• 대한소아신경학회지
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• 제26권4호
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• pp.205-209
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• 2018

목적: 마그네슘은 N- 메틸 -D- 아스 파르 테이트(NMDA) 이온 채널 수용체를 차단하여 NMDA 관련 발작을 조절하는 데 중요한 역할을 한다는 것이 밝혀져 있다. 경련 시 총 혈청 마그네슘 수치를 주로 측정하고 있는데, 생물학적으로 활성화된 형태인 이온화 마그네슘 수치를 측정하는 것이 체내 마그네슘 양을 평가하기 위한 보다 적절한 방법이다. 이에 연구자는 뇌전증 환아들 중 발열과 동반된 경련 발작(FTS) 이 있었던 환아들과 없었던 환아들에서 혈청 이온화 마그네슘($iMg^{2+}$) 수치를 비교해 보았다. 방법: 2015년 1월부터 2017년 7월까지 고려 대학교 구로 병원 외래 또는 소아 응급실을 방문한 뇌전증 환아들 중 2년 이내에 새로 진단받은 1-8 세의 환아들을 대상으로 하였으며 열과 동반된 경련을 할 수 있는 뇌전증 증후군(드라베 증후군, PCDH19 뇌전증 증후군 등)은 제외하였다. 결과: 12명의 발열을 동반한 경련 발생군(FTS)과 16명의 발열을 동반한 경련이 없었던 군(without FTS)으로 분류를 하였으며, 혈중 $iMg^{2+}$ 농도는 0.93 (0.85-1.14, quartile) mEq/L이었다. 혈청 $iMg^{2+}$ 수치는 without FTS 군(1.10 mEq/L)에 비해 FTS군에서 0.86 mEq/L으로 유의하게 낮았다(P=0.005). 두 군간의 임상 적 변수에는 차이가 없었다. 혈청 $iMg^{2+}$ 수준이 낮을수록 다 변수 로지스틱 회귀 분석(OR=0.028)에 근거하여 뇌전증 환아에서 FTS를 가질 위험이 유의하게 증가했다. 결론: 혈청 $iMg^{2+}$ 수치는 FTS 가 있었던 뇌전증 환아들에서 FTS가 없었던 환아들보다 유의하게 낮았다. 반복적인 FTS를 가진 뇌전증 환아들에서 생물학적으로 활성화 형태인 혈청 $iMg^{2+}$ 수치를 측정을 고려할 수 있겠으며, 앞으로 대규모 전향적 연구가 필요할 것으로 생각된다.

• 대한약침학회지
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• 제26권1호
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• pp.38-43
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• 2023

Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients. Methods: Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared-placebo, conventional treatments, and no treatment-to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses. Results: This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement. Conclusion: This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권1호
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• pp.144-149
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• 2000

심인성 발작은 신경과 및 정신과 임상에서 가끔씩 접하게 되는 질환으로서 진성 간질성 발작과의 감별진단이 가장 중요하다고 하겠다. 특히 정신과의사는 면밀한 환자의 병력청취, 임상양상 관찰 등을 통하여 확진 전 단계에서 심인성 발작을 어느 정도 진단내릴 수 있다고 생각된다. 저자들은 11세 여아의 심인성 발작 증례를 경험했는데, 심리환경적 스트레스가 명확했고, 임상특징이 일치 했으며, 신속한 검사와 정신과적 중재에 의해서 좋은 결과를 얻었다. 본 증례로 볼 때 소아기 심인성 발작의 진단과 치료에 있어서 뇌파 검사 외에도 철저한 가족배경 조사 및 병력청취와 정신교육학적 중재가 중요하다고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.124-128
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• 2005

Objective: Congenital bilateral perisylvian syndrome(CBPS) has been defined as a characteristic malformative perisylvian polymicrogyria(PMG) in patients with clinical symptoms of pseudobulbar palsy and epileptic seizures. For the present study, we investigate clinicopathologic features of CBPS associated with timing of lesion formation. Methods: Clinicopathologic features of CBPS from 6 patients with surgical resection of the cerebral lesions due to medically intractable seizures were studied. Results: Seizure onset ranged from 1 to 10years (average 6.7years) of age, and average duration of seizure was 23years. All had complex partial seizures, and two patients had additional tonic clonic seizures. Magnetic resonance (MR) images showed polymicrogyria, atropic gyri with gliosis. In the histopathologic examination, the cortical lesions revealed features of ulegyria; atrophic and sclerotic gyri, laminar loss of neurons, extensive lobular gliosis throughout the gray and white matter, neuronoglial nodule formation, and many amyloid bodies. Unlayered or four-layered PMG was not identified. Conclusion: Above data suggest that CBPS might be caused by ulegyria resulting from developmental cortical defect during early fetal stage or acquired hypoxic/ischemic injury in prenatal or postnatal life.

• Clinical and Experimental Pediatrics
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• 제60권6호
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• pp.189-195
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• 2017

Purpose: The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy. Methods: Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, $9.1{\pm}3.4years$) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses had been administered. The mean interval of ADHD testing was approximately 12.3 months. The initial dosage of lamotrigine was 1 mg/kg/day (maximum 25 mg/day for the first 2 weeks), and increased by 1 mg/kg every 2 weeks until titrated up to 7 mg/kg/day (or maximum 200 mg/day). Results: The mean ADHD test score of the 90 subjects was $17.0{\pm}1.8$ at baseline. It was slightly reduced to $15.6{\pm}1.7$ after lamotrigine monotherapy (P>0.01). Prior to treatment, a total of 31 patients (34.4%) met the diagnostic criteria for ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, Of these 31 patients, 27 (87.1%) had significantly improved ADHD scores with lamotrigine monotherapy ($28.0{\pm}1.6$ reduced to $18.1{\pm}2.6$, P<0.001). Among these 27 patients, 25 (92.6%) showed normalized electroencephalogram (EEG) and 26 (96.3%) achieved total freedom from seizures within 12 months of the initiation of lamotrigine monotherapy. Conclusion: The results from our study show that lamotrigine had a positive effect in pediatric epilepsy patients by reducing ADHD symptoms, preventing seizures, and normalizing EEG. However, further research is required to determine whether lamotrigine is efficacious against ADHD symptoms independent of its effects on epileptic seizures.

• Clinical and Experimental Pediatrics
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• 제55권12호
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• pp.487-490
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• 2012

We report a case of isodicentric chromosome 15 (idic(15) chromosome), the presence of which resulted in uncontrolled seizures, including epileptic spasms, tonic seizures, and global developmental delay. A 10-month-old female infant was referred to our pediatric neurology clinic because of uncontrolled seizures and global developmental delay. She had generalized tonic-clonic seizures since 7 months of age. At referral, she could not control her head and presented with generalized hypotonia. Her brain magnetic resonance imaging scans and metabolic evaluation results were normal. Routine karyotyping indicated the presence of a supernumerary marker chromosome of unknown origin (47, XX +mar). An array-comparative genomic hybridization (CGH) analysis revealed amplification from 15q11.1 to 15q13.1. Subsequent fluorescence in situ hybridization analysis confirmed a idic(15) chromosome. Array-CGH analysis has the advantage in determining the unknown origin of a supernumerary marker chromosome, and could be a useful method for the genetic diagnosis of epilepsy syndromes associated with various chromosomal aberrations.

• 동의생리병리학회지
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• 제21권1호
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• pp.328-332
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• 2007

Epilepsy is any of various neurological disorders characterized by sudden, recurring attacks of motor, sensory, or psychic malfunction with or without loss of consciousness or convulsive seizures. It could be divided into subcategories due to the international classification of epileptic seizure and the complex partial seizure, that is one of epileptic seizure subcategories, is characterized by elaborate and multiple sensory, motor, and/or psychic components accompanying the clouding of consciousness, prodrome, automatism, postictal confusion. This study reports a patient who was presumptive diagnosed as complex partial seizure by having the clouding of consciousness, prodrome, postictal confusion. We also diagnosed him as a ‘dianxian’ patient induced by sum deficiency of liver & kidney. This patient was treated by acupuncture to tonifying eum of liver & kidney and it achieved markedly improved symptoms.

• BMB Reports
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• 제44권5호
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• pp.306-311
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• 2011

Although NCX-3 is highly expressed in the brain, the distribution of NCX-3 in the epileptic hippocampus is still controversial. Therefore, to assess the distribution and pattern of NCX-3 expression in epileptic hippocampus, we performed a comparative analysis of NCX-3 immunoreactivities in the hippocampus of seizure-resistant (SR) and seizure-sensitive (SS) gerbils. In SR gerbils, NCX-3 immunoreactivity was higher than pre-seizure SS gerbils, particularly in the pavalbumin (PV)-positive interneurons. Three h post-ictal, NCX-3 immunoreactivity in the SS gerbil hippocampus was markedly elevated to the level of SR gerbils. Six h post-ictal, the expression of NCX-3 was reduced to the level of pre-seizure SS gerbils. Therefore, the results of the present study suggest that down-regulation of NCX-3 expression in the SS gerbil hippo-campus may be involved in the hyperexcitability of SS gerbils due to an imbalance of intracellular $Na^+/Ca^{2+}$ homeostasis and $Ca^{2+}$ concentration.

• 대한한방소아과학회지
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• 제30권3호
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• pp.61-68
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• 2016

Objectives The purpose of this study is to report a case of one infant patient diagnosed as Sik-Gan (食癎) who was treated by Korean medical treatment. Methods We diagnosed an infant patient as Sik-Gan (食癎) and treated him with herbal medicine, acupuncture, moxa and chuna therapy while correcting his eating habit. To measure the degree of the patient's progress, the frequency and exact symptoms of seizure events, and gastrointestinal symptoms were recorded. Results Korean medical treatment reduced the patient's the frequency of seizure, and improved gastrointestinal symptoms. Conclusions A patient who has past medical history of epileptic seizures, unhealthy eating habits and gastrointestinal malfunctions is prone to have a specific form of seizure called the Sik-Gan (食癎). In this report, we have proven that variety of Korean medical treatment can considerably be effective in preventing recurring seizure events and improving the patients' gastrointestinal symptoms.

• Annals of Clinical Neurophysiology
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• 제9권2호
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• pp.63-68
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• 2007

The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.