• Title/Summary/Keyword: epileptic patients

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Contributions of CYP2C9/CYP2C19 Genotypes and Drug Interaction to the Phenytoin Treatment in the Korean Epileptic Patients in the Clinical Setting

  • Lee, Soo-Youn;Lee, Seung-Tae;Kim, Jong-Won
    • BMB Reports
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    • v.40 no.3
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    • pp.448-452
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    • 2007
  • We examined the contribution of CYP2C9 and CYP2C19 genotypes and drug interactions to the phenytoin metabolism among 97 Korean epileptic patients to determine if pharmacogenetic testing could be utilized in routine clinical practice. The CYP2C9 polymorphism is a wellknown major genetic factor responsible for phenytoin metabolism. The CYP219 polymorphism, with a high incidence of variant alleles, has a minor influence on phenytoin treated Koran patients. Using a multiple regression model for evaluation of the CYP2C9 and CYP2C19 genotypes, together with other non-genetic variables, we explained 39.6% of the variance in serum phenytoin levels. Incorporation of genotyping for CYP2C9 and CYP2C19 into a clinical practice may be of some help in the determination of phenytoin dosage. However, because concurrent drug treatment is common in patients taking phenytoin and many environmental factors are likely to play a role in drug metabolism, these factors may overwhelm the relevance of CYP polymorphisms in the clinical setting. Further investigations with an approach to dose assessment that includes comprehensive interpretation of both pharmacogenetic and pharmacokinetic data along with understanding of the mechanism of drug interactions in dosage adjustment is warranted.

Sparganum infections in normal adult population and epileptic patients in Korea: A seroepidemiologic observation (항체검사에 의한 한국인 스파르가눔 감염의 혈청역학적 조사)

  • Yoon Kong;Seung-Yull Cho;Woo Shik Kang
    • Parasites, Hosts and Diseases
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    • v.32 no.2
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    • pp.85-92
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    • 1994
  • A seroepidemiologic observation of anti-Spirometrc erinacei plerocercoid (sparganum) antibody (IgG) in serum was made in normal adult and epileptic patients in Korea from february, 1987 to September, 1990. Sera were tested by enzyme-linked immunosorbent assay (ELISA) for anti-sparganum antibody together with anti-Taenic soEiun metacestode, and anti-Parusonimus westermcni antibodies. Sera reacted positively to sparganum antigen only were considered. Positive rate for anti-sparganum antibody in 850 normal adults was 1.9% (standardized rate by provincial population was 1.7%). In 2,667 randomly selected patients of epilepsy at 28 local centers of the Changmi Club, positive rate was 2.5% (standardized rate: 2.3%). In both normal adult and patient groups, the higher antibody rates were observed in Kangwon and Chonnam Provinces. Positive rates were 10 times higher in male than in female in normal adults and 4.5 times in male epileptic patients. The rates were elevated especially with age over 30-year. odd ratio of the antibody was 1.32 which indicated an ambiguous etiologic factor for epilepsy.

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A Clinical Study on the Seizure and Spontaneous Lobar Intracerebral Hemorrhage (경련과 자연발생 엽상뇌출혈의 임상적연구)

  • Yu, Sung-dong;Sohn, Eun-Hee;Kwon, Do-Hyoung;Kim, Tae-Woo;Jung, Ki-Young;Kim, Jae-Moon
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.16-20
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    • 2002
  • Background and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated the factors affecting development of epilepsy following spontaneous lobar ICH. Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospital with spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died within few days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epileptic seizure and died five and eight months later each. Medical history was obtained through medical record and by telephone interview. Statistical analyses were performed using Chi-square test, Student's t - test, Fisher's exact test. Results : Seizure occurred in 19 patients. As three patients had previous history of seizures, 16 patients(22.2%) showed first onset early- and late-seizures. Early seizure occurred in 14 patients(19.4%). Three out of 14 were heavy alcoholics. Five patients developed late recurrent seizure 61 days to 800 days after the early seizure. Late seizure with no acute seizure occurred in two patients. The types of seizure were diverse as generalized tonic clonic seizure(10), partial seizure with secondary generalization(5), and complex partial seizure(1). The common risk factors for lobar ICH were hypertension(HT), arteriovenous malformation(AVM), and excessive use of alcohol. We could not find any causes in 23 patients. Although size of hematoma, age of onset, sex, incidence of HT or AVM were not different between patients with seizure and without seizure, the history of excessive alcohol drinking was more frequent in patients with seizure. Five patients with late recurrent seizure had ICH involving temporal area. Conclusions : This study suggests that the risk of seizure in patients with lobar ICH was increase in chronic alcoholics and patient with late recurrent seizure had ICH frequently involving temporal area.

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MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE (기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료)

  • Cha, Yoon-Sun;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.38-42
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    • 2014
  • A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

Evaluation of Immunological Safety of Topiramate, an Anti-epileptic Drug, in a Murine Model

  • Han, Sang-Bae;Kim, Jee-Youn;Kwon, Soon-Woo;Kang, Jong-Soon;Kim, Hwan-Mook;Song, Suk-Gil;Hong, Jin-Tae;Kim, Young-Soo;Kim, Won-Seop
    • Biomolecules & Therapeutics
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    • v.17 no.2
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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.

CHILDREN WITH CHRONIC CONVULSIVE DISORDER AND THEIR FAMILIES (경련성 질환 환아와 가족)

  • Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.67-75
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    • 2002
  • Objectives:This study was conducted to investigate the degree of psychopathologies of the family members of children with chronic convulsive disorder and evaluate the structures and dynamics of those families. Methods:The participant patients and family members were recruited from the population attending the outpatient clinic of department of pediatric neurology in Seoul National University Hospital in Korea. All the patients had idiopathic chronic convulsive disorder. Any patient with mental retardation, pervasive developmental disorder and gross brain pathology was excluded. As controls, normal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The author interviewed the children and their family members twice and obtained informations about patient-parent relationship, patient-sibling relationship and others. For in-depth evaluation, we used family environment scales(FES), symptom Checklist-90-revised(SCL-90-R), self administered dependency questionnaire for mother(SADQ). Results:After interviewing with the parents of epileptic children, overprotection of parents, hostile feeling of siblings toward index children were higher than controls. The parental conflict was also more expressed than control families. According to results from FES, the scores of the subscales of expression, achievement-orientation, intelligence-orientation and active recreation were significantly lower than control group. The epileptic children showed higher dependency to parents especially in affection, communication and traveling areas of SADQ than control group. Maternal psychopathologies evaluated by SCL-90-R were much higher than the mothers of controls. According to T scores of SCL-90-R, about 40% of mothers with epileptic children had the risk of clinically significant depressive or anxiety disorders. Conclusion:These results suggested that the family members of epileptic children had more relationship problems and psychopathologies than control group and some mothers might have clinically significant depressive or anxiety disorders. so, effective psychiatric family interventions are needed for resolution of conflict and psychopathologies of family members.

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New Approach in the Treatment of Epilepsy : Efficacy of New Antiepileptic Drugs

  • Lee, Dae Hie
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.175-183
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    • 1998
  • To consider current concepts of epilepsy further, the brief review begins with a discussion of what is epilepsy, discribes multifactorial nature of epileptic disorders, and ends with a presentation of current classifications. A combination of the standard antiepielptic drugs(AEDs) may be necessary to treat intractable seizures, but no studies have been done to indicate an optimal combination. The new AEDs provide alternative choices, but questions remain about the optimal timing and manner of administration. AEDs selection must individualized, no drug of choice can be named for all patients.

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A Study on Computer-Assisted Automatic Spike Detection System in EEG Signal of Epileptic Patients (콤퓨터를 이용한 간질환자 뇌파의 극파 자동검출 방법에 관한 연구)

  • Park, Gwang-Seok;Min, Byeong-Gu;Lee, Chung-Ung
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.17 no.6
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    • pp.28-32
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    • 1980
  • A digital system has been designed for the detection of abnormal spikes appearing in the epileptic patient's electroencephalogram(EEG). The detection is based on the waveform characteristics of spikes, such as the large slope, the sharpness of the apex, and the time duration of the spike. After the patient's data are collected and processed suing a minicomputer and A/D converter, the computer algorithms recognize the spikes based on the parameters representing the above waveform characteristics.

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A Case Report of Infant Diagnosed as Sik-Gan (食癎) (식간 (食癎)으로 진단된 영아기 환아 1례에 대한 증례 보고)

  • Lee, Eun Ju;Lee, Bo Ram;Lee, Ji Hong;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.30 no.3
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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.

Epileptic Seizure Detection for Multi-channel EEG with Recurrent Convolutional Neural Networks (순환 합성곱 신경망를 이용한 다채널 뇌파 분석의 간질 발작 탐지)

  • Yoo, Ji-Hyun
    • Journal of IKEEE
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    • v.22 no.4
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    • pp.1175-1179
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    • 2018
  • In this paper, we propose recurrent CNN(Convolutional Neural Networks) for detecting seizures among patients using EEG signals. In the proposed method, data were mapped by image to preserve the spectral characteristics of the EEG signal and the position of the electrode. After the spectral preprocessing, we input it into CNN and extracted the spatial and temporal features without wavelet transform. Results from the Children's Hospital of Boston Massachusetts Institute of Technology (CHB-MIT) dataset showed a sensitivity of 90% and a false positive rate (FPR) of 0.85 per hour.