• Title/Summary/Keyword: epileptic patients

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Seizures in Patients with Brain Tumors

  • Yang, Seung-Ho;Lee, Kwan-Sung;Lee, Tae-Kyu;Jeun, Sin-Soo;Park, Chun-Kun;Hong, Yong-Kil
    • Journal of Korean Neurosurgical Society
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    • v.41 no.6
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    • pp.387-390
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    • 2007
  • Objective : To determine the presentation, incidence, and risk factors of seizures in patients treated for brain tumors. Methods : One hundred patients who consecutively underwent a craniotomy for the treatment of supratentorial brain tumors were assessed. The pathologies of the patients enrolled in the study included glioma [n=56], meningioma [n=31], metastatic brain tumor [n=7], primary central nervous system lymphoma [n=4], and central neurocytoma [n=2]. Anti-epileptic drugs [AEDs] were administered to all patients for up to six months after the surgery. Pre-defined variables for outcome analysis included tumor grade and location, extent of tumor resection, number of seizures, age at tumor diagnosis, adjuvant therapy, medication and radiological abnormalities. Results : Thirty patients [30%] presented at least a single episode of seizure at the time of admission. Five of these patients [16.7%] developed the seizure during the follow-up period. Newly developed seizure was noticed in six out of seventy patients [8.6%] without prior seizure. Histopathology was malignant gliomas in 10 and supratentorial meningioma in one. Early seizure developed only in two patients. Conclusion : Compared with patients without seizure, patients with seizure at the time of admission showed younger age [p=0.003], a higher portion of low-grade glioma [p=0.001], tumor location in the frontal and temporal lobes [p=0.003] and cortical involvement [p=0.017]. Our study suggestes that tumor progression is considered a significant risk factor for seizure development in glioma patients.

Neuronal function and dysfunction of CYFIP2: from actin dynamics to early infantile epileptic encephalopathy

  • Zhang, Yinhua;Lee, Yeunkum;Han, Kihoon
    • BMB Reports
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    • v.52 no.5
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    • pp.304-311
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    • 2019
  • The cytoplasmic FMR1-interacting protein family (CYFIP1 and CYFIP2) are evolutionarily conserved proteins originally identified as binding partners of the fragile X mental retardation protein (FMRP), a messenger RNA (mRNA)-binding protein whose loss causes the fragile X syndrome. Moreover, CYFIP is a key component of the heteropentameric WAVE regulatory complex (WRC), a critical regulator of neuronal actin dynamics. Therefore, CYFIP may play key roles in regulating both mRNA translation and actin polymerization, which are critically involved in proper neuronal development and function. Nevertheless, compared to CYFIP1, neuronal function and dysfunction of CYFIP2 remain largely unknown, possibly due to the relatively less well established association between CYFIP2 and brain disorders. Despite high amino acid sequence homology between CYFIP1 and CYFIP2, several in vitro and animal model studies have suggested that CYFIP2 has some unique neuronal functions distinct from those of CYFIP1. Furthermore, recent whole-exome sequencing studies identified de novo hot spot variants of CYFIP2 in patients with early infantile epileptic encephalopathy (EIEE), clearly implicating CYFIP2 dysfunction in neurological disorders. In this review, we highlight these recent investigations into the neuronal function and dysfunction of CYFIP2, and also discuss several key questions remaining about this intriguing neuronal protein.

Epileptic Seizure Detection Using CNN Ensemble Models Based on Overlapping Segments of EEG Signals (뇌파의 중첩 분할에 기반한 CNN 앙상블 모델을 이용한 뇌전증 발작 검출)

  • Kim, Min-Ki
    • KIPS Transactions on Software and Data Engineering
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    • v.10 no.12
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    • pp.587-594
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    • 2021
  • As the diagnosis using encephalography(EEG) has been expanded, various studies have been actively performed for classifying EEG automatically. This paper proposes a CNN model that can effectively classify EEG signals acquired from healthy persons and patients with epilepsy. We segment the EEG signals into sub-signals with smaller dimension to augment the EEG data that is necessary to train the CNN model. Then the sub-signals are segmented again with overlap and they are used for training the CNN model. We also propose ensemble strategy in order to improve the classification accuracy. Experimental result using public Bonn dataset shows that the CNN can detect the epileptic seizure with the accuracy above 99.0%. It also shows that the ensemble method improves the accuracy of 3-class and 5-class EEG classification.

Development of Real-time Closed-loop Neurostimulation System for Epileptic Seizure Suppression (뇌전증 경련 억제를 위한 실시간 폐루프 신경 자극 시스템 설계)

  • Kim, Sowon;Kim, Sunhee;Lee, Yena;Hwang, Seoyoung;Kang, Taekyeong;Jun, Sang Beom;Lee, Hyang Woon;Lee, Seungjun
    • Journal of Biomedical Engineering Research
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    • v.36 no.4
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    • pp.95-102
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    • 2015
  • Epilepsy is a chronic neurological disease which produces repeated seizures. Over 30% of epileptic patients cannot be treated with anti-epileptic drugs, and surgical resection may cause loss of brain functions. Seizure suppression by electrical stimulation is currently being investigated as a new treatment method as clinical evidence has shown that electrical stimulation to brain could suppress seizure activity. In this paper, design of a real-time closed-loop neurostimulation system for epileptic seizure suppression is presented. The system records neural signals, detects seizures and delivers electrical stimulation. The system consists of a 6-channel electrode, front-end amplifiers, a data acquisition board by National Instruments, and a neurostimulator and Generic Osorio-Frei algorithm was applied for seizure detection. The algorithm was verified through simulation using electroencephalogram data, and the operation of whole system was verified through simulation and in- vivo test.

A Case of Psychogenic Non-epileptic Seizure Patient Complaining Myoclonic Seizure Treated with Ukgansan and Hwangnyeonhaedok-tang (전신 근간대성 경련을 호소하는 정신성 비간질성 경련 환자에 대한 억간산 및 황련해독탕 병용 투여 치험 1례)

  • Bae, In hu;Ha, Won Jung;Seo, Yuna;lee, Hyun-kue;Kim, Su hyeon;Cho, Ki-Ho;Moon, Sang-Kwan;Jung, Woo-Sang;Kwon, Seungwon;Jin, Chul
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.21 no.1
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    • pp.33-38
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    • 2020
  • ■ Objectives This case report is reported to show the effect of Ukgansan and Hwangnyeonhaedok-tang on a patient who complaining myoclonic seizure due to psychogenic non epileptic seizure, occurred after traumatic stress event. ■ Methods A female patients with myolconic seizure was treated with Ukgansan and Hwangnyeonhaedok-tang during 5 days. Then we assessed dyskinesia severity by AIMS(Abnormal Involuntary Movement Scale) every two days til discharge. ■ Results Seizure decreased two days after hospitalization, then disappeared third day. There was no recurrence till discharge. When she revisited outpatients clinic, there was no symptom. ■ Conclusion This case showed the effect of Ukgansan and Hwangnyeonhaedok-tang on psychogenic epileptic seizure.

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A case report of epilepic children (가미곽향정기산(加味藿香正氣散) 투여로 호전된 소아 간질 환자 2례)

  • Han, Kyung-Hun;Lee, Hai-Ja;Park, Eun-Jung;Na, Won-Kyung
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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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.

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From Resection to Disconnection for Seizure Control in Pediatric Epilepsy Children

  • Hwang, Jun Kyu;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.336-343
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    • 2019
  • Epilepsy surgery revealed dramatically improved seizure outcomes over medical therapy in drug-resistant epilepsy patients. Children with epilepsy, however, have multiple epileptic focuses which require multilobar resection for better seizure outcome. Multilobar resection has not only the several severe surgical complications, such as hydrocephalus and shunt-related craniosynostosis, due to intracranial volume reduction. Isolation method (disconnection surgery) was progressively studied over epileptic focus removal (resective surgery) for seizure control. This concept was first introduced for functional hemispherotomy, and its primary principle is to preserve the vital vascularized brain that is functionally disconnected from the contralateral healthy brain. Currently in most epilepsy centers, the predominant disconnection surgical methods, including functional hemispherotomy, are continually being refined and are showing excellent results. They allow the functional isolation of the hemisphere or multi-lobe, affected by severe epilepsy. This review describes recent findings concerning the indication, surgical technique, seizure outcome and complications in several disconnection surgeries including the functional hemispherotomy for refractory pediatric epilepsy.

Genetic Variations of ABCC2 Gene Associated with Adverse Drug Reactions to Valproic Acid in Korean Epileptic Patients

  • Yi, Ji Hyun;Cho, Yang-Je;Kim, Won-Joo;Lee, Min Goo;Lee, Ji Hyun
    • Genomics & Informatics
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    • v.11 no.4
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    • pp.254-262
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    • 2013
  • The multidrug resistance protein 2 (MRP2, ABCC2) gene may determine individual susceptibility to adverse drug reactions (ADRs) in the central nervous system (CNS) by limiting brain access of antiepileptic drugs, especially valproic acid (VPA). Our objective was to investigate the effect of ABCC2 polymorphisms on ADRs caused by VPA in Korean epileptic patients. We examined the association of ABCC2 single-nucleotide polymorphisms and haplotype frequencies with VPA related to adverse reactions. In addition, the association of the polymorphisms with the risk of VPA related to adverse reactions was estimated by logistic regression analysis. A total of 41 (24.4%) patients had shown VPA-related adverse reactions in CNS, and the most frequent symptom was tremor (78.0%). The patients with CNS ADRs were more likely to have the G allele (79.3% vs. 62.7%, p=0.0057) and the GG genotype (61.0% vs. 39.7%, p=0.019) at the g.-1774delG locus. The frequency of the haplotype containing g.-1774Gdel was significantly lower in the patients with CNS ADRs than without CNS ADRs (15.8% vs. 32.3%, p=0.0039). Lastly, in the multivariate logistic regression analysis, the presence of the GG genotype at the g.-1774delG locus was identified as a stronger risk factor for VPA related to ADRs (odds ratio, 8.53; 95% confidence interval, 1.04 to 70.17). We demonstrated that ABCC2 polymorphisms may influence VPA-related ADRs. The results above suggest the possible usefulness of ABCC2 gene polymorphisms as a marker for predicting response to VPA-related ADRs.

Effectiveness of the Shugan Jieyu Capsule against Psychiatric Symptoms in Epilepsy: a protocol for systematic review and meta-analysis

  • Sejin Kim;Yunna Kim;Seung-Hun Cho
    • Journal of Pharmacopuncture
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    • v.26 no.1
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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.

Predictive value of cobalt chloride solution for hypohidrosis with topiramate (약물 유발 소한증에서 cobalt chloride solution의 임상적 유용성)

  • Lee, Hyuk;Lee, Seung Hyun;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1180-1185
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    • 2006
  • Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.