• Clinical and Experimental Pediatrics
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• 제57권9호
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• pp.384-395
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• 2014

Febrile seizure (FS) is the most common seizure disorder of childhood, and occurs in an age-related manner. FS are classified into simple and complex. FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Various animal models have elucidated the pathophysiological mechanisms of FS. Risk factors for a first FS are a family history of the disorder and a developmental delay. Risk factors for recurrent FS are a family history, age below 18 months at seizure onset, maximum temperature, and duration of fever. Risk factors for subsequent development of epilepsy are neurodevelopmental abnormality and complex FS. Clinicians evaluating children after a simple FS should concentrate on identifying the cause of the child's fever. Meningitis should be considered in the differential diagnosis for any febrile child. A simple FS does not usually require further evaluation such as ordering electroencephalography, neuroimaging, or other studies. Treatment is acute rescue therapy for prolonged FS. Antipyretics are not proven to reduce the recurrence risk for FS. Some evidence shows that both intermittent therapy with oral/rectal diazepam and continuous prophylaxis with oral phenobarbital or valproate are effective in reducing the risk of recurrence, but there is no evidence that these medications reduce the risk of subsequent epilepsy. Vaccine-induced FS is a rare event that does not lead to deleterious outcomes, but could affect patient and physician attitudes toward the safety of vaccination.

• 대한한방소아과학회지
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• 제24권2호
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• pp.1-12
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• 2010

Objectives Taking detailed patient history helps earlier diagnosis and treatment of developmental disability. In this study we analyzed the clinical questionnaire to find out the clinical characteristics of those with five-retardation, five-limpness, or five-stiffness. Methods The data was collected from 484 children under the age of six who have visited H oriental medicine clinic for developmental delay. The clinical questionnaire was filled out by their parents and the data was analyzed statistically. Results 436 children showed symptoms of five-retardation, 90 children suffered from five-stiffness, 54 children showed five-limpness and 7 children suffered from five-stiffness and five-limpness complex. Generally, boys had higher chance to show disease symptoms than the girls (2.32:1) and 40 children (8.26%) reported family history of developmental disability. Cerebral palsy ranks the most common familial disease, followed by developmental delay, mental retardation, autistic disorder and language disorder. Among the children we have studied, 285 children (63.19%) showed delayed unassisted walk while 192 children (42.57%) had language disorder. Also, 138 children (28.51%) had both walk and language disorders. The children in this study also showed delayed toilet training and half of them had little stranger anxiety when they were infants. It was also found that 120 children (24.79%) experienced epilepsy. This study reaffirmed that low birth weight, premature birth, and suffocation are major risks causing neurological damage. Conclusions They had history which including family history, problems at birth, epilepsy, face recognition, muscle tone disorder, delayed walking without assistance, language ability, and toilet training.

• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.299-307
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• 2024

Cerebral cavernous malformation (CCM) is a vascular anomaly commonly found in children and young adults. Common clinical presentations of pediatric patients with CCMs include headache, focal neurological deficits, and seizures. Approximately 40% of pediatric patients are asymptomatic. Understanding the natural history of CCM is crucial and hemorrhagic rates are higher in patients with an initial hemorrhagic presentation, whereas it is low in asymptomatic patients. There is a phenomenon known as temporal clustering in which a higher frequency of symptomatic hemorrhages occurs within a few years following the initial hemorrhagic event. Surgical resection remains the mainstay of treatment for pediatric CCMs. Excision of a hemosiderin-laden rim is controversial regarding its impact on epilepsy outcomes. Stereotactic radiosurgery is an alternative treatment, especially for deep-seated CCMs, but its true efficacy needs to be verified in a clinical trial.

• 대한한의학방제학회지
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• 제28권4호
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• pp.451-458
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• 2020

뇌졸중 후 발생한 뇌전증 환자에서 항경련제와 함께 진간식풍탕가감방(鎭肝熄風湯加減方), 우황청심원(牛黃淸心元)을 위주로 하는 한의 치료를 병행하여 발작 억제 효과를 확인하였다.

• 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.

• Clinical and Experimental Pediatrics
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• 제53권4호
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• pp.571-578
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• 2010

목 적: 간질 환자의 20-30%는 난치성 간질로 알려졌는데, 기존의 항경련제나 새로운 항경련제에 반응하지 않는 난치성 간질환자에게 LEV를 부가요법으로 투여 후 효과와 부작용을 알아보고자 본 연구를 시행하였다. 방 법: 1989년 3월부터 2009년 3월까지 충남대학교병원 소아청소년과를 방문하여 난치성 간질로 진단받은 환자 중 6개월 이상 추적 관찰한 86명을 대상으로, LEV 투여 전 6개월간의 평균 경련 횟수를 기준으로 LEV외에 다른 항경련제를 추가하기 전까지의 평균 경련 감소 정도를 백분율로 분석하였다. 결 과: 86명의 환자 중 남자는 47명, 여자는 39명이었고, 발작 소실은 86명 중 44명(51.1%), 50% 이상 발작 감소는 86명 중 62명(72.1%)이었고, 19.8%는 변화가 없었으며, 5.8%는 발작이 증가했다. 나이, 동반질환, 발작형 및 치료 전 6개월간 발작 횟수는 발작 소실이나 50% 이상 발작 감소율과 관계가 없었다. 통계적으로 의미 있는 발작 소실과 50% 이상 발작 감소를 보인 경우는, 질병기간, LEV 투여 전 치료기간, LEV의 용량과 치료 전 사용한 항경련제의 숫자였으며, LEV 치료 기간과 뇌파는 발작 소실에만 의의가 있었고, 원인은 50% 이상 감소율에만 의의가 있었다. 부작용은 86명 중 40명(46%)에서 나타났고, 부작용은 기면, 과잉 행동, 과민성, 공격성, 피로 등이었으며, 대부분 일시적이거나 경미하여 치료 도중 소실되었다. 결 론: 난치성 소아 간질의 치료에 LEV의 부가 요법은 부분 발작뿐만 아니라 전신발작에도 효과와 반응이 좋고, 심각한 부작용도 없었다.

• Clinical and Experimental Pediatrics
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• 제59권sup1호
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• pp.157-160
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• 2016

Coexistence of paroxysmal kinesigenic dyskinesia (PKD) with benign infantile convulsion (BIC) and centrotemporal spikes (CTS) is very rare. A 10-year-old girl presented with a 3-year history of frequent attacks of staggering while laughing and of suddenly collapsing while walking. Interictal electroencephalogram (EEG) revealed bilateral CTS, but no changes in EEG were observed during movement. The patient's medical history showed afebrile seizures 6 months after birth, while the family history showed that the patient's mother and relatives on the mother's side had similar dyskinesia. Genetic testing demonstrated that the patient had a heterozygous mutation, c.649_650insC, in the PRRT2 gene. To our knowledge, this constitutes only the second report of a patient with PKD, BIC, CTS, and a PRRT2 mutation.

• 대한치과마취과학회지
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• 제14권2호
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• pp.95-100
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• 2014

Background: About 60% of patients with epilepsy showed a variety of complications after returning home. The purpose of this study is to get further information and to help in the anesthetic management of the disable patients with epilepsy. Methods: After searching the outpatient anesthesia list of Seoul National University Dental Hospital clinic of the disabled from September 2010 to March 2012, we found total 83 patient cases who were taking antiepileptic drugs. A nurse of anethesiology department called to the patient's home after general anesthesia and got surveys with questionnaires form filled with complications at home. We enrolled total of 51 patients who agreed to participate this survey. And we also reviewed pre-anesthesia evaluation sheet, anesthesia record, and recovery and discharge record. Results: 11 of 51 (21.6%) patients had seizure convulsion at home within 1 weeks. 33.4% of patients who had at least once seizure attack per week had a seizure attack within 3 days. And 50% of once a month frequency patients had a seizure attack within 1 week. 33% of 1 - 3 seizure attacks per year patient group had a convulsion within 1 week. But there was no seizure attack within 1 week in whom had no seizure attack history during more than 1 year. Conclusions: After dental treatment, patient taking anticonvulsant have so many complications-especially seizure, more than we respected. We need more research about handle these problems.

• 대한한방소아과학회지
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• 제21권3호
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• pp.189-203
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• 2007

Objectives The prognosis, recurrence rate and treatment of febrile seizure were studied through the research of recent western medicine and Chinese oriental medicine paper. Methods Recent western medicine paper of internal and external and chinese oriental medicine paper from 1999 to 2007 were investigated. Results and Conclusions The prognosis of febrile seizure was good in most cases, but children with febrile seizure who developed epilepsy range between 2 and 10%. The risk factors developed epilepsy including complex febrile seizure, focal and prolonged seizure, pre-existing neurodevelopmental abnormalities and recurrent febrile seizure. Recurrence rate of febrile seizure ranges between 30 and 50% was high. The risk factors can be predicted by their age at first febrile seizure happened, family medical history of febrile seizure and epilepsy, complex febrile seizure, and neurodevelopmental abnormalities. However, the most important factor of those is the age when they have first febrile seizure. Diazepam or Lorazepam was administrated for a child with prolonged seizure but only Diazepam was used for reducing recurrence of febrile seizurein febrile illness. However, there were some side effects such as lethargy, ataxia, and irritability. The study of chinese oriental medicine demonstrates that the acupuncture and venesection were used for seizure attack and reduced of recurrences and second attack. To reduce recurrence of febrile seizure, herbal medicine was also used for febrile illness or after seizure attack within a certain period of time, so reduce the recurrence, frequency of seizure and febrile illness. The most of herbs in prescription were used for removing heat and toxic meterials(淸熱解毒), extinguishing wind and to stopping the convulsion(熄風止痙)

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.329-331
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• 2020

Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80-140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.