the study cases were with epilepsy children. The most frequently used herbal medicine was Gwakhyangjeonggi-san gami, and the most commonly used acupoints were LI4 and LR3. Treatment periods range from 13 days to 14 months, and all of the seizures were completely cured or relieved after the treatments. Conclusions This study shows that there are common symptoms and treatments for seizures in children. The reported different treatments can be used in primary medical care. Developing guideline standards of the seizure treatments can be possible with further studies.

• Clinical and Experimental Pediatrics
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• 제50권8호
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• pp.757-760
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• 2007

목 적 : 열성 경련은 간질과는 구별되는 양성 질환이지만 복합 열성 경련에서는 간질의 발생이 더 많은 것으로 알려져 있다. 복합 열성 경련의 정의에 해당하는 환자에서 간질 이행의 발생률이 증가하는지 알아보기 위하여 본 연구를 시행하였다. 방 법 : 열성 경련으로 건양대학교 병원 소아과를 방문하였던 환자들을 대상으로 후향적 연구를 시행하였으며 환자의 정보는 의무 기록 분석과 부모와의 면담을 통하여 조사하였다. 결 과 : 2000년 3월부터 2003년 12월까지 열성 경련으로 본원을 내원한 환아는 314명이었으며, 이 중 복합 열성 경련으로 진단받은 환아는 63명(20.0%)으로 12개월 이상 추적 관찰은 44명(44/63, 70.0%)에서 가능했다. 평균 $34.2{\pm}11.6$개월의 추적 관찰 기간동안 10명에서 간질이 발생하였고, 부분 발작(57.1%)을 한 경우가 2회 이상(26.7%) 또는 15분 이상의 경련(24.1%)과 비교하였을때 더 높은 간질 발생률을 보였다. 결 론 : 복합 열성 경련이 있는 환자에서 첫 열성 경련의 양상이 부분 발작의 형태로 나타난 경우에 이후 간질 발생 빈도가 높음을 알 수 있었다.

• 동의신경정신과학회지
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• 제33권2호
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• pp.181-214
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• 2022

Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

• 대한한방소아과학회지
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• 제24권2호
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• pp.1-12
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• 2010

Objectives Taking detailed patient history helps earlier diagnosis and treatment of developmental disability. In this study we analyzed the clinical questionnaire to find out the clinical characteristics of those with five-retardation, five-limpness, or five-stiffness. Methods The data was collected from 484 children under the age of six who have visited H oriental medicine clinic for developmental delay. The clinical questionnaire was filled out by their parents and the data was analyzed statistically. Results 436 children showed symptoms of five-retardation, 90 children suffered from five-stiffness, 54 children showed five-limpness and 7 children suffered from five-stiffness and five-limpness complex. Generally, boys had higher chance to show disease symptoms than the girls (2.32:1) and 40 children (8.26%) reported family history of developmental disability. Cerebral palsy ranks the most common familial disease, followed by developmental delay, mental retardation, autistic disorder and language disorder. Among the children we have studied, 285 children (63.19%) showed delayed unassisted walk while 192 children (42.57%) had language disorder. Also, 138 children (28.51%) had both walk and language disorders. The children in this study also showed delayed toilet training and half of them had little stranger anxiety when they were infants. It was also found that 120 children (24.79%) experienced epilepsy. This study reaffirmed that low birth weight, premature birth, and suffocation are major risks causing neurological damage. Conclusions They had history which including family history, problems at birth, epilepsy, face recognition, muscle tone disorder, delayed walking without assistance, language ability, and toilet training.

• Clinical and Experimental Pediatrics
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• 제58권9호
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• pp.354-357
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• 2015

Parry-Romberg syndrome (PRS) is a rare, acquired disorder characterized by progressive unilateral facial atrophy of the skin, soft tissue, muscles, and underlying bony structures that may be preceded by cutaneous induration. It is sometimes accompanied by ipsilateral brain lesions and neurological symptoms. Here we present the case of a 10-year-old girl with right-sided PRS and recurrent monoplegic ataxia of the left leg. At 4 years of age, she presented with localized scleroderma over the right parietal region of her scalp; her face gradually became asymmetric as her right cheek atrophied. Brain magnetic resonance imaging revealed hemiatrophy of the face and skull base, and T2-weighted images showed increased signal in the right hemipons and hemicerebellar peduncle. Magnetic resonance angiography findings were unremarkable. She was treated with oral prednisolone, and her recurrent gait ataxia diminished within 2 months of the follow-up period. To the best of our knowledge, this is only the second case of PRS presenting with an abnormal involvement of the ipsilateral hemipons.