No abstract available.
Epilepsies, Partial* ; Paragonimiasis*

Child ; Epilepsies, Partial ; Humans

Epilepsia syndromes in children, commonly happen as simple partial seizures without impairing consciousness, and usually are overlooked. In this article, the authors described some simple partial seizures which mostly wer overlooked through different previous clinical examinations. Owing to carefully taking the history of the disease from the parents relating some highly suggestive events such as somnambulism, distraction, repetitive stomach and headache without any physical lesion, and particularly owing to the specific device almost patients have been.
Epilepsies, Partial ; Child

Epilepsies, Partial ; Humans ; Syndrome

PURPOSE AND BACKGROUND: Korean Topiramate Study Group (KTSG) was organized to evaluate the efficacy and safety of lower dose (300 mg/day) and slower dose-titration of topiramate as add-on therapy in medically intractable partial epilepsies. METHODS: This study was a multicenter open clinical trial consisting of each 8 weeks of baseline phase, titration phase, and maintence phase. The patient should have partial epilepsies refractory to the maximally tolerable doses of one to two antiepileptic drugs and should have at least two or more episodes of clinical seizures every 4 weeks during the baseline phase. The target dose of topiramate (TPM) was 300 mg/day. TPM was started at the initial dose of 25 mg/day and increased by 25 mg/day every week until 100 mg/day was reached. Thereafter, the dose was increased by 50 mg/day every week. RESULTS: A total of 213 patients entered to the titration phase, 198 patients entered to the maintenance phase, and 182 patients finished the trial as planned. Median baseline seizure frequency was 3.7 episodes/4 weeks which was decreased to 2.1 episodes/4 weeks after the introduction of TPM. Median seizure frequency reduction rate (MSFRR) was 44.8%, responder rate was 47.6% and seizure free rate (SFR) was 9%. Adverse events (AE) occurred in 22% of patients with dizziness being the most common (10.0%). Premature withdrawl from the study due to AE occurred in 13 patients (6.1%). CONCLUSION: TPM 300 mg/day was as effective as TPM 600 mg/day and safety was markedly improved by a slower dose titration. We did not find any dose-response relationship of TPM in this study.
Anticonvulsants ; Dizziness ; Epilepsies, Partial* ; Humans ; Seizures

BACKGROUND AND PURPOSE: To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients. METHODS: Twenty-four drug-nasmall yi, Ukrainianve focal epilepsy patients (15 males; overall mean age 29.8 years) were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200 stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP), cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared. RESULTS: All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni's correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres. CONCLUSIONS: These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNS-induced changes in cortical excitability.
Epilepsies, Partial ; Humans ; Isoxazoles ; Transcranial Magnetic Stimulation

BACKGROUND AND PURPOSE: To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients. METHODS: Twenty-four drug-nasmall yi, Ukrainianve focal epilepsy patients (15 males; overall mean age 29.8 years) were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200 stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP), cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared. RESULTS: All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni's correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres. CONCLUSIONS: These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNS-induced changes in cortical excitability.
Epilepsies, Partial ; Humans ; Isoxazoles ; Transcranial Magnetic Stimulation

Epilepsy surgery has become an important treatment option in patients with medically refractory epilepsy. The ability to precisely localize the epileptogenic zone is crucial for surgical success. The tools available for localization of the epileptogenic zone are limited. Seizure semiology is a simple and cost effective tool that allows localization of the symptomatogenic zone which either overlaps or is in close proximity of the epileptogenic zone. This becomes particularly important in cases of MRI negative focal epilepsy. The ability to video record seizures made it possible to discover new localizing signs and quantify the sensitivity and specificity of others. Ideally the signs used for localization should fulfill these criteria; 1) Easy to identify and have a high inter-rater reliability, 2) It has to be the first or one of the earlier components of the seizure in order to have localizing value. Later symptoms or signs are more likely to be due to ictal spread and may have only a lateralizing value. 3) The symptomatogenic zone corresponding to the recorded ictal symptom has to be clearly defined and well documented. Reproducibility of the initial ictal symptoms with cortical stimulation identifies the corresponding symptomatogenic zone. Unfortunately, however, not all ictal symptoms can be reproduced by focal cortical stimulation. Therefore, the problem the clinician faces is trying to deduce the epileptogenic zone from the seizure semiology. The semiological classification system is particularly useful in this regard. We present the known localizing and lateralizing signs based on this system.
Epilepsies, Partial ; Epilepsy ; Humans ; Seizures ; Sensitivity and Specificity

BACKGROUND AND PURPOSE: There is growing interest in high-frequency oscillations (HFO) as electrophysiological biomarkers of the epileptic brain. We evaluated the clinical utility of interictal HFO events, especially their occurrence rates, by comparing the spatial distribution with a clinically determined epileptogenic zone by using subdural macroelectrodes. METHODS: We obtained intracranial electroencephalogram data with a high temporal resolution (2000 Hz sampling rate, 0.05-500 Hz band-pass filter) from seven patients with medically refractory epilepsy. Three epochs of 5-minute, artifact-free data were selected randomly from the interictal period. HFO candidates were first detected by an automated algorithm and subsequently screened to discard false detections. Validated events were further categorized as fast ripple (FR) and ripple (R) according to their spectral profiles. The occurrence rate of HFOs was calculated for each electrode contact. An HFO events distribution map (EDM) was constructed for each patient to allow visualization of the spatial distribution of their HFO events. RESULTS: The subdural macroelectrodes were capable of detecting both R and FR events from the epileptic neocortex. The occurrence rate of HFO events, both FR and R, was significantly higher in the seizure onset zone (SOZ) than in other brain regions. Patient-specific HFO EDMs can facilitate the identification of the location of HFO-generating tissue, and comparison with findings from ictal recordings can provide additional useful information regarding the epileptogenic zone. CONCLUSIONS: The distribution of interictal HFOs was reasonably consistent with the SOZ. The detection of HFO events and construction of spatial distribution maps appears to be useful for the presurgical mapping of the epileptogenic zone.
Biomarkers ; Brain ; Electrodes ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Humans ; Neocortex ; Seizures

Postictal sequential serum prolactin concentrations were observed in 28 patients with various type of seizures who were hospitalized at Keimyung University Hospital. Of 28 epileptic patients, 18 male and 10 female, age ranged from 18 years to 79 years (mean 42 years), 15 with generalized seizures, 13 with focal seizures (5 with simple partial seizures and 8 with partial seizures with generalization). Symptomatic epilepsy and epileptic patients with factors which may affect serum prolactin concentrations were excluded in this study. Serum prolactin concentrations were measure at 15, 30 and 60 minutes after convulsion and 24 hours after convulsion for the base line serum prolactin level. Patients with generalized seizsures and significant elevation of serum prolactin concentrations at 15, 30 and 60 minutes after ictus (Table 1). Same results were obtained in patients with simple partial seizures at 30 minutes and 60 minutes after ictus, and 15 minutes and 30 minutes after ictus in patients with partial seizures with secondary generalization (Table 2 and 3). Level of serum prolactin concentrations were higher in patients with generalized seizure than the other type of seizures. Therefore, measuring serum prolactin level could help differentiate postictal state and other causes of mental change, and also differentiative various type of seizures.
Epilepsies, Partial ; Epilepsy ; Female ; Generalization (Psychology) ; Humans ; Male ; Prolactin* ; Seizures*