The efforts of ILAE for providing a standardized classifi cation and terminology of epileptic seizures and epilepsy syndrome; the international classifi cation of epileptic seizures in 1981 and international classifi cation of epilepsy syndromes and epilepsies in 1989, have provided outstanding achievement in promoting epilepsy care, research, and education over the past decades. However, further attempts of ILAE to improve and update the classifi cation systems have not been successful due to signifi cant heterogeneities and still incomplete knowledge on the fundamental pathophysiology of epilepsies. Despite these shortcomings, the Commission on Classifi cation and Terminology of ILAE recently published a new proposal, “Revised Terminology and Concepts for Organization of Epileptic seizures and Epilepsies”, which has generated lively discussions and debates throughout the international epilepsy communities. The basic concepts for the change seem to be rational and well taken but the proposal was not a classifi cation, which made the epilepsy communities somewhat confused and disappointed. A new proposal of classifi cation is urgently needed to replace the overdue ILAE-classifi cation.

Any human trials should be designed and conducted within the ethical framework of the “Declaration of Helsinki” stating that any new agent must be tested against standard, proven therapies when available. In the clinical development of antiepileptic drugs, a double-blinded, placebo-controlled study is generally considered the gold standard for establishing their clinical effi cacy. However, placing patients with epilepsy on placebo is unethical because of negative impact of subsequent seizures resulting from “nontherapy”. The ethical concern is relatively small in an add-on trial but becomes problematic when a monotherapy is designed. Asia is expected to play a key role for future clinical development of new antiepileptic drugs. Timely action and collaborations of Asian epilepsy communities for advances in future clinical trials seems high in priority.

No Abstract Available.
Mammals*

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No abstract available.
Child* ; Growth Hormone* ; Humans ; Pharmacokinetics* ; Yeasts*

Partial lipoatrophy is a relatively rare disease characterized by depression in certain areas of body due to absence of subcutaneous fat tissue. In the typical case, the face is affected first, and gradually spreads to the upper half of the body. Recently, Imamura et al reported an atypical form of partial lipoatrophy characterized by involvement of abdomen and neighboring regions and centrifugal enlargement of the lesions with re4dish and scaly change in the surrounding area. They proposed. the name lipodystrophia centrifugalis a,bdominalis infantilis for this disorder. The authors reported two cases of partial lipoatrophy sirnilar to the cases of Imamura et al. Case 1 was 5 year-old female with depressed Iesions on the lower abdomen, inguinal areas, and around the external genital and perineal areas. Eliopsy specimen showed absence of subcutaneous fat tissue. Case 2 was 5 year-old. female with depressed lesions on the left lower abdomen and inguinal region Riopsy specimen showed decrease in subcutaneous fat and inflammatory infiltrates in the dermis and subcutis.
Abdomen ; Child, Preschool ; Depression ; Dermis ; Female ; Humans ; Rare Diseases ; Subcutaneous Fat

No abstract available.

Pneumocephalus is a rare complication of anesthetic procedures involving the epidural space. With the loss of resistance technique using air, air may be injected in through the dural puncture site. Epidural blood patch was performed for the treatment of post-lumbar puncture headache, and 10 minutes after the treatment, 8 ml of 0.5% bupivacaine hydrochloride was injected through epidural catheter. Loss of consciousness and apnea were developed about 8 minutes after injection of local anesthetics. Computerized tomographic brain scan revealed the presence of air within intracranial cavity. Pneumocephalus may be symptomatic or asymptomatic. It generally responds well to conservative management. The patient did not complain of a headache. The patient was discharged from the hospital on the seventh day postpartum with no neurologic sequelae.
Anesthetics, Local ; Apnea ; Blood Patch, Epidural ; Brain ; Bupivacaine ; Catheters ; Epidural Space ; Headache ; Humans ; Pneumocephalus* ; Post-Dural Puncture Headache ; Postpartum Period ; Punctures* ; Unconsciousness

No abstract available.
Congenital Hypothyroidism*