• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.344-352
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• 2019

Epilepsy is one of the major chronic neurological diseases affecting many patients. Resection surgery is the most effective therapy for medically intractable epilepsy, but it is not feasible in all patients. Vagus nerve stimulation (VNS) is an adjunctive neuromodulation therapy that was approved in 1997 for the alleviation of seizures; however, efforts to control epilepsy by stimulating the vagus nerve have been studied for over 100 years. Although its exact mechanism is still under investigation, VNS is thought to affect various brain areas. Hence, VNS has a wide indication for various intractable epileptic syndromes and epilepsy-related comorbidities. Moreover, recent studies have shown anti-inflammatory effects of VNS, and the indication is expanding beyond epilepsy to rheumatoid arthritis, chronic headaches, and depression. VNS yields a more than 50% reduction in seizures in approximately 60% of recipients, with an increase in reduction rates as the follow-up duration increases. The complication rate of VNS is 3-6%, and infection is the most important complication to consider. However, revision surgery was reported to be feasible and safe with appropriate measures. Recently, noninvasive VNS (nVNS) has been introduced, which can be performed transcutaneously without implantation surgery. Although more clinical trials are being conducted, nVNS can reduce the risk of infection and subsequent device failure. In conclusion, VNS has been demonstrated to be beneficial and effective in the treatment of epilepsy and various diseases, and more development is expected in the future.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.2
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• pp.263-271
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• 2004

Objective : Epilepsy is a brain condition which causes a person to suddenly lose consciousness and sometimes to have fits. The etiologic factors of epilepsy are various, but most of cases are idiopathic. The purpose of this study is to report a pediatric patient with idiopathic epilepsy. Method : We treated him with herb medicine, acupucture and anticonvulsant. Then, we stopped administering anticonvulsant, and observed the progress of his condition. Result : We had good effect with oriental medical treatment on an epileptic who quitted taking anticonvulsant. Conclusion : We report the good results of oriental medicine on a pediatric patient with idiopathic epilepsy. And the further study is needed with more cases, longer duration and other tools.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.22-28
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• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

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

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.4 no.1
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• pp.17-20
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• 2008

In the brain of epilepsy patients, sudden and unusually intense bursts of electrical charges are occurred repeatedly. So, epilepsy patient experiences seizure. Seizure shows various frequency and precipitating factor and has a prodrome. Also, epilepsy patient present various behavior pattern during seizure. If the biting injury occurred during seizure, there would be pain, infection, defect of soft tissue and esthetic problem. The dental management of self-mutilation includes preserve methods of using appliances such as lip bumper or soft mouth guard and radical methods such as extraction of all teeth or orthognathic surgery. A case of epilepsy patient with self-mutilation of mento-labial sulcus is presented. She was treated successfully with soft mouth guard.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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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.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.920-923
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• 2005

Epilepsy is a neurological disorder from many molecular and biochemical responses. In the underlying mechanism, free radicals play an important role in seizure initiation and seizure-induced brain damage. Excessive production of oxygen free radicals and other radical species have been implicated in the development of seizures under pathological conditions and linked to seizure-induced neurodegeneration.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.202-205
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• 2007

Abdominal epilepsy is an uncommon disorder and a rare cause of recurrent abdominal pain of children. Diagnostic criteria of this disorder include otherwise unexplained, paroxysmal gastrointestinal complaints, symptoms of a central nerve system disturbance, an abnormal electroencephalogram with a finding specific for a seizure disorder, and improvement with anticonvulsant medication. We present a case of a 6-year-old boy with abdominal epilepsy presenting with recurrent, paroxysmal abdominal pain for 4 years. This patient had definite electroencephalogram abnormalities and a striking response to administration of an anticonvulsant.

• Journal of Korean Neurosurgical Society
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• v.67 no.3
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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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• v.51 no.12
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• pp.1290-1294
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• 2008

Seizures are a frequent symptom in metabolic disorders, although metabolic disorders are rarely found to be the cause of epilepsy. A precise diagnosis might not only influence treatment, but it might also call for counseling of the family, even if there are no direct therapeutic consequences. We review the main characteristics of epilepsy in metabolic disorders with regard to energy metabolism, toxic effects, neurotransmitters, and vitamins.