• Clinical and Experimental Pediatrics
• /
• v.55 no.10
• /
• pp.383-387
• /
• 2012

Purpose: Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE. Methods: In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological tests including the Korean versions of the Wechsler intelligence scale for children III, frontal executive neuropsychological test, rey complex figure test, Wisconsin card sorting test, attention deficit diagnostic scale, and child behavior checklist scale. Results: The study subjects included 13 boys and 10 girls aged $9.0{\pm}1.6$ years. Our subjects showed an average monthly seizure frequency of $0.9{\pm}0.7$, and a majority of them had focal seizures (70%). The spike index (frequency/min) was $4.1{\pm}5.3$ (right) and $13.1{\pm}15.9$ (left). Of the 23 subjects, 9 showed frequent spikes (>10/min) on the EEG. The subjects had normal cognitive and frontal executive functions, memory, and other neuropsychological sub-domain scores, even though 8 children (35%) showed some evidence of learning difficulties, attention deficits, and aggressive behavior. Conclusion: Our data have limited predictive value; however, these data demonstrate that although BRE appears to be benign at the onset, children with BRE might develop cognitive, behavioral, and other psychiatric disorders during the active phase of epilepsy, and these problems may even outlast the BRE. Therefore, we recommend scrupulous follow-up for children with BRE.

• Clinical and Experimental Pediatrics
• /
• v.62 no.7
• /
• pp.269-273
• /
• 2019

Purpose: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy. Methods: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. A responder was defined as a patient with ${\geq}50%$ reduction in monthly seizure frequency compared with the baseline. Adverse events and discontinuation data were obtained to evaluate tolerability. Results: Twenty-two patients (8 males, 14 females) aged 3.1-11.4 years (mean, $8.0{\pm}2.5years$) were included in this study. After an average of 9.2 months (range, 0.5-19 months) of follow-up, 15 patients (68%) showed a reduction in seizure frequency, including 5 patients (23%) with seizure freedom. The age at epilepsy onset was significantly lower (P=0.048), and the duration of epilepsy was significantly longer (P=0.019) in responders than in nonresponders. Nine patients (41%) experienced adverse events, including somnolence (23%), respiratory depression (9%), violence (4.5%), and seizure aggravation (4.5%). The most serious adverse event was respiratory depression, which required mechanical ventilation in 2 patients (9%). Eight patients (36%) discontinued perampanel due to lack of efficacy or adverse events. Three out of 4 patients (75%) who discontinued perampanel due to adverse events had an underlying medical condition. Conclusion: Perampanel offers a treatment option for refractory epilepsy in children. Adjunctive treatment with perampanel requires special consideration in those with underlying medical conditions to prevent serious adverse events.

• Korean Journal of Psychosomatic Medicine
• /
• v.28 no.1
• /
• pp.63-71
• /
• 2020

Objectives : The aim of this study was to investigate the impact of clinical and psychological factors on the parental stress of children and adolescents with epilepsy. Methods : Children and adolescents with epilepsy (n=90, age range=6-17 years) completed questionnaires on epilepsy-related variables, children's depressive symptoms (Children's Depression Inventory, CDI), children's anxiety (Revised Children's Manifest Anxiety Scale, RCMAS) and performed the scale for children's intelligence (IQ). Parents who have children and adolescents with epilepsy completed questionnaires on parental stress (Questionnaire on Resources and stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), children's attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children's behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise regression analysis was performed to determine the significant predictive variables that affect parental stress. Results : In the correlational analysis, duration of seizure treatment (r=0.253, p=0.016), children's IQ (r=-0.544, p<0.001), children's attention problems (r=0.602, p<0.001), children's depressive symptoms (r=0.335, p=0.002), children's anxiety (r=0.306, p=0.004), children's behavioral problems (r=0.618, p<0.001), and parental anxiety (r=0.478, p<0.001), showed a significant correlation with parental stress. Children's behavioral problem (β=0.241, p=0.010), children's IQ (β=-0.472, p<0.001), and parental anxiety (β=0.426, p<0.001) were significantly related to the parental stress (Adjusted R²=0.619). Conclusions : Clinicians should pay attention to children's intelligence and behavioral problems and parental anxiety, which affect parental stress with children and adolescents with epilepsy.

• The Journal of Pediatrics of Korean Medicine
• /
• v.29 no.1
• /
• pp.15-26
• /
• 2015

Objectives The goal of this study is to investigate childhood epilepsy based on the recent literature of Eastern and Western medicine and look for better treatment. Methods This study reviewed definition, etiology and therapy method of childhood epilepsy based on 24 studies about the treatment of epilepsy in children Results and Conclusions Based on the comparison studies, not only herbal medication has shown better efficacy than anti-epileptics, but also as a monotherapy, or as combination therapies, herbal medications were superior in childhood epilepsy.

• Journal of Genetic Medicine
• /
• v.18 no.1
• /
• pp.8-15
• /
• 2021

Recent genetic advances allow for identification of the genetic etiologies of epilepsy within individual patients earlier and more frequently than ever. Specific targeted treatments have emerged from improvements in understanding of the underlying epileptogenic pathophysiology. These targeted treatment strategies include modifications of ion channels or other cellular receptors and their function, mechanistic target of rapamycin signaling pathways, and substitutive therapies in hereditary metabolic epilepsies. In this review, we explore targeted treatments based on underlying pathophysiologic mechanisms in specific genetic epilepsies.

• Journal of Korean Neurosurgical Society
• /
• v.39 no.1
• /
• pp.58-60
• /
• 2006

Hypothalamic hamartoma[HH] is an unusual nonneoplastic developmental lesion associated with gelastic epilepsy and precocious puberty, mostly found in children. Although open surgery has been attempted when antiepileptic medication failed to control seizures, its deep location and surrounding vital structures often rendered surgery unsuccessful. We describe the outcome of gamma knife radiosurgery in three children with a HH associated with gelastic epilepsy and reviewed the literature for a possible therapeutic mechanism.

• The Journal of Pediatrics of Korean Medicine
• /
• v.28 no.1
• /
• pp.61-70
• /
• 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.

• Journal of Genetic Medicine
• /
• v.18 no.2
• /
• pp.137-141
• /
• 2021

Genetic causes of developmental and epileptic encephalopathy (DEE) have been rapidly uncovered from mid-2010s. The mutations of gene enconding calcium channel, voltage-dependent, P/Q type, alpha 1A subunit (CACNA1A) are recently detected in DEE, which gene is already known well in familial hemiplegic migrine type 1 or episodic ataxia type 2. Ketogenic diet therapy (KDT) is effective in some DEE, which data is short in CACNA1A encephalopathy. A 3-month-old male with global developmental delay and multidrug-resistant focal seizures was diagnosed as epilepsy of infancy with migrating focal seizures (EIMFS). Brain magnetic resonance imaging and metabolic screening were all normal. Whole exome sequencing revealed two variants of CACNA1A: c.899A>C, and c.2808del that is from his mother. His seizures disappeared within 3 days whenever on KDT, which recurred without it. To our knowledge, this rare case of EIMFS with novel mutations of CACNA1A, is the first report in CACNA1A encephalopathy becoming seizure-free on KDT.

• Advances in pediatric surgery
• /
• v.1 no.2
• /
• pp.170-176
• /
• 1995

Abdominal epilepsy is accepted as unusual cause of abdominal pain in children and young adolescents. Although its abdominal symptoms may be similar to those of the irritable bowel syndrome, it may be distinguished from the latter condition by the presence of the altered consciousness during some of attacks, EEG abnormalities, and a good response to anticonvulsant medication. The diagnosis of abdominal epilepsy came into vogue in the 1950s and 1960s as an explanation for childhood abdominal complaints. More recently, it has been recognized that isolated vomiting without loss of consciousness or other more common paroxysmal symtoms is rarely attributable to abdominal epilepsy. We report 4 cases of abdominal epilepsy, whose ages ranged from 8 to 11 years, with paroxysmal abdominal pain or vomiting consistent with a diagnosis of abdominal epilepsy.

• Research in Community and Public Health Nursing
• /
• v.32 no.2
• /
• pp.205-219
• /
• 2021

Purpose: This concept analysis was conducted to clarify 'parents' treatment adherence for an epileptic child or adolescent'. Methods: The analysis used a hybrid model comprising three phases: theoretical phase, fieldwork phase, and integration phase. In the theoretical phase, fifty studies were reviewed. Interviews with four parents of epileptic children or adolescents were conducted during the fieldwork phase. In the integration phase, the results derived from prior phases were synthesized and clarified. All phases were performed cyclically. Results: The concept, 'parents' treatment adherence for an epileptic child or adolescent' was defined as parents' voluntary and goal-directed behavior towards the epilepsy treatment for their children: a collaborative decision-making process with health-care providers, establishing a support system, adaptability to the treatment plans, and appraisals of the child's health condition. Conclusion: This achievement is thought to contribute to improving the accuracy and validity of the concept measurement. It has implications for additional research on how the concept 'treatment adherence' differs in diverse health problems and other population groups than parents of children and adolescents with epilepsy.