• Clinical and Experimental Pediatrics
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• 제59권2호
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• pp.74-79
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• 2016

Purpose: Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures. Methods: The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between the subsequent occurrence of epilepsy and clinical factors including seizure and fever-related variables were analyzed by multivariate analysis. Results: Twenty-five patients (10.0%) had additional afebrile seizures later and were diagnosed with epilepsy. The subsequent occurrence of epilepsy in patients with a history of febrile seizures was associated with a seizure frequency of more than 10 times during the first 2 years after seizure onset (P<0.001). Factors that were associated with subsequent occurrence of epilepsy were developmental delay (P<0.001), preterm birth (P =0.001), multiple seizures during a febrile seizure attack (P =0.005), and epileptiform discharges on electroencephalography (EEG) (P =0.008). Other factors such as the age at onset of first seizure, seizure duration, and family history of epilepsy were not associated with subsequent occurrence of epilepsy in this study. Conclusion: Febrile seizures are common and mostly benign. However, careful observation is needed, particularly for prediction of subsequent epileptic episodes in patients with frequent febrile seizures with known risk factors, such as developmental delay, history of preterm birth, several attacks during a febrile episode, and epileptiform discharges on EEG.

• 대한상한금궤의학회지
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• 제14권1호
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• pp.1-26
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• 2022

Objectives: We aimed to confirm the safety and effectiveness of the decoction of Sibjo-tang, which is a powder type purgative. In addition, we checked whether the '發作' of 『Shanghanlun』 can be interpreted to have the same meaning as "seizure" in English. By confirming these objectives, we intend to lead the progress in the application of Sibjo-tang and to expand the clinical application of the 152nd provision and Sibjo-tang. Methods: We analyzed the medical records of patients who visited Apgujeongjeongin Oriental Clinic and Almyeon Oriental Clinic for seizures. We confirmed side effects in patients who took Sibjo-tang for a long time. Sibjo-tang was prepared as a hot water extract by using 5 g each of Euphorbiae Pekinensis Radix, Eurphobiae Kansui Radix, and Genkwae Flos and 15 g of Zizyphi Fructus. The "seizure" recorded in the 152nd provision was interpreted through the shape analysis of Oracle bone scripts. The seizure frequency of patients diagnosed with epilepsy after taking Sibjo-tang was compared, and we analyzed other symptoms and psychosocial conditions associated with seizures at the first episode. Results: No side effects were found in 7 patients who took Sibjo-tang for 16.57 ± 14.10 months. Seizures were eliminated in 6 cases while taking Sibjo-tang and significantly decreased in 1 case. Frequent indigestion (in 7 cases), mild exhaustion (in 5 cases), and inferiority complex (in 5 cases) were identified as accompanying pathogenic conditions. The "seizure" in the 152nd provision was interpreted as "a state of being stabbed by a sharp substance in clothes", confirming a deep connection with epileptic seizures. Conclusions: The results suggest that using a decoction of Sibjo-tang is safe and efficacious. In addition, the necessity of conducting an advanced study on epileptic seizures accompanied by frequent indigestion using Sibjo-tang was confirmed.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.415-421
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• 2022

Objective : Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate. Methods : We retrospectively analysed 45 consecutive patients with a supratentorial CCM and symptomatic epilepsy in a single centre. Pre- and postoperative epidemiological data, seizure-related patient histories, neuroimaging results, surgery details and outcomes were obtained from hospital medical records. Seizure outcomes were assessed at least 12 months after surgery. Results : Thirty-five patients (77.8%) were seizure free at the long-term follow-up (Engel class I); six (13,3%) had rare, nocturnal seizures (Engel class II); and four (8.9%) showed meaningful improvement (Engel class III). In 15 patients (33%) in the Engel I group; it was possible to discontinue antiepileptic medication. Although there was not statistical significance, our results suggest that patients can benefit from early surgery. No deaths occurred in our study, and mild postoperative neurologic deficits were observed in two patients (4%) at the long-term follow-up. Conclusion : Surgical resection of CCMs should be considered in all patients with a supratentorial malformation and epilepsy due to the favourable surgical results in terms of the epileptic seizure control rate and low postoperative morbidity risk, despite the use of different predictors for the seizure outcome.

• Clinical and Experimental Pediatrics
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• 제63권3호
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• pp.88-95
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• 2020

Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone, particularly when it is interpreted by experienced neuroradiologists. Ultra-high-field imaging and postprocessing analysis with automated machine learning algorithms can detect subtle structural abnormalities in MRI-negative patients. Tractography derived from diffusion tensor imaging can delineate white matter connections associated with epilepsy or eloquent function, thus, preventing deficits after epilepsy surgery. Arterial spin-labeling perfusion MRI, simultaneous electroencephalography (EEG)-functional MRI (fMRI), and magnetoencephalography (MEG) are noinvasive imaging modalities that can be used to localize the epileptogenic foci and assist in planning epilepsy surgery with positron emission tomography, ictal single-photon emission computed tomography, and intracranial EEG monitoring. MEG and fMRI can localize and lateralize the area of the cortex that is essential for language, motor, and memory function and identify its relationship with planned surgical resection sites to reduce the risk of neurological impairments. These advanced structural and functional imaging modalities can be combined with postprocessing methods to better understand the epileptic network and obtain valuable clinical information for predicting long-term outcomes in pediatric epilepsy.

• 기본간호학회지
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• 제11권1호
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• pp.74-81
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• 2004

Purpose: This study investigated the need for information and social support in parents of children with epilepsy. Method: A total of 119 parents of children with epilepsy were recruited and asked to fill out questionnaires. Result: Of 119 parents, two-third reported that they received full and sufficient information about their child's disease and its management but one-third felt the information was insufficient and incomplete. Most parents (62.2%) felt at loss when their child had a seizure, either at home or at school. They wanted information on the causes of seizures, adequate steps deal with seizure and steps they should take to become adequate and supportive parents for their children. However, most parents were reluctant to disclose the disease or to receive support from outsiders. Conclusion: Regardless of the fact that most parents received sufficient information about the management of epilepsy, they felt at a loss when their child had a seizure attack. Therefore nurses should give specific instruction on seizure management and assess the needs of parents on a regular basis.

• 한국정보통신학회논문지
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• 제10권8호
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• pp.1471-1477
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• 2006

뇌파 기록은 난치성 간질 환자인 성인을 대상으로 하였다. 경막하 전극으로 부터 기록된 피질뇌파를 위상차해석에 의해서 간질 초점의 동정 및 발작파 전파의 가시화를 행하였다. 발작파의 세밀한 시간변화를 조사하기 위해서 자기 회귀모델, 웨이브렛해석을 이용하여 발작파 성분을 구하고, 상호상관법에 의해 각 전극 간의 위상차를 해석했다. 그 결과, 발작파의 초점은 적어도 2종류가 존재하였고, 각각의 전파방법도 달랐다. 이로 부터 발작파의 출현 기구는 동시에 적어도 2종류 존재하는 것을 확인할 수 있었다. 또한, 발작파 출현의 변화를 경시적으로 해석할 수 있기 때문에 발작파 전파의 가시화에 유효하다고 생각되어 진다.

• 대한한방소아과학회지
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• 제18권1호
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• pp.131-138
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• 2004

Background: Epilepsy is a disorder of the central nervous system characterized by loss of consciousness and convulsions. Epilepsy, a typical chronic disease, may cause high level of psychosocial difficulties for all family members, including stigmatization, stress, martial problems, poor self esteem and restriction of social activities. Objective & Method: To demonstrate the therapeutic effect of herbal medicine (Kamigoakhyangjeonggisan) on patients with epilepsy. We treated two cases of epileptic children, who had frequent seizures. Results: Two children improved in the frequency of the seizure, the combined disabilities. Conclusion: We report that we had good effects of herbal medicine treatment on two cases of epileptic children.

• Childhood Kidney Diseases
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• 제8권1호
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• pp.68-73
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• 2004

Gitelman 증후군과 Bartter 증후군은 모두 상염색체 열성으로 유전되는 신 세뇨관 질환으로 낮은 혈중 포타시움 농도, 대사성 알칼리혈증, 염분 소실, 정상 또는 낮은 혈압을 특징으로 한다. Gitelman 증후군은 thiazide-sensitive Na-Cl cotransporter(NCCT)의 유전자 돌연변이로 발생하며, 저마그네슘혈증과 저칼슘뇨증이 있는 것으로 Bartter 증후군과 구별된다. 환자들은 대개 증상이 없으며, 일정 기간 동안 근 약화, 테타니 등을 보이지만, 대부분의 경우 성인이 되어서 진단된다. 저자들은 11세된 여아에서 간질 발작의 악화로 내원하였다가 우연히 발견된 Gitelman 증후군 1례를 경험하였기에 보고하는 바이다. Gitelman 증후군의 진단은 대사성 알칼리혈증, 저칼륨혈증, 저마그네슘혈증, 저칼슘뇨증에 의해 근거하였다. 저자들은 또한 환자의 SLC12A3 유전자에서 이종접합체성 $^{642}$Arg(CGC)>Cys(TGC)변이와 동종접합체성 가성엑손을 확인하였다.

• 대한약침학회지
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• 제26권4호
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• pp.327-337
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• 2023

Objectives: Epilepsy is a neurological condition characterized by repeated seizures attributable to synchronous neuronal activity in the brain. The study evaluated the effect of acetone extract of Adansonia digitata stem bark (ASBE) on seizure score, cognition, depression, and neurodegeneration as well as the level of Gamma-Aminobutyrate acid (GABA) and glutamate in Pentylenetetrazol-kindled rats. Methods: Thirty-five rats were assigned into five groups (n = 7). Groups 1-2 received normal saline and 35 mg/kg PTZ every other day. Groups 3-4 received 125 mg/kg and 250 mg/kg ASBE orally while group 5 received 5 mg/kg diazepam daily for twenty-six days. Group 3-5 received PTZ every other day, 30 mins after ASBE and diazepam. Results: The results showed that Pentylenetetrazol (PTZ) induces seizure, reduces mobility time in force swim test and decreases the normal cell number in the brain. It also significantly decreases (p < 0.05) catalase, superoxide dismutase and reduced glutathione activities compared to the ASBE pre-treated rats. Pre-treatment with ASBE reportedly decreases seizure activities significantly (p < 0.05) and increases mobility time in the force swim test. ASBE also significantly elevate (p < 0.05) the normal cell number in the hippocampus, temporal lobe, and dentate gyrus. Conclusion: ASBE reduced seizure activity and prevented depression in PTZ-treated rats. It also prevented neurodegeneration by regulating glutamate and GABA levels in the brain as well as preventing lipid peroxidation.

• Clinical and Experimental Pediatrics
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• 제48권11호
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• pp.1225-1231
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• 2005

목 적 : 뇌실 주위 백질연화증(periventricular leukomalacia)은 동맥혈의 허혈로 인하여 뇌실 주변에 백질 괴사가 초래되어 발생하는 질환으로 미숙아와 만삭아 모두에서 관찰될 수 있으며 간질 발생의 요인이 된다. 본 연구는 뇌실 주위 백질연화증이 관찰된 간질 환아에서 재태 연령에 따라 간질 발작의 임상적인 차이점이 있는지 알아보고자 시행되었다. 방 법 : 뇌 자기공명영상으로 뇌실 주변부에 T2 강조 영상으로 고신호강도의 병변이 관찰된 108례(미숙아군 79례, 만삭아군 29례) 중 2회 이상의 간질 발작을 보이고 6개월 이상 추적 관찰이 가능했던 37례를 연구 대상으로 하였으며, 이를 다시 재태 기간이 37주 미만의 미숙아군(27례)과 37주 이상의 만삭아군(10례)으로 나누어 두 군을 비교하였다. 각각의 증례별 병력 기록지를 조사하여 두 군간의 간질 발작의 초발 연령, 첫 간질 발작의 유형, 뇌파 소견 및 항경련제에 대한 치료 반응을 비교하는 후향적 연구를 하였다. 결 과 : 첫 간질 발작은 미숙아군의 경우 평균 $22.2{\pm}18.3$개월, 만삭아군의 경우에는 평균 $26.9{\pm}21.1$개월에서 시작되었으며 통계학적으로 유의한 차이는 없었다(P=0.505). 첫 간질 발작의 유형으로는 미숙아군의 경우 영아 연축이 11례(40.7%), 단순 또는 복잡 부분 발작이 7례(25.9%), 이차성 전범화의 부분 발작이 6례(22.2%), 그리고 전신성 발작이 3례의 순으로 많았다. 만삭아군에서는 단순 또는 복잡 부분 발작이 7례(70.0%), 전신성 발작이 2례(20.0%) 그리고 지발형 영아 연축이 1례(10.0%)의 순으로 많았다. 뇌파 소견으로 미숙아군에서 고부정 뇌파가 11례(40.7%), 국소성 간질파가 6례(22.2%), 다초점성 간질파가 4례(14.8%)의 순으로 많았고, 만삭아군에서는 국소성 간질파가 5례(50.0%)였으며 3례(30.0%)에서 간질파가 관찰되지 않았다. 항경련제에 대한 반응은 추적 관찰 기간 동안 간질 발작의 재발을 보이지 않았던 경우가 미숙아군은 27례 중 16례(59.3%), 만삭아군의 경우 10례 중 6례(60.0%)였으며 난치성 간질은 미숙아군에서 6례(22.2%)가 있었으나 만삭아군에서는 1례도 관찰되지 않았다. 결 론 : 뇌실 주위 백질연화증을 가진 간질 환아에서 영아 연축과 같은 중증 간질은 미숙아군에서 주로 발생하는 경향이 있었으며 난치성 간질은 미숙아군에서만 관찰되어 만삭아군과 임상적으로 간질 발작의 유형이나 치료에 대한 반응 등에서 차이가 있는 것으로 생각된다. 향후 뇌실 주위 백질연화증의 정도나 발생 기전에 대해 두 군간의 차이점이 있는지에 대한 연구가 두 군간의 간질 발작의 임상적 차이를 이해하는데 도움이 될 것으로 생각된다.