It has been known that sleep and epilepsy have strong mutual influence and many reports have emphasized the imortance of the EEG recording during sleep in epileptic patients. We analyzed waking and sleep EEGs of 153 consecutive cases of epileptic patients. Waking and sleep recordings were perforrned in succession during 26 minutes. Sleep induction method was 24 to 26 hour sleep deprivation. Most of the sleep recordings consisted of stage 1 and stage 2 sleep. 134 patients had localization-related epilepsy including 23 cases of benign rolandic epilepsy and benign epilepsy with occipital paroxysms, and 19 patients had generalized epilepsy. Ninty-two cases showed definite epileptiform discharges and 37 patients including 30 cases of complex partial seizure disorder had all their epileptiform discharges detected only during sleep state. The epileptiforrn discharges of 43 patients were detected on both waking and sleep recordings and underwent modifications of focalization, synchronization, generalization and the appearance of independent spikes during sleep state.
Electroencephalography* ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Complex Partial ; Epilepsy, Generalized ; Epilepsy, Rolandic ; Generalization (Psychology) ; Humans ; Sleep Deprivation

n the patients with epilepsy, especially in psychomotor epilepsy the epileptiform discharges occasionally has its origin from the basal structure of brain or the mesial side of temporal lobe which is not accessible to the standard surface EEG. The nasopharyngeal electrode, which was introduced by Grinker and Serota in 1938 and modified several times, is a kind of special electrodes to investigate electrical activity from the mesiobasal part of the temporal lobe, and there are several studies about clincial usefulness of the nesopharyngeal EEGs with some controversies in other countries. In this country, however, there is no reports about this topic, and in fact only a few laboratories are known to use the nasopharyngeal electrode. To determine clinical significance of nasapharyngeal EEG in patients with psychomotor seizure, the selecting records of 123 cases who had been taken both standard surface and nasopharyngeal EEG are analysed and compared with each other. Eight nine of cases are the patients with seizure disorder including 13 simple partial seizure with or without secondary generalization, 47 psychomotor seizure (or complex partial seizure) with or without secondary generalization and 29 primary generalized seizure, diagnosed by history and clincial findings. The other 34 cases are the patients with similar symptoms of psychomotor seizure but without definite convulsion. The standard surface EEG revealed 48 (56%) of epileptiform activity, 24(28%) of nonspecific dysrrhytmia and 17(19%) of normal record in 89 patients with seizure discharges. There are 38 patients who showed spike or sharp wave on nasopharyngeal generalized seizures. In nonseizure cases, however, epileptiform activity is not detected on nasopharyngeal electrodes. Five cases are technically unsatisfactory. The significances of nasopharyngeal EEG in 38 with epiletiform discharges on nasopharyngeal electrode(s) are; more definite and prominent epileptiform activity in 17 and unexpected nasopharyngeal discharges in 10 patients including 5 with normal standard surface EEGs. In 47 psychomotor seizure, 42 cases (89%) reveal epileptiform discharges on standard surface and/or nasopharyngeal EEG and the sensitivity of nasopharyngeal EEG (75%) is higher than that of standard surface.
Brain ; Electrodes ; Electroencephalography* ; Epilepsy ; Epilepsy, Complex Partial ; Generalization (Psychology) ; Humans ; Seizures* ; Temporal Lobe

BACKGROUND: Auditory auras are rare but may have localizing value in patients presenting with epilepsy. We conducted the study to correlate the clinical characteristics, EEG and MRI findings in patients with auditory auras. METHODS: We identified 44 epileptic patients (23 male, 21 female) with auditory auras from Yonsei epilepsy registry between 1989 and 2000. All had routine EEG and MRI. These patients were subjected for the classification of lobar epilepsies based on the clinical-EEG-MRI correlations, which aimed at demonstrating 1) the association of auditory auras with temporal lobe epilepsy and 2) the localizing value of auditory auras to the neocortical temporal lobe epilepsy. RESULTS: Auditory auras were elementary in twenty-three, complex in eighteen, and both in three. Twenty patients described auditory aura only, and 24 patients described other associated auras including cephalic sensation, emotional, experiential, autonomic, epigastric, visual, vestibular, and somatosensory phenomena. The classification based on the Clinic-EEG-MRI correlations revealed that 33 of 44 patients (75%) were classified as temporal lobe epilepsy, however, it did not suggest any strong correlations with neocortical temporal lobe epilepsy. CONCLUSION: Auditory aura was strongly related with the temporal lobe epilepsy but it did not provide any further localizing value of seizure origin in patients with TLE.
Classification ; Electroencephalography* ; Epilepsy* ; Epilepsy, Complex Partial* ; Epilepsy, Temporal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Seizures ; Sensation ; Vestibular Nuclei

This study was to investigate the clinical difference between the normal and abnormal EEG group of psychomotor epileptic patients. Selected for this study were 75 subjects who was diagnosed as the psychomotor epilepsy at the Seoul National Mental Hospital during the period from March, 1980 to June 1983 . 1. In the distribution of age group, 61.33% of total patients belonged under the ages between 20 and 29. 2. As to the precipitating factors, the unknown or none occupied 32.0% of total paeitnts. In normal EEG groups the unknown or none was the most frequent one and in abnormal EEG groups sleep and psychogenic factors were the most frequent one. 3. As to the frequency of psychomotor attack, the patient who had the frequency of ""less than one two weeks but more than one a month"" occupied 34.67% of the total. The abnormal EEG groups tended to have the attacks more frequent than the normal EEG groups. 4. As to the age of onset, 50.67% of total patients had their first attack at the ages between 10 and 19. The abnormal EEG groups had the attacks at the earlier than the normal EEG groups. 5. As to the personality trait, the aggressive personality trait was rated 29.33%, the next came the dependent personality trait. 6. As to the psychiatric symptoms and manifestations which were associated with the convulsion, the compound type was rated 38.67% of the total patients. 7. In the proportion of wave patterns of abnormality, paroxysmal slow wave was 40.74% of the abnormality and isolated spike or sharp wave was 22.22% spikes and slow wave was 14.81%. 8. The abnormality which was facalized or localized on the temporal leads was 64.86% of the abnormal EEGs. The aggressive personality trait was 37.5% of them.
Age of Onset ; Electroencephalography* ; Epilepsy, Complex Partial* ; Hospitals, Psychiatric ; Humans ; Precipitating Factors ; Seizures ; Seoul

This study was to investigate the clinical difference between the normal and abnormal EEG group of psychomotor epileptic patients. Selected for this study were 75 subjects who was diagnosed as the psychomotor epilepsy at the Seoul National Mental Hospital during the period from March, 1980 to June 1983 . 1. In the distribution of age group, 61.33% of total patients belonged under the ages between 20 and 29. 2. As to the precipitating factors, the unknown or none occupied 32.0% of total paeitnts. In normal EEG groups the unknown or none was the most frequent one and in abnormal EEG groups sleep and psychogenic factors were the most frequent one. 3. As to the frequency of psychomotor attack, the patient who had the frequency of ""less than one two weeks but more than one a month"" occupied 34.67% of the total. The abnormal EEG groups tended to have the attacks more frequent than the normal EEG groups. 4. As to the age of onset, 50.67% of total patients had their first attack at the ages between 10 and 19. The abnormal EEG groups had the attacks at the earlier than the normal EEG groups. 5. As to the personality trait, the aggressive personality trait was rated 29.33%, the next came the dependent personality trait. 6. As to the psychiatric symptoms and manifestations which were associated with the convulsion, the compound type was rated 38.67% of the total patients. 7. In the proportion of wave patterns of abnormality, paroxysmal slow wave was 40.74% of the abnormality and isolated spike or sharp wave was 22.22% spikes and slow wave was 14.81%. 8. The abnormality which was facalized or localized on the temporal leads was 64.86% of the abnormal EEGs. The aggressive personality trait was 37.5% of them.
Age of Onset ; Electroencephalography* ; Epilepsy, Complex Partial* ; Hospitals, Psychiatric ; Humans ; Precipitating Factors ; Seizures ; Seoul

PURPOSE: Hippocampal sclerosis is known to strongly correlate with medical intractability of temporal lobe epilepsy. However, the informations about this have been biased due to improper selection of the sampling obtained from severe cases of tertiary epilepsy center and surgical epilepsy field. We tried to investigate the influence of hippocampal sclerosis on the pharmacoresistance in temporal lobe epilepsy by group comparison study. METHODS: The fifty patients with complex partial seizures of temporal lobe origin, and temporal spike on EEG and/or hippocampal sclerosis on brain MRI were selected. Follow-up period of them were more than 2 years. The patients who had a seizure or seizures during the last 1-year period and had already been in adequate doses of two or more antiepileptic drugs were considered to be poorly controlled epileptics. RESULTS: Five of 17 patients without hippocampal sclerosis (29. 4%) and 24 of 33 patients with hippocampal sclerosis (72.7%) were poorly controlled by medication and the difference was significant (p=0.003, chi-square). Other factors, including sex, age of onset, febrile convulsion, secondary generalization, familial history of epilepsy, duration of disease, and delay of initial therapy had no significant effects on medical response (p>0.05). The only independent predictor of intractable epilepsy after multiple logistic regression analysis was also hippocampal sclerosis (p=0.005). CONCLUSION: Medical response in temporal lobe epilepsy was significantly associated with hippocampal sclerosis. Hippocampal sclerosis on brain MRI itself may be a crucial factor determining pharmacoresistance of temporal lobe epilepsy.
Age of Onset ; Anticonvulsants ; Bias (Epidemiology) ; Brain ; Drug Resistance ; Electroencephalography ; Epilepsy ; Epilepsy, Complex Partial ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Generalization (Psychology) ; Hippocampus ; Humans ; Logistic Models ; Magnetic Resonance Imaging* ; Sclerosis* ; Seizures ; Seizures, Febrile ; Temporal Lobe*

Anticonvulsants ; administration & dosage ; therapeutic use ; Brain ; diagnostic imaging ; physiopathology ; Child ; Child, Preschool ; Chromosome Deletion ; Chromosome Disorders ; diagnosis ; genetics ; Chromosomes, Human, Pair 20 ; genetics ; Electroencephalography ; Epilepsy ; diagnosis ; drug therapy ; genetics ; Epilepsy, Complex Partial ; diagnosis ; drug therapy ; genetics ; Humans ; Karyotyping ; Radiography ; Ring Chromosomes