• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.1
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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.

• Journal of Korean Neurosurgical Society
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• v.29 no.12
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• pp.1650-1656
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• 2000

Objective : Little consensus exists concerning which temporal lobe structures need to be resected or how much resection should be done during hippocampal resection. The purpose of this study is to identify whether the extent of hippocampal resection influences seizure after anterior temporal lobectomy. Materials and Methods : The extent of hippocampal resection was assessed in 96 patients who underwent temporal lobectomy for medically intractable complex partial seizures originating from a unilateral seizure focus in the anteromesial temporal lobe. Patients who had structural lesion were excluded from the study. Postoperative magnetic resonance imaging in the coronal and saggital planes were used to quantify the extent of the hippocampal and lateral cortical resection. The patients were divided into two groups. Patients who underwent hippocampal resection to the level of the cerebral peduncle were included in the partial resection group, and those who had resection to the level of the colliculus were assigned to total resection group. Seizure outcomes were defined according to the Engel classification and compared between the two groups. Neuropsychologic outcomes in the selected cases were reviewed. Results : The over-all seizure-free outcome(Engel classification 1) was accomplished in 75%(72/96) of the patients (mean duration of follow-up, 36.8 months). The total hippocampectomy group had a statistically superior seizure outcome than the partial hippocampectomy group(87.3% versus 58.5% seizure-free, p-value=0.001). Also, younger patients had a more favorable outcome. Other variables such as laterality, the extent of lateral cortical resection, age at onset and gender were not significant. The pre- and postoperative memory functions were evaluated in 24 patients. A worse postoperative memory outcome was associated with partial hippocampectomy. However this was not acceptable due to a former bias. Conclusion : The result of this study conforms that aggressive hippocampectomy resulted in a better seizure outcome.

• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.107-114
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• 1995

This study was to investigate the anatomical evidence of anxiety. MRI was used to study 11 patients with panic disorder and 15 patients with complex partial seizure, and 21 controls. The regions of interest in the MRI were measured with computer-assisted planimetry using the AutoCad and digitizer. The following results were obtained ; 1) The mean age was 49.7(12.4) years in patients with panic disorder and 30.1(7.5) years in patients with complex partial seizure. 2) There were na signi ficant differences between 3 groups in the values of cerebral area, temporal lobe, caudate nucleus, hippocampus, parahippocampus, amygdala, third ventricle and VBR. The right parahippocampal region which attracted most attention in neurobiological studies regarding anxiety, tended to be larger in both study groups compared to the control group, but with no statistical significance. 3) There was lett-right reversal of temporal lobes in both study groups. And these are mainly due to asymmetrical increase in area of the temporal lobe on right side. These results suggest that temporal lobe, especially right temporal, is the anatomical correspondence of anxiety and functional activation of temporo-limbic system may be accompanied by the structural change of temporal lobe.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.16-20
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• 2002

Background and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated the factors affecting development of epilepsy following spontaneous lobar ICH. Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospital with spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died within few days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epileptic seizure and died five and eight months later each. Medical history was obtained through medical record and by telephone interview. Statistical analyses were performed using Chi-square test, Student's t - test, Fisher's exact test. Results : Seizure occurred in 19 patients. As three patients had previous history of seizures, 16 patients(22.2%) showed first onset early- and late-seizures. Early seizure occurred in 14 patients(19.4%). Three out of 14 were heavy alcoholics. Five patients developed late recurrent seizure 61 days to 800 days after the early seizure. Late seizure with no acute seizure occurred in two patients. The types of seizure were diverse as generalized tonic clonic seizure(10), partial seizure with secondary generalization(5), and complex partial seizure(1). The common risk factors for lobar ICH were hypertension(HT), arteriovenous malformation(AVM), and excessive use of alcohol. We could not find any causes in 23 patients. Although size of hematoma, age of onset, sex, incidence of HT or AVM were not different between patients with seizure and without seizure, the history of excessive alcohol drinking was more frequent in patients with seizure. Five patients with late recurrent seizure had ICH involving temporal area. Conclusions : This study suggests that the risk of seizure in patients with lobar ICH was increase in chronic alcoholics and patient with late recurrent seizure had ICH frequently involving temporal area.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.1007-1013
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• 2006

Seizure can be categorized in various ways. Seizures are divided into those that are generalized and those affecting only part of the brain (focal seizure). Focal (partial) seizures are subdivided into simple seizures and complex seizures. Simple focal seizures may be manifested by focal motor, sensory or autonomic symptoms and consciousness is preserved. The above symptoms may be preceded, accompanied or followed by, and consciousness is impaired in, complex focal seizures. Ictal aphasia can arise from epileptiform discharge on cortical language areas. Generally next to the ictal aphasia, generalized seizures occur, but without losing consciousness, only aphasia takes place. A 61-year-old woman was admitted due to ictal aphasia and facial spasm, and she showed a little palpitation and was startled easily. We diagnosed her as Shimdamgiheo (心膽氣虛) and Damhwashimyo (痰火心擾), so we prescribed Chungsimondam-tang. It was effective on that case. so we report.

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

• The Journal of Korean Medicine
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• v.36 no.2
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• pp.50-55
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• 2015

Infants with tuberous sclerosis complex (TSC) have a higher chance of experiencing seizures before the age of 1 year; in particular, they commonly accompany infantile spasms. In cases where infantile spasms resulting from TSC are drug-resistant, more severe neuro-developmental and cognitive impairments occur. This particular case dealt with an infant with TSC who continued to experience partial seizures and infantile spasms despite using two different kinds of antiepileptic drugs (AEDs). His spasms ceased on the seventh day of taking modified Yukmijihwang-tang (YMJ), at which point he stopped the use of all AEDs. He became seizure-free after a month of the treatment and modified hypsarrythmia was found to have been resolved in the electroencephalogram test. Until now, the infant has been taking YMJ for 16 months and is maintaining the seizure-free state without side effects. Moreover, his developmental status is continually improving, with a significant progress in language and cognitive-adaptive abilities. Such results suggest that YMJ can serve as an alternative treatment option for refractory epilepsy.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.565-570
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• 2010

Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining 119 patients was analyzed. Results : We enrolled 119 pediatric epilepsy patients (aged 2.8-19.3 years; 66 males and 53 females) in this study. Out of 119 patients, 29 (25.2%) had generalized epilepsy and 90 (74.8%) had partial epilepsy. The responses of seizure reduction were as follows: Seizure freedom (no seizure attack for at least 6 months) in 87/111 (78.4%, n=111) patients; partial response (reduced seizure frequency compared to baseline) in 13 (11.7%) patients; and persistent seizure in 11 (9.9%) patients. The seizure freedom rate was in 81.6% in patients with partial seizure (75.9% for complex partial seizure and 90.9% for benign rolandic epilepsy) and 44.8% in patients with generalized epilepsy (30.0% for absence seizure, 35.7% for juvenile myoclonic epilepsy patients, and 100.0% for idiopathic generalized epilepsy patients). Adverse reactions were reported in 17 (14.3%) patients, and 8 patients (6.7%) discontinued LTG because of rash and tic. No patient experienced severe adverse reaction such as Stevens-Johnson syndrome. Conclusion : LTG showed excellent therapeutic response and had few significant adverse effects. Our findings report may contribute in promoting the use of LTG monotherapy in epileptic children.

• 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.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.757-760
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• 2007

Purpose : Febrile convulsions (FC) were considered to be a benign seizure syndrome that is distinct from epilepsy. But it is thought that children with complex features i.e., partial or prolonged seizures or multiple episodes of FC would bear a higher risk of developing unprovoked seizures. The aim of this study is to look into the relative significance of each criteria that define complex febrile convulsions (CFC) as a predictor of subsequent epilepsy. Methods : All children were retrospectively identified for a febrile seizure through pediatric departments of the Konyang University Hospital. Information was collected from medical records and interviews with parents. Patients with abnormal neurological examinations at presentation were excluded. Results : This study was performed from March 2000 to December 2003. Sixty-three out of 314 children (20.0%) with febrile convulsion fulfilled the criteria for CFC and forty-four children of them have been followed for 12 months or more. Ten of these (23.2%) had unprovoked seizures for 14-62 months (median $34.2{\pm}11.6$ months). The patients with partial FC showed a trend toward a higher risk (57.1%) of developing epilepsy than the patients with multiple or prolonged febrile convulsions (26.7%, 24.1% respectively). Conclusion : We found that the partial feature of febrile convulsion is associated with subsequent epilepsy.