• 제목/요약/키워드: epileptic seizure

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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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    • 제62권3호
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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.

간질의 분류법에 대한 동서의학적 문헌고찰 및 새로운 제안 (A Critical Review on the Epilepsy-related Classification Systems Delineated in the Literatures both Western and East Asian Medicine : A Suggestion to Develope a New Classification)

  • 손광현;김문주
    • 대한예방한의학회지
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    • 제14권2호
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    • pp.135-148
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    • 2010
  • The major purpose of this study is to evaluate the classification of epileptic seizure types and epilepsy described in the literatures of both Western and East Asian medicine, especially based on the two criteria- a theoretical and a practical aspect of the classification systems. Currently, the 1981 classification of epileptic seizure types, and the 1989 classification of epilepsy syndromes and epilepsies which were proposed and approved by the International League Against Epilepsy(ILAE) have been generally accepted worldwide, although a variety of modifications have been consistently suggested. A large proportion of epilepsy cases cannot be easily classified as either 'focal' or 'generalized' or as either 'symptomatic' or 'idiopathic', so they fail to be precisely fallen into any of the ILAE categories. Terms and concepts used in the East Asian medicine are also inadequate to identify epileptic seizure types and epilepsy syndromes as discrete diagnostic entities because of ambiguities in definition and use. Therefore, this article suggests an alternative approach not only more helpful in understanding mechanism of epilepsy but also more easily applicable and effective in clinical value.

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

  • 김소원;김선희;이예나;황서영;강태경;전상범;이향운;이승준
    • 대한의용생체공학회:의공학회지
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    • 제36권4호
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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.

Quadriplegia Following Epileptic Seizure : Things to Keep in Mind

  • Kozak, Hasan Huseyin;Yesilbudak, Zulal;Sisman, Lokman;Uca, Ali Ulvi
    • Journal of Korean Neurosurgical Society
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    • 제59권3호
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    • pp.319-321
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    • 2016
  • People with epilepsy are believed to be at a higher risk of incurring accidental injury than people who do not have seizures. The incidence of injury, either due to seizure or accident as a consequent of seizure is also high and varies from 0.03% to 3%. The most common injuries are head contusions, lacerations, burns and fractures. In this article, we present a case of quadriplegia after a generalized epileptic seizure.

A Retrospective Study on Canine Epilepsy: Etiological Distribution, Therapeutic Outcome, and Survival Time

  • Park, Seo-Yeon;Jeong, Yoonsoo;Yun, Taesik;Jung, Dong-In;Chang, Dong-Woo;Kang, Ji-Houn;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • 한국임상수의학회지
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    • 제36권3호
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    • pp.150-154
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    • 2019
  • The purpose of this study was to investigate the etiological distribution, therapeutic outcome, and survival time in canine epilepsy. The medical records of 57 epileptic dogs were reviewed for the evaluation of etiological distribution. Among them, 27 dogs (47%) and 30 dogs (52%) had idiopathic epilepsy (IdE) and structural epilepsy (StE), respectively. Twenty-nine dogs (IdE: 16 dogs, StE: 13 dogs) were evaluated for therapeutic outcome and survival time. The incidence of generalized epileptic seizure (IdE, 56% vs. StE, 44%; P = 0.043) and the median seizure frequency at the time of first presentation (IdE, 2.0/month vs. StE, 13.3/month; P < 0.01) were significantly different between the two groups. Although pre-treatment seizure frequency and duration were not different, the median duration of seizure in the IdE group (0.5 min) was significantly shorter than that in the StE group (3 min) after treatment (P < 0.01). In addition, the median frequency of seizure was relatively lower in the IdE group (0.25/month) compared to the StE group (2.00/month) following antiepileptic therapy (P = 0.053). The median survival time of the IdE group (1.5 years [95% CI, 1.0-2.3 years]) was significantly longer than that of the StE group (0.4 year [95% CI, 0.2-1.3 years]) (P < 0.01). The information on etiological data and intracranial lesions may be useful for predicting treatment response and prognosis in epileptic dogs.

Early-onset epileptic encephalopathies and the diagnostic approach to underlying causes

  • Hwang, Su-Kyeong;Kwon, Soonhak
    • Clinical and Experimental Pediatrics
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    • 제58권11호
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    • pp.407-414
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    • 2015
  • Early-onset epileptic encephalopathies are one of the most severe early onset epilepsies that can lead to progressive psychomotor impairment. These syndromes result from identifiable primary causes, such as structural, neurodegenerative, metabolic, or genetic defects, and an increasing number of novel genetic causes continue to be uncovered. A typical diagnostic approach includes documentation of anamnesis, determination of seizure semiology, electroencephalography, and neuroimaging. If primary biochemical investigations exclude precipitating conditions, a trial with the administration of a vitaminic compound (pyridoxine, pyridoxal-5-phosphate, or folinic acid) can then be initiated regardless of presumptive seizure causes. Patients with unclear etiologies should be considered for a further workup, which should include an evaluation for inherited metabolic defects and genetic analyses. Targeted next-generation sequencing panels showed a high diagnostic yield in patients with epileptic encephalopathy. Mutations associated with the emergence of epileptic encephalopathies can be identified in a targeted fashion by sequencing the most likely candidate genes. Next-generation sequencing technologies offer hope to a large number of patients with cryptogenic encephalopathies and will eventually lead to new therapeutic strategies and more favorable long-term outcomes.

강직을 동반한 전신 발작을 호소하는 심인성 비간질성 발작 환자에 대한 복합 한의치험 1례 (A Case of Psychogenic Non Epileptic Seizure Patient Complaining Generalized Tonic-Clonic Seizures Treated with Combined Korean Medical Treatment)

  • 이성욱;이현규;배인후;조기호;문상관;정우상;권승원;진철
    • 대한중풍순환신경학회지
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    • 제22권1호
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    • pp.11-20
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    • 2021
  • Psychogenic Non Epileptic Seizure (PNES) refers to a case in which symptoms are similar to epileptic seizures (ES), but ES do not appear in EEG and temporary abnormalities caused by physical diseases are also excluded. Psychotherapy and pharmacotherapy are most commonly used, but standard treatment for PNES has not been established and there is no alternative treatment available in the case of patients those treatments are not applied. We herein report a case of 46 year old male diagnosed with PNES who suffered from generalized tonic-clonic seizures. The patient underwent korean medical treatment by acupuncture and herbal medicine. The clinical symptom was evaluated by assessing occurrence frequency, number of seizures per 28 days. Compared to the period without korean medical treatment, the number of seizures decreased during the treatment period. The present case report suggested that korean medical treatment could be an effective option for those PNES patients complaining generalized tonic-clonic seizures.

복합국소형발작으로 사료되는 간신음허형(肝腎陰虛形) 및 전간 환자의 침치료 예 (Case of 'Dianxian' Patient Induced by Eum Deficiency of Liver & Kidney Who was Considered as Complex Partial Seizure Treated by Acupuncture)

  • 조창현;조윤성;윤지원;이상관
    • 동의생리병리학회지
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    • 제21권1호
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    • pp.328-332
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    • 2007
  • Epilepsy is any of various neurological disorders characterized by sudden, recurring attacks of motor, sensory, or psychic malfunction with or without loss of consciousness or convulsive seizures. It could be divided into subcategories due to the international classification of epileptic seizure and the complex partial seizure, that is one of epileptic seizure subcategories, is characterized by elaborate and multiple sensory, motor, and/or psychic components accompanying the clouding of consciousness, prodrome, automatism, postictal confusion. This study reports a patient who was presumptive diagnosed as complex partial seizure by having the clouding of consciousness, prodrome, postictal confusion. We also diagnosed him as a ‘dianxian’ patient induced by sum deficiency of liver & kidney. This patient was treated by acupuncture to tonifying eum of liver & kidney and it achieved markedly improved symptoms.

소아간질의 임상적 관찰 (Clinical Investigation of Childhood Epilepsy)

  • 문한구;박용훈
    • Journal of Yeungnam Medical Science
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    • 제2권1호
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    • pp.103-111
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    • 1985
  • 저자들은 1983년 5월부터 1985년 11월까지 만 30개월간 본원 소아과를 통해 진료받은 100명의 소아간질환아를 대상으로 관찰한 결과 다음과 같은 성적을 얻었다. 1. 남녀별 발생빈도는 1.2:1로 남아에서 약간 많았다. 2. 경련발생 연령은 6개월 미만이 13예(12.6%), 6개월~3세군이 34예(33.0%), 3~5세군이 16예(15.5%), 5~10세군이 24예(23.3%), 10~15세군이 16예 (15.5%)였다. 3. 간질경련 양상은 generalized tonic-clonic, tonic, clonic seizure가 49.5%, 간대성 근경련이 5.8%, 비전형 소발작이 5.8%, 이완성발작이 1%였고, simple P.S.가 7.8%, complex P.S.가 3.9%, simple P.S. $\overline{c}$ 2nd G.이 17.5%, complex P.S. $\overline{c}$ 2nd G.이 2.9%, 미분류가 5.8%였다. 4. 간질의 원인으로 추정이 가능했던 경우가 17예(16.5%)였는데 주산기 저산소증(4.9%), 뇌막염(3.9%), 미숙아분만(1.9%) 등이 많은 원인이었다. 5. 간질과 동반된 질환은 30예(29%)에서 보였는데 지능장애, 과다행동증, 운동발달지연, 뇌성마비 등이 많았다. 6. 42예에서 행한 뇌 전산화단층촬영에서 14예의 이상소견을 보였는데 뇌 위축이 6예, 뇌경색이 3예, 수두증 및 뇌부종소견이 각각 2 예씩 나타났다.

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간질이 있는 산모에서 간질의 예방 및 분만통 감소를 위한 경막외 진통의 경험 1예 -증례 보고- (Continuous Lumbar Epidural Analgesia for Labor and Vaginal Delivery in Epileptic Pregnant Women)

  • 최소용;임성진;이정태
    • The Korean Journal of Pain
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    • 제11권2호
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    • pp.332-334
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    • 1998
  • A 25-year-old epileptic female patient scheduled for vaginal delivery, was referred to the pain clinic for the relief of labor pain. She had been taking anticonvulsant drugs, but suffered from seizure attacks three or four times a month. We had induced continuous lumbar epidural analgesia successfully and she subsequently gave birth to a healthy infant. So we report that continuous lumbar epidural analgesia should be considered as a safe method for reduction of labor pain and prevention of seizure attacks in epileptic pregnant women.

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