• Biomolecules & Therapeutics
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• 제17권2호
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• pp.168-174
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• 2009

Epilepsy is one of the most common neurological disorders, and topiramate (TPM) is one of the most effective drugs that can render patients seizure-free. The focus of the present study was to evaluate the immunological safety of TPM in a mouse model. We examined the in vitro effect of TPM on immune functions of BV2 microglial cells, RAW 264.7 macrophages, B cells, T cells, and dendritic cells. We also examined the in vivo effect of TPM on mouse immune organs, such as lymph node, spleen, and thymus. When cells were directly treated with TPM at concentrations from 1 to $30{\mu}g/ml$, TPM did not affect nitrite production by BV2 cells and macrophages, proliferation of B cells and T cells, or maturation of dendritic cells. In addition, TPM did not change the weight and cellularity of lymph nodes, spleen, and thymus in vivo at doses from 3 to 100 mg/kg injected i.p. into mice once a day for 4 consecutive days. These data showed that TPM, which is widely used as an anti-epileptic drug, is immunologically safe.

• 정신신체의학
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• 제22권2호
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• pp.63-70
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• 2014

기분장애에서 과체중과 비만의 문제가 일반인구보다 더 심각하고, 심혈관 치명률의 증가와 무관하지 않기 때문에 비만에 대한 치료가 필수적이다. 일반적인 상황에서 비만에 대한 치료와 동일하게 생활습관교정과 같은 비약물치료가 선행되어야 한다. 이 같은 시도가 실패하는 경우에는 약물치료가 필요하다. 기분장애의 비만치료로 공식 승인된 약은 없다. 따라서 일반인구의 비만에 승인된 약을 처방하거나 여러 연구를 통해서 효과가 입증된 약을 처방하게 된다. 여러 치료 지침과 연구 등은 orlistat, metformin, topiramate와 bupropion 등이 효과적임을 지지한다.

• 대한치과의사협회지
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• 제49권6호
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• pp.327-333
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• 2011

Clinically, treatment goal of neuropathic pain focused on not elimination of etiology but management and control of symptoms because we don't know certain about clear etiology of neuropathic pain yet. The drugs used for the management of neuropathic pain were classified as drugs with strong evidence for benefit(antidepressants, anticonvulsants, opioid analgesics etc.), modest evidence for benefit(mexiletine, carbamazepine, clonidine etc.), preliminary evidence for benefit(NSAIDs, dextromethorphan, topiramate etc.). Finally, the treatment for trigeminal neuralgia was outlined separately since this disorder responds to a different group of drugs than other neuropathic pain conditions.

• The Korean Journal of Medicine
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• 제93권6호
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• pp.501-508
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• 2018

Obesity is a chronic disorder that is a significant risk factor for diabetes, cardiovascular diseases, malignancy, and other chronic diseases. Lifestyle modifications form the basis of most treatments for obesity, but it has become clear that such modifications alone are not enough for many obese patients. When a behavioral approach is insufficient, pharmacological treatment may be recommended. In recent years, the US Food and Drug Administration (FDA) has withdrawn several therapeutic options for obesity due to their side effects, but has approved four novel anti-obesity agents. Until recently, orlistat was the only drug approved for the management of long-term obesity, but the US FDA approved the novel anti-obesity drugs lorcaserin and phentermine/topiramate in 2012, and naltrexone/bupropion and liraglutide in 2014. The present review discusses the different pharmacotherapeutic options for the treatment of obesity.

• Journal of Yeungnam Medical Science
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• 제41권3호
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• pp.158-165
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• 2024

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

• Clinical and Experimental Pediatrics
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• 제58권2호
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• pp.73-76
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• 2015

Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither nonsteroidal anti-inflammatory drugs nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging scan showed isolated sphenoid sinusitis. Both patients' symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

• Clinical and Experimental Pediatrics
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• 제55권3호
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• pp.111-113
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• 2012

Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the seizures did not respond to conventional antiepileptic drugs, including valproic acid, phenytoin, and topiramate. The clinical course was complicated by the development of acute psychosis, including bipolar mood, insomnia, agitation, and hallucinations. The diagnosis of HE was supported by positive results for antithyroperoxidase and antithyroglobulin antibodies. Treatment with methylprednisolone was effective; her psychosis improved and the number of seizures decreased. HE is a serious but curable, condition, which might be underdiagnosed if not suspected. Anti-thyroid antibodies must be measured for the diagnosis. HE should be considered in patients with diverse neuropsychiatric manifestations.

• KSBB Journal
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• 제29권1호
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• pp.67-71
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• 2014

Planaria were recently reported to be a simple and sensitive model to investigate the mechanistic aspect of seizure and to screen potential anticonvulsants. Using planarian model, we analyzed the pharmacological effect of ukgansan (UGS), an oriental herbal medicine containing seven medicinal herbs, on the planarian locomotor velocity (pLMV) and glutamate-induced seizure-like activity (pSLA). To test whether D. japonica is suitable for studying anti-seizure agents, we investigated the effect of glutamate on pLMV and pSLA in D. japonica. In the present study we first confirmed that pSLA in D. japonica was induced by L-glutamate. Glutamate significantly produced pSLA in a dose dependent manner, but did not affect pLMV. These glutamate-induced paroxysms were decreased by antiepileptic drug, topiramate. A similar inhibitory effect on glutamate-induced pSLA was observed after the treatment of UGS. The present results suggest that UGS and its active constituents possess useful substance inhibiting seizure in planarian and that D. japonica provides a convenient model to search active herbs containing anti-seizure activity.

• Clinical and Experimental Pediatrics
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• 제61권11호
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• pp.355-361
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• 2018

Purpose: Headache is a common symptom during childhood. It is usually persistent and requires special care. This study aimed to identify the characteristics of headache in children <7 years of age. Methods: We reviewed 3 years of clinical files on children <7 years of age with a chief complaint of headache. Results: This study included 146 children (66 males, 80 females; mean age, $5.5{\pm}1.0years$). Mean symptom duration was $5.8{\pm}7.9months$. Attack durations were longer than 2 hours in 31 patients, shorter than 2 hours in 70 patients, and unchecked in 45 patients. Attack frequency was $15.1{\pm}10.6$ times per month. Pain locations and characteristics were also variable. Mean pain severity score was $5.1{\pm}2.2$ on the visual analog scale. Of 38 patients who underwent electroencephalography, 9 showed positive findings. Of 41 who underwent brain magnetic resonance imaging, 20 showed positive findings. The diagnoses were migraine (including probable migraine) in 34, tension-type headache in 5, and congenital malformations in 3. Medications were used in 29 patients: acetaminophen in 17, ibuprofen in 8, naproxen sodium in 1, and topiramate or amitriptyline in 3. Conclusion: In children aged <7 years, headache has a relatively benign course, but detailed history taking is needed for more accurate diagnosis.

• Clinical and Experimental Pediatrics
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• 제55권5호
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• pp.171-176
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• 2012

Purpose: The aim of this study was to investigate the natural history of epilepsy and response to anti-epileptic drug treatment in patients with Angelman syndrome (AS) in Korea. Methods: We retrospectively reviewed the clinical records of 14 patients diagnosed with epilepsy out of a total of 17 patients with a genetic diagnosis of AS. These patients were seen at the Department of Pediatric Neurology at Severance Children's Hospital from March 2005 to March 2011. Results: Fourteen (9 males and 5 females) subjects (82.3%) were diagnosed with epilepsy in AS. The most common seizure types were generalized tonic-clonic (n=9, 27%) and myoclonic (n=9, 27%), followed by atonic (n=8, 24%), atypical absence (n=4, 12%) and complex partial seizure (n=3, 9%). The most commonly prescribed antiepileptic drug (AED) was valproic acid (VPA, n=12, 86%), followed by lamotrigine (LTG, n=9, 64%), and topiramate (n=8, 57%). According to questionnaires that determined whether each AED was efficacious or not, VPA had the highest response rate and LTG was associated with the highest rate of seizure exacerbation. Complete control of seizures was achieved in 6 patients. Partial control was achieved in 7 patients, while one patient was not controlled. Conclusion: Epilepsy is observed in the great majority of AS patients. It may have early onset and is often refractory to treatment. There are few reports about epilepsy in AS in Korea. This study will be helpful in understanding epilepsy in AS in Korea.