• Title/Summary/Keyword: Epilepsy

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Epilepsy Surgery in Children versus Adults

  • Lee, Ki Hyeong;Lee, Yun-Jin;Seo, Joo Hee;Baumgartner, James E.;Westerveld, Michael
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.328-335
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    • 2019
  • Epilepsy is one of the most common chronic neurological disorder affecting 6-7 per 1000 worldwide. Nearly one-third of patients with newly diagnosed epilepsy continue to have recurrent seizures despite adequate trial of more than two anti-seizure drugs : drug-resistant epilepsy (DRE). Children with DRE often experience cognitive and psychosocial co-morbidities requiring more urgent and aggressive treatment than adults. Epilepsy surgery can result in seizure-freedom in approximately two-third of children with improvement in cognitive development and quality of life. Understanding fundamental differences in etiology, co-morbidity, and neural plasticity between children and adults is critical for appropriate selection of surgical candidates, appropriate presurgical evaluation and surgical approach, and improved overall outcome.

Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes

  • Kim, Eun-Hee;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.59 no.4
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    • pp.155-164
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    • 2016
  • Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered important. In recent studies, antecedent cognitive impairment before the first recognized seizure and microstructural and functional alteration of the brain at onset of epilepsy suggest the presence of a common neurobiological mechanism between epilepsy and cognitive comorbidity. However, the overall impact of cognitive comorbidity in children with epilepsy and the independent contribution of each of these factors to cognitive impairment have not been clearly delineated. This review article focuses on the significant contributors to cognitive impairment in children with epilepsy.

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

  • Kim, Si Eun;Park, Kang Min
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.20-27
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    • 2017
  • Background: We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy. Methods: Thirty patients with epilepsy of unknown cause as well as age- and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled epilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we investigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images. Results: The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-controlled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050). Conclusions: We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.

Epilepsy in Korean patients with Angelman syndrome

  • Park, Sung-Hee;Yoon, Jung-Rim;Kim, Heung-Dong;Lee, Joon-Soo;Lee, Young-Mock;Kang, Hoon-Chul
    • Clinical and Experimental Pediatrics
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    • v.55 no.5
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    • pp.171-176
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    • 2012
  • Purpose: The aim of this study was to investigate the natural history of epilepsy and response to anti-epileptic drug treatment in patients with Angelman syndrome (AS) in Korea. Methods: We retrospectively reviewed the clinical records of 14 patients diagnosed with epilepsy out of a total of 17 patients with a genetic diagnosis of AS. These patients were seen at the Department of Pediatric Neurology at Severance Children's Hospital from March 2005 to March 2011. Results: Fourteen (9 males and 5 females) subjects (82.3%) were diagnosed with epilepsy in AS. The most common seizure types were generalized tonic-clonic (n=9, 27%) and myoclonic (n=9, 27%), followed by atonic (n=8, 24%), atypical absence (n=4, 12%) and complex partial seizure (n=3, 9%). The most commonly prescribed antiepileptic drug (AED) was valproic acid (VPA, n=12, 86%), followed by lamotrigine (LTG, n=9, 64%), and topiramate (n=8, 57%). According to questionnaires that determined whether each AED was efficacious or not, VPA had the highest response rate and LTG was associated with the highest rate of seizure exacerbation. Complete control of seizures was achieved in 6 patients. Partial control was achieved in 7 patients, while one patient was not controlled. Conclusion: Epilepsy is observed in the great majority of AS patients. It may have early onset and is often refractory to treatment. There are few reports about epilepsy in AS in Korea. This study will be helpful in understanding epilepsy in AS in Korea.

A Concept Analysis of Uncertainty in Epilepsy (뇌전증 환자의 불확실성 개념분석)

  • Lee, Juna;Lee, Insook
    • Journal of Korean Academy of Nursing
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    • v.47 no.4
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    • pp.499-513
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    • 2017
  • Purpose: This concept analysis was done to clarify 'uncertainty in epilepsy'. Methods: Walker and Avant's methodology guided the analysis. In addition, the concept was compared with uncertainty in other health problems. Results: 'Uncertainty in epilepsy' was defined as being in the condition as seen from the epilepsy experience where cues were difficult to understand because they changed, were in discord with past ones, or they had two or more contradictory values at the same time. Uncertainty in epilepsy is evolved from appraisal of the epilepsy experience. As a result, uncertainty leads epilepsy patients, their family or health care providers to impaired functioning and proactive/passive coping behavior. Conclusion: Epilepsy patients with uncertainty need to be supported by nursing strategies for proactive, rational coping behavior. This achievement has implications for interventions aimed at changing perception of epilepsy patients, their families or health care providers who must deal with uncertainty.

Factors associated with seizure and cognitive outcomes after epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumors in children

  • Ko, Ara;Lee, Joon Soo
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.171-177
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    • 2020
  • Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are responsible for drug-resistant chronic focal epilepsy, and are the second-most common reason for epilepsy surgery in children. LEATs are extremely responsive to surgical treatment, and therefore epilepsy surgery should be considered as a treatment option for LEATs. However, the optimal time for surgery remains controversial, and surgeries are often delayed. In this review, we reviewed published article on the factors associated with seizure and cognitive outcomes after epilepsy surgery for LEATs in children to help clinicians in their decision whether to pursue epilepsy surgery for LEATs. The achievement of gross total resection may be the most important prognostic factor for seizure freedom. A shorter duration of epilepsy, a younger age at surgery, and extended resection of temporal lobe tumors have also been suggested as favorable prognostic factors in terms of seizure control. Poor cognitive function in children with LEATs is associated with a longer duration of epilepsy and a younger age at seizure onset.

The Effects of a Epilepsy Education Program on Self Efficacy and Self Management in Patients with Epilepsy (간질교육 프로그램이 성인 간질환자의 자기효능과 자기관리에 미치는 효과)

  • 박영숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.405-417
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    • 1999
  • The purpose of this study was to test the effects of a epilepsy education program as a nursing intervention for patients with epilepsy. A quasi treatment research (non equivalent control group pretest-posttest design) was used in this study. The subjects were 40 epilepsy patients visiting an outpatient department of a general hospital in Daegu city.(treatment group : 20 patients, control group : 20 patients). The study was carried out from June, 1998 to September, 1998. Data was collected before the education program (pretest), immedately after(posttest 1) and 4 weeks later(posttest 2) and were analyzed with repeated measures ANOVA, t-test, Chi-sqare test and Pearson correlation coefficient. The results are as follows : There was a significant difference in epilepsy self efficacy between two groups(F=26.27, p=.000). There was a significant difference according to pretest, posttest 1 and posttest 2(F=111.20, p=.000), and interaction effect between treatment and time(F=109.42, p=.000). There was a significant difference in epilepsy self management between two groups(F=78.02, p=.000). There was a significant difference according to pretest, posttest 1 and posttest 2 test(F=94.02, p=.000), and interaction effect between treatment and time(F=88.14, p=.000). There was a significant correlation(r=.76, p=.000) between epilepsy self efficacy and epilepsy self management. These results suggest that a epilepsy education program is effective ill promoting self efficacy and self management of the patient with epilepsy. Thus this program can be recommended as an effective nursing intervention for the epilepsy patients.

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The Historical Study of Epilepsy in East Asain Medicine through Epilepsy section of 『Classified Assemblage of Medical Prescriptions(醫方類聚)』 (『의방류취(醫方類聚)·전간문(癲癎門)』을 통해 본 한의학에서 간질(癎疾)의 역사)

  • Kang, Yeon-Seok;Lee, Sang-Seop;Park, Hee-Sue;Lee, Seo-Young
    • The Journal of Korean Medical History
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    • v.24 no.1
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    • pp.111-117
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    • 2011
  • "Classified Assemblage of Medical Prescriptions(醫方類聚)" is a valuable material which can explain about historical records of East Asian medicine till 15th century. We can also konw what were regarded as important idea by contemporary doctors of Korean in 'Chosun' dynasty. And, Epilepsy is the one of the olddest diseases with a humankind history for a long time. All the concetps of disease including epilepsy in East Asia has been developed and specilized. So, we can find out some valuable facts from Epilepsy section in "Classified Assemblage of Medical Prescriptions". First, 'Epilepsy' was mixed with 'Mad', 'Spasm' before 7th century but after than, it had been divided into in detail. Since 14th century, we can find out that it was separated with 'Spasm' completely. In conclusion, 'Epilepsy' concept in "Classified Assemblage of Medical Prescriptions" at 15th century is similar with mordern 'Epilepsy' concept. Second, We can find out that 'Epilepsy disease' was divided into 'Five epilepsy' before 7th century, and divided into 'external cause', 'internal cause', 'external & internal cause' in 12th century. And, it also was divided into 'yin' or 'yang' epilepsy. So, 'Epilepsy' concept in " Classified Assemblage of Medical Prescriptions" at 15th century can be divided into 'yin' or 'yang' generally, and also it is similar with 'Acute and slow shock'. Especially, 'yinyang' of epilepsy is related to organs & bouls, depth & shallow, interior & exterior, not cold & heat definitely. From now on, the researches about how it had been understood in East Asia can help to find out modern significance of Korean medicine. and, it would be helpful for comprehensive study about "Classified Assemblage of Medical Prescriptions" from these researches in each section.

Cognitive function of idiopathic childhood epilepsy

  • You, Su-Jeong
    • Clinical and Experimental Pediatrics
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    • v.55 no.5
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    • pp.159-163
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    • 2012
  • Most children with epilepsy are of normal intelligence. However, a significant subset will have temporary or permanent cognitive impairment. Factors that affect cognitive function are myriad and include the underlying neuropathology of the epilepsy, seizures, epileptiform discharges, psychosocial problems, age at seizure onset, duration of epilepsy, and side effects associated with antiepileptic drugs. This review article discusses cognitive function in children with idiopathic epilepsy and the effects of antiepileptic drugs on cognitive function in children.

Sleep and Epilepsy in Clinical Practice "fears, rages, deliria, leaps out of bed and seizures during the night" - Hippocrates (임상실제에서의 수면과 간질)

  • Kim, Chang-Song
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.18-33
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    • 1998
  • Sleep and Epilepsy either represent the opposite and independent spectrum of episodic manifestations from brain or closely interact with each other. Sleep or sleep deprivation may provoke epileptic seizures or activate epileptiform discharges in epilepsy patients whereas epilepsy may alter the sleep structure. Sleep stages are also known to influence pathophysiology of seizures in terms of ictogenesis. In this review, the impact of sleep on epilepsy as well as that of epilepsy on sleep are presented. Additionally the interaction between sleep and epilepsy will be discussed. This review will also comment on the differential diagnosis between nocturnal or sleep-related epilepsy and various sleep disorders. Finally, clinical application of the above perspectives of sleep and epilepsy will be suggested for the purpose of a better management of epilepsies.

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