• Annals of Clinical Neurophysiology
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• v.16 no.2
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• pp.70-73
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• 2014

Nonconvulsive status epilepticus usually presents with altered mentation without distinct manifestations of seizures. It may be related with various medical disorders. Hashimoto's encephalopathy is characterized by various neurological manifestations accompanied by high titers of anti-thyroid antibodies. Here, we report a patient with nonconvulsive status epilepticus caused by Hashimoto's encephalopathy who showed a dramatic response to steroids.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.414-417
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• 2007

A 52-year-old woman with hypertension and moyamoya disease presented with chronic subdural hematoma [CSDH]. The presumed cause of bleeding was ascribed to administrated antiplatelet agents. She responded slowy and clumsily to verbal commands and had right arm weakness. After surgery, her clinical condition improved. But two days after surgery, her symptoms became aggravated and a convulsive seizure was noted within 24 hours. Brain magnetic resonance imaging showed no organic lesion except a small amount of residual CSDH. In addition, there was no laboratory evidence of metabolic brain disease. Moreover, after the administration of an antiepileptic drug [phenytoin], her manifestations disappeared. Therefore, the authors presume that her symptoms were resulted from nonconvulsive status epilepticus [NCSE], despite a lack of ictal period electroencephalographic findings. The authors were unable to find a single case report on postoperative NCSE in Korea. Therefore, the authors report this case of nonconvulsive status epilepticus after drainage of a CSDH in a patient with moyamoya disease.

• Annals of Clinical Neurophysiology
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• v.20 no.2
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• pp.97-100
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• 2018

Nonconvulsive status epilepticus (NCSE) is an unusual complication in patients treated with cefepime. An 82-year-old woman on maintenance hemodialysis was given cefepime for pneumonia. Her level of consciousness decreased since the administration of cefepime, and she was diagnosed with NCSE based on electroencephalography (EEG) findings. After discontinuation of cefepime, improvement was seen both in the level of consciousness and EEG findings. Clinicians should be aware of cefepime-induced NCSE, particularly in patients with renal failure.

• The Journal of the Society of Stroke on Korean Medicine
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• v.23 no.1
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• pp.55-64
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• 2022

Nonconvulsive Status Epilepticus(NCSE) refers to continuous epileptic condition with altered mental status and behavioral symptoms, but without convulsive movement at least 10 minutes. In Salzburg criteria, well known as the diagnostic criteria of NCSE, it is diagnosed with clinical symptoms, electroencephalogram (EEG), and effects before and after the use of antiepileptic drugs (AEDs). Commonly being used to treat NCSE, AEDs are likely to have adverse effects. In the present case, a 85-year-old female NCSE patient complaining delirium underwent combined Korean medical treatment by acupuncture and herbal medicine for 13 days. The effect of treatment was assessed with delirium scales including Delirium Rating Scale-Revised-98(DRS-R-98) and Assessment Test for Delirium & Cognitive Impairment(4AT) per 2 days. After the treatment, both DRS-R-98 and 4AT scores decreased, and orientation and mental status of patient improved. This case report suggests that Korean medical treatment might be an effective option without side for those NCSE patients complaining delirium.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.26-30
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• 2011

Although the pathophysiologic mechanism is unknown, there has been long-running debate on whether periodic discharges such as periodic lateralized epileptiform discharges (PLEDs) and generalized periodic epileptiform discharges are an ictal or interictal EEG pattern. The goal of this review is to give evidence that such periodic discharges on EEG are not ictal phenomenon and just represent underlying acute brain damage. This review includes coma with epileptiform EEG pattern and its prognostic and therapeutic implications. Based on previous reports, rather than taking the view PLEDs represent either an underlying ictal process or an electrographic correlate of neuronal injury, it would be more reasonable that PLEDs are considered as a dynamic pathophysiological state in which unstable neurobiological processes create an ictal-interictal continuum.

• Annals of Clinical Neurophysiology
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• v.9 no.2
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• pp.63-68
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• 2007

The EEG plays an important diagnostic role in epilepsy and provides supporting evidence of a seizure disorder as well as assisting with classification of seizures and epilepsy syndromes. There are a variety of electroclinical syndromes that are really defined by the EEG such as Lennox-Gastaut syndrome, benign rolandic epilepsy, childhood absence epilepsy, juvenile myoclonic epilepsy and also for localization purposes, it is vitally important especially for temporal lobe epilepsy. The sensitivity of first routine EEG in diagnosis of epilepsy has been known about 20-50%, but this proportion rises to 80-90% if sleep EEG and repetitive recording should be added. Convincing evidences suggest that the EEG may also provide useful prognostic information regarding seizure recurrence after a single unprovoked attack and following antiepileptic drug (AED) withdrawal. Moreover, patterns in the EEG make it possible to disclose an ictal feature of nonconvulsive status epilepticus, separate epileptic from other non-epileptic episodes and clarify the clues predictive of the cause of the encephalopathy (i.e., triphasic waves in metabolic encephalopathy). Therefore, regardless of its low sensitivity and other pitfalls, EEG should be considered not only in the situation of new onset episode such as a newly developed, unprovoked seizure or a condition manifesting decreased mentality from obscure origin, but also as a barometer of the long-term outcome following AED withdrawal.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.191-200
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• 2022

Intractable hiccups are those which persist for more than one month and can often occur in patients with disorders of the central nervous system, such as stroke, epilepsy, or brain tumor. An 80-year-old male patient undergoing conservative hemodialysis for diabetic nephropathy, recently developed paralysis and dysphagia due to central nervous system complications including stroke and epilepsy. He was admitted to the ◯◯ Oriental Medicine Hospital, and treated with herbal medicine (Gyulpijugyeo-tang, Jeonssiigong-san, and Ijin-tang) and electrical acupuncture for 30 days. No side effects were observed during hospitalization. The frequency and duration of hiccups were measured daily and found to reduce, and the effect persisted during his admission. The patient took no other nervous system drugs. In conclusion, Korean medicine like gyulpijugyeo-tang and acupuncture can be effective for patients with intractable hiccups who cannot use alternative drugs or treatment, because of other complications.