• Korean Journal of Clinical Laboratory Science
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• v.37 no.2
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• pp.96-101
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• 2005

Status epilepticus is a medical emergency, so that rapid and vigorous treatment is required to prevent neuronal damage and systemic complication. Status epilepticus is generally defined as a continuous or intermittent seizure or an unconscious condition after the onset of seizure, lasting for 30 minutes or more. We report here the outcome of status epilepticus. We retrospectively reviewed medical record of 15 patients who were diagnosed with status epilepticus at the Asan Medical Center from January 2003 to February 2004. This outcome was evaluated considering various factors such as age of patients, history of seizures, neurologic impairment, etiology, mortality, return to baseline and initial electroencephalogram (EEG) findings. The range of age was between 1 to 79 years old and the longest duration of treatment was 118 days. Most patients were treated by using pentobarbital, midazolam, phenobarbital and other antiepileptic drugs. The overall mortality was 5 (33%) out of 15 patients. The mortality was related to etiology, underlying other medical conditions and initial EEG findings. 5 (55%) out of the 9 patients with acute etiology, 5 (71%) out of the 7 patients with a multifocal or burst-suppression EEG activity, and 3 (60%) out of the 5 patients with other medical disease were related to mortality. This data demonstrate high mortality due to status epilepticus. Mortality is related to etiology, other medical conditions and abnormalities on the initial EEG.

• Parasites, Hosts and Diseases
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• v.52 no.2
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• pp.125-129
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• 2014

Several reports on taeniasis and cysticercosis in Vietnam show that they are distributed in over 50 of 63 provinces. In some endemic areas, the prevalence of taeniasis was 0.2-12.0% and that of cysticercosis was 1.0-7.2%. The major symptoms of taeniasis included fidgeted anus, proglottids moving out of the anus, and proglottids in the feces. Clinical manifestations of cysticercosis in humans included subcutaneous nodules, epileptic seizures, severe headach, impaired vision, and memory loss. The species identification of Taenia in Vietnam included Taenia asiatica, Taenia saginata, and Taenia solium based on combined morphology and molecular methods. Only T. solium caused cysticercosis in humans. Praziquantel was chosen for treatment of taeniasis and albendazole for treatment of cysticercosis. The infection rate of cysticercus cellulosae in pigs was 0.04% at Hanoi slaughterhouses, 0.03-0.31% at provincial slaughterhouses in the north, and 0.9% in provincial slaughterhouses in the southern region of Vietnam. The infection rate of cysticercus bovis in cattle was 0.03-2.17% at Hanoi slaughterhouses. Risk factors investigated with regard to transmission of Taenia suggested that consumption of raw meat (eating raw meat 4.5-74.3%), inadequate or absent meat inspection and control, poor sanitation in some endemic areas, and use of untreated human waste as a fertilizer for crops may play important roles in Vietnam, although this remains to be validated.

• Clinical and Experimental Pediatrics
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• v.56 no.12
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• pp.540-544
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• 2013

Down syndrome, the most common chromosomal abnormality, may be associated with various neurologic complications such as moyamoya syndrome, cervical spinal cord compression due to atlantoaxial subluxation, and basal ganglia damage, as well as epileptic seizures and stroke. Many cases of Down syndrome accompanied by isolated neurologic manifestations have been reported in children; however, Down syndrome with multiple neurologic conditions is rare. Here, we have reported a case of Down syndrome in a 10-year-old girl who presented with asymptomatic moyamoya syndrome, atlantoaxial subluxation with spinal cord compression, and basal ganglia calcification. To the best of our knowledge, this is the first report of Down syndrome, in a child, which was accompanied by these 3 neurologic complications simultaneously. As seen in this case, patients with Down syndrome may have neurologic conditions without any obvious neurologic symptoms; hence, patients with Down syndrome should be carefully examined for the presence of neurologic conditions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4487-4491
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• 2014

Objective: To explore the clinical manifestations and imaging characteristics of gliomatosis cerebri to raise the awareness and improve its diagnostic accuracy for patients. Materials and Methods: Clinical data, imaging characteristics and pathological examination of 12 patients with GC from Jan., 2008 to Jan., 2012 were analyzed retrospectively. Results: Patients with GC were clinically manifested with headache, vomiting, repeated seizures, fatigue and unstable walking, most of whom had more than 2 lesions involving in parietal lobe, followed by temporal lobe, frontal lobe, periventricular white matter and corpus callosum. Magnetic resonance imaging (MRI) showed diffuse distribution, T1-weighted images (T1WI) with equal and low signals and T2-weighted images (T2WI) with bilateral symmetrical high diffuse signals. There was no reinforcement by enhancement scanning and signals were different in diffusion-weighted images (DWI). The higher the tumor staging, the stronger the signals. Pathological examination showed neuroastrocytoma in which tumor tissues were manifested by infiltrative growth in blood vessels and around neurons. Conclusions: In clinical diagnosis of GC, much attention should be paid to the diffuse distribution of imaging characteristics, incomplete matching between clinical and imaging characteristics and confirmation by combining with histopathological examination.

• Journal of Genetic Medicine
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• v.16 no.2
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• pp.71-75
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• 2019

Periventricular nodular heterotopia (PNH) is a malformation of cortical development in which normal neurons inappropriately cluster in periventricular areas. Patients with Mowat-Wilson syndrome (MWS) typically present with facial gestalt, complex neurologic problems (e.g., severe developmental delay with marked speech impairment and epilepsy), and multiple anomalies (e.g., Hirschsprung disease, urogenital anomalies, congenital heart defects, eye anomalies, and agenesis of the corpus callosum [CC]). MWS is mostly caused by haploinsufficiency of the gene encoding zinc-finger E-box-binding homeobox 2 (ZEB2) due to premature stops or large deletions. We present a case report of a 9-year-old girl with PNH, drug-responsive epilepsy, severe intellectual disability, and facial dysmorphisms only in whom we performed whole-exome sequencing and found a de novo heterozygous missense mutation (c.3134A>C; p.His1045Pro) of ZEB2 (NM_014795.3; NP_055610.1). This mild case of MWS caused by a rare novel missense mutation of ZEB2 represents the first report of MWS with isolated PNH.

• Clinical and Experimental Pediatrics
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• v.60 no.9
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• pp.302-306
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• 2017

Purpose: This study aimed to investigate whether serum neuron-specific enolase (NSE) was expressed in acute encephalitis syndrome (AES) that causes neuronal damage in children. Methods: This prospective observational study was conducted in the pediatric neurology ward of Soetomo Hospital. Cases of AES with ages ranging from 1 month to 12 years were included. Cases that were categorized as simple and complex febrile seizures constituted the non-AES group. Blood was collected for the measurement of NSE within 24 hours of hemodynamic stabilization. The median NSE values of both groups were compared by using the Mann-Whitney U test. All statistical analyses were performed with SPSS version 12 for Windows. Results: In the study period, 30 patients were enrolled. Glasgow Coma Scale mostly decreased in the AES group by about 40% in the level ${\leq}8$. All patients in the AES group suffered from status epilepticus and 46.67% of them had body temperature >$40^{\circ}C$. Most of the cases in the AES group had longer duration of stay in the hospital. The median serum NSE level in the AES group was 157.86 ng/mL, and this value was significantly higher than that of the non-AES group (10.96 ng/mL; P<0.05). Conclusion: AES cases showed higher levels of serum NSE. These results indicate that serum NSE is a good indicator of neuronal brain injury.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.173-179
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• 2015

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

• Korean Journal of Biological Psychiatry
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• v.24 no.3
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• pp.110-128
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• 2017

Electroconvulsive therapy (ECT) has been recognized effective as primary or secondary treatments for major psychiatric disorders including depression and schizophrenia, as well as psychiatric emergency such as suicide, food refusal and catatonia, and so on. Medicines used in anesthetic induction for ECT, cause various reactions in autonomous, hemodynamic, and neuromuscular systems. The anesthetics also affect the duration, threshold, and intensity of seizures evoked with electric stimuli, and thus modify the seizure quality in ECT. Individual characteristics of age, sex, weight, comorbid physical disorders, and medications should also be considered for optimal clinical response after ECT. When preparing for anesthesia, adequate anesthetic agents and muscle relaxants, and rapid recovery should be carefully considered. We conducted a case-series study to address practical issues that are frequently encountered during ECT anesthesia with reviews of updated journals in order to provide practical helps to clinicians who are preparing ECT for their patients.

• Molecules and Cells
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• v.25 no.1
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• pp.124-130
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• 2008

Astrocyte ion channels participate in ionic homeostasis in the brain. Inward rectifying potassium channels (Kir channels) in astrocytes have been particularly implicated in $K^+$ homeostasis because of their high open probability at resting potential and their increased conductance at high concentrations of extracellular $K^+$. We examined the expression of the Kir2.1 subunit, one of the Kir channel subunits, in the mouse brain by immunohistochemistry. Kir2.1 channels were widely distributed throughout the brain, with high expression in the olfactory bulb and the cerebellum. Interestingly, they were abundantly expressed in astrocytes of the olfactory bulb, while astrocytes in other brain regions including the hippocampus did not show any detectable expression. However, Kir2.1 channel-expressing cells were dramatically increased in the hippocampus by kainic acid-induced seizure and the cells were glial fibrillary acidic protein (GFAP)-positive, which confirms that astrocytes in the hippocampus express Kir2.1 channels under pathological conditions. Our results imply that Kir2.1 channels in astrocyte may be involved in buffering $K^+$ against accumulated extracellular $K^+$ caused by neuronal hyperexcitability under phathophysiological conditions.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.21 no.1
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• pp.55-61
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• 2011

Cyclonite is a white powder and is very explosive. It can cause seizures (a problem of the nervous system) in human and animals when large amounts are inhaled or eaten. Research papers for workers exposure assesment of the cyclonite are very a few in the world. A field study was conducted at explosive compounds and bomb manufacturing companies to evaluate workers exposure to cyclonite. The airborne average concentration of cyclonite in explosive compounds manufacturing company was $4.10{\mu}g/m^3$(range: ND - $59.92{\mu}g/m^3$), and that of cyclonite in bomb manufacturing company was $31.49{\mu}g/m^3$(range: ND - $291.41{\mu}g/m^3$). Package process and assembly process in both companies were considered the high potential of exposure to cyclonite. Even though all airborne concentrations of cyclonite were lower than occupational exposure standard (MOEL: $500{\mu}g/m^3$), exposure to cyclonite can also occur through dermal contact during manufacture, handling, and clean-up of cyclonite. So control measures for protecting skin absorption of cyclonite were needed for preventing adverse health effect by cyclonite exposure.