• Annals of Clinical Neurophysiology
• /
• v.4 no.2
• /
• pp.137-139
• /
• 2002

Background : Subtle status epilepticus (SE) is an end-stage of convulsive SE. This phenomenon might be a clinical expression of neuronal exhaustion caused by sustained electrical discharges. As subtle SE may show diverse clinical features, early detection depends on clinical suspicion. Case : A 68-year-old woman was presented with repetitive involuntary movement of right limbs after two generalized tonic-clonic seizures. She experienced right middle cerebral artery infarction 4 months ago, and after the event, left side hemiplegia sustained. These seizures were first-ever after the cerebral infarction. Orientation and verbal responses were fairly preserved but general cognitive function was minimally slowed. During the video-EEG monitoring, repetitive sharp waves were noted in the right hemisphere and these sharp waves occasionally spread to the contralateral side. Her right side involuntary movement was identifiable when the epileptic discharges were found on her right hemisphere. Conclusion : We suggested that this unexpected convulsive movement is a reflection of earlier exhaustion in the right hemisphere or deefferentation of right hemisphere because of preexisting neuronal damage.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.7
• /
• pp.861-867
• /
• 2000

Purpose : Neuronal migration disorder(NMD) is a major underlying pathology of patients with intractable epilepsy. The role of NMD on seizure susceptibility or epileptogenecity, however, has not been documented. Methods : External irradiation of total amount of 250 cGY was performed to the fetal rats on days 16(E16) and 17(E17) of gestation. After delivery, the rats of 230-260g were decapitated for the histopathologic study. Epileptog-enecity of the NMD was studied by observing electroclinical events after intraperitoneal kainic acid(KA) injection in the control rats and NMD rats. Results : Histopathologic findings revealed focal and/or diffuse cortical dysplasia consisting of dyslamination of the cerebral cortex and appearance of the cytomegalic neurons, neuronal heterotopia in the periventricular white matter, dispersion of the pyramidal layer and the dentate gyrus of the hippocampus, and agenesis of the corpus callosum. Abnormal expression of neurofilaments protein(NF-M/H) was characteristically observed in the dysplastic neurons of the neocortex and hippocampus. Early ictal onset and prolonged ictal activity on EEG and clinical seizures were observed from the NMD rats unlike with the control rats. Conclusions : Exteranl irradiation on the fetal rats produced NMD. And the rats with NMD were highly susceptible to kainic acid provoked seizures. This animal model would be useful to study the pathophysiology of clinically relevant NMDs.

• Archives of Plastic Surgery
• /
• v.32 no.2
• /
• pp.250-254
• /
• 2005

Burns due to epileptic seizures are commonly deep and usually require operative treatment. The purpose of this study is to identify the characteristics of burned epileptic patients that could lead to the development of preventive programs to reduce the incidence of burn injuries. We analyzed epidemiological data for 34 patients acutely burned due to epileptic seizure admitted retrospectively. There were 15 male and 19 female subjects. The age distribution was from 6 years to 70 years with the mean age of 42.7 years. Seizures usually occurred while carrying out daily domestic chores. Scalding burns were the most common(38.2%) and most burns were above deep second degree(94.1%). The most common seizure type was generalized tonic-clonic, followed by absence and complex partial. The seizure mostly occurred in the morning because the therapeutic blood level of antiepileptic drugs was decreased extremely at that time by stopping drug arbitrarily or taking inadequately. So more frequent follow-ups at the neurology outpatient clinics for epileptics should be strictly reinforced to maintain the adequate therapeutic blood levels of antiepileptic drugs and fire protective implements should be prepared in the house.

• Korean Journal of Veterinary Research
• /
• v.49 no.4
• /
• pp.365-368
• /
• 2009

A six-year-old female cocker spaniel presented with recurring episodes of pelvic limb weakness and intermittent seizures. Laboratory analysis revealed marked hypoglycemia and an elevated serum insulin concentration. A pancreatic beta-cell tumor at stage III ($T_1N_1M_1$) was diagnosed based on serial blood glucose and insulin measurements along with diagnostic imaging. The patient survived for 140 days after diagnosis with medical management, including frequent feeding and prednisolone therapy. On necropsy, necrosis and masses in the peripancreatic omentum and liver were found; pancreatic beta-cell neoplasia with metastasis to the liver was confirmed by histopathologic examination. This case reports hyper-insulinism in a dog presenting with hypoglycemic seizures.

• Clinical and Experimental Pediatrics
• /
• v.46 no.11
• /
• pp.1131-1134
• /
• 2003

The ketogenic diet is a high-fat, low-protein, low-carbohydrate diet developed in the 1920s for the treatment of difficult-to-control seizures. Despite advances in both the pharmacotherapy and the surgery of epilepsy, many children continue to have difficult-to-control seizures. In this situation, a ketogenic diet should be considered as an alternative therapy. However, less attention has been paid to associated adverse events in the ketogenic diet. We report a case of infantile spasm associated with acute renal failure, lipoid pneumonitis and kwashiorkor after ketogenic diet. A better understanding of this adverse event profile will allow the pediatric neurologist to have a true informed consent discussion with the care giver when considering initiation of the ketogenic diet.

• Toxicological Research
• /
• v.13 no.3
• /
• pp.215-222
• /
• 1997

The features of seizure-related brain injuries in rats poisoned i.p. with diisopropylfiuorophosphate were investigated. Pyridostigmine bromide (0.1 mg/kg) and atropine methylnitrate (20 mg/kg), which are centrally inactive, were pretreated i.m. 30 min and 10 min, respectively. before diisopropylfluorophosphate (10 mg /kg, $2LD_50$) poisoning to reduce the mortality and eliminate peripheral signs. Diisopropylfluorophosphate induced severe limbic seizures, and early necrotic and delayed apoptotic brain injuries. The necrotic brain injury, which was closely related to seizure intensity, was exerted as early as 1 hr predominently in hippocampus and piriform cortex. showing spongiform change (malacia) of neurophils in severe cases, in contrast to a typical apoptotic (TUNEL-positive)pattern after 12 hr in thalamus, and a mixed type in amygdala. Nitric oxide content in cerebrospinal fiuid significantly increased after 2 hr, reaching a maximal level at 6 hr. Pretreatment with $_L-N^G$-nitroarginine, an inhibitor of nitric oxide synthase, reduced nitric oxide content and attenuated only apoptotic brain injury in all four brain regions examined without affecting seizure intensity and necrotic injury. Taken together, early necrotic and delayed apoptotic brain injuries induced by diisopropylfiuorophosphate poisoning in rats may be related to seizure intensity and nitric oxide production, respectively.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.10 no.3
• /
• pp.335-344
• /
• 2003

Purpose: The purpose of this study was to develop an educational program for parents of children with epilepsy. Method: The first step was to survey the need for information and social support for these parents. The second step was to design the educational program based on the survey results, literature review, and the theory of chronic sorrow that provided a framework for understanding and working with people suffering a loss of health. Result: The information which these parents were most anxiously seeking was information on the causes of seizures, appropriate steps deal with seizures, and appropriate and supportive parental re]e for their children. The educational program for parents of children with epilepsy included understanding the responses to loss, increasing the parents' knowledge about how to care for their children, managing their stress, enhancing the psychosocial adaptation of children, and encouraging the participation of the family. Conclusion: The educational program developed by the researcher can used with parents of children with epilepsy, and is expected to enhance the psychosocial adaptation of these children.

• Clinical and Experimental Pediatrics
• /
• v.59 no.sup1
• /
• pp.129-132
• /
• 2016

Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days. During video-monitored EEG and echocardiography (ECG), she showed multiple myoclonic seizures simultaneously or independently, as well as frequent sinus pauses. After treatment with valproic acid, myoclonus and generalized tonic seizures were well controlled and only 2 sinus pauses were seen on 24-hour Holter ECG monitoring. Sinus dysfunction should be recognized on EEG, and it can sometimes be treated successfully with only antiepileptic medication.

• Clinical and Experimental Pediatrics
• /
• v.45 no.12
• /
• pp.1601-1605
• /
• 2002

Henoch-Sh${\ddot{o}}$nlein Purpura(HSP) is an immuologically mediated systemic vasculitis of small blood vessels affecting predominantly the skin, gastrointestinal tract, joints, and kidneys. Clinical neurological manifestations such as headaches, behavioral changes, mental changes, seizures, and visual loss are described, but neurological complication are rare during the course of HSP. We experienced a case of an 8 year-old male with HSP who presented with seizures. Magnetic resonance imaging(MRI) showed multiple high signal intensity in both cortical and subcortical areas of frontal and parieto-occipital lobes and magnetic resonance(MR) angiogram showed stenosis of cerebral arteries, compatible with MRI and MR angiogram findings of cerebral vasculitis. We report this case with related literature.

• Clinical and Experimental Pediatrics
• /
• v.57 no.9
• /
• pp.384-395
• /
• 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.