No abstract available.
Carotid Artery, Internal* ; Epilepsy, Generalized*

Classification of epileptic seizures and syndromes is essential in the management of epileptic patients. Both of the classifications proposed by ILAE are still popularly applied in clinical situations. We tried to verify the differences and usefulness of each classification. During the two year period, 385 consecutive patients (248 male, 137 female) of five years of age or more were classified according to the ILAE classimification of epileptic seizures (1981). These patients were independently classified by two neurologists with the ILAE classification (1989) with same clinical informations. We tentatively add three different sub-categories (focal/multifocal structural lesions with generalized epilepsy, isolated and situation-related epilepsy, and unclassified epilepsy) on the ILAE classification (1989) because of some unclassifiable epileptics. In epilepsies and epileptic syndromes, 61.8% were localization related, 21.8% were generalized, 2.9% were undetermined, 10.9% were special syndrome, 2.6% were unclassifed. After the classification of some patients into the three sub-categories, observed amount of agreement was rised as 95.9%. In the classification of epilepsy and epileptic syndromes proposed by ILAE (1989), debatable definition of categories and resulting unclassifiable epileptic seizure limit the clinical application in some patients.
Chungcheongnam-do* ; Classification* ; Epilepsy* ; Epilepsy, Generalized ; Humans ; Male

We performed callosotomy and amygdalo-hippocampectomy in medically intractable seizure patients. Symptom duration of these patients was over 2 years and seizure was not controlled with anticonvulsants in spite of high level in drug monitoring according to their seizure type. 7 patients with generalized epilepsy were treated by anterior callosotomy and 8 patients with temporal lobe epilepsy were treated by amygdalo-hippocampectomy. Anyone of these patients were not dead and discovered permanent complications. And so these methods, anterior callostomy and amygdalo-hippocampectomy seems to be relatively safety and effective methods in treatment of medically intractable seizure.
Anticonvulsants ; Drug Monitoring ; Epilepsy, Generalized ; Epilepsy, Temporal Lobe ; Humans ; Seizures*

Rolandic epilepsy(or benign epilepsy with centrotemporal spikes) and childhood absence epilepsy are idiopathic epilepsies and are the most common forms of age-related epilepsies, occurring in previously neurologically normal children. Benign epilepsy with centrotemporal spikes is the most common partial childhood epilepsy, beginning between 2 and 13 years of age and characterized by typical EEG focal discharges and a self- limited course with recovery in or before puberty. Childhood absence epilepsy is one of generalized epilepsies with bilateral synchronous and symmetrical spike-wave paroxysms of 3 Hz and it has a good prognosis under a correct antiepilepsy treatment. These two epilepsies share some common features : similar age at onset, overall good prognosis and marked hereditary predisposition. A coincidence of these two epilepsies in a patient is very rare. We experienced a case of a coincidence of rolandic and childhood absence epilepsy in a 6 year-old female. The presence of an absence focus in rolandic epilepy, however, makes the coincidence of these entirely distinct phenomena, even if very rare, not excluded. We present the case with a review of related literature.
Adolescent ; Child ; Electroencephalography ; Epilepsy ; Epilepsy, Absence* ; Epilepsy, Generalized ; Epilepsy, Rolandic ; Female ; Humans ; Prognosis ; Puberty

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

BACKGROUND: Although a history of febrile convulsion (FC) is common in epilepsy patients, the preferential associa-tion of febrile convulsion with temporal lobe epilepsy (TLE) is not clear. METHODS:We obtained the FC data from "Paik and Bongsang hospital" epilepsy clinic. We classified epilepsy syndromes into generalized epilepsy (GE), temporal lobe epilepsy (TLE), extratemporal epilepsy (ETLE), unclassified partial and undetermined epilepsy by standardized criteria. The incidence of antecedent FC was evaluated in relation to the epilepsy classifications. We calculated kappa values for inter and intra observer reliability for the classifications of epilepsy syndromes. RESULTS: The agreement of epilepsy classifications were reliable (intra-observer kappa value=0.78, inter-observer kappa value=0.77). Thirteen percent of the studied patients (72/537) had a history of FC and 38% of FC (27/72) were complex types of FC. TLE was more likely to be preceded by FC 25% (42/166) than ETLE 6% (12/189), p<0.05 or GE 13% (12/93), p<0.05 and 85% of complex FC (23/27) preceded TLE. GE however, was more likely to have non-complex FC 100% (12/12) than partial epilepsy 55% (32/58), p<0.05. CONCLUSIONS We therefore conclude and agree that FC should be preferentially associated with TLE.
Classification ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Generalized ; Epilepsy, Temporal Lobe* ; Humans ; Incidence ; Seizures, Febrile* ; Temporal Lobe*

Eyelid myoclonia with absence is a distinct syndrome of idiopathic generalized epilepsy, characterized by the triad of eyelid myoclonia associated with brief absences, generalized discharges of 3-6 Hz polyspike and slow waves, which are mainly precipitated by eye closure or photosensitivity. We experienced two women with eyelid myoclonia with absence, who typically showed fixation off sensitivity and catatmenial exacerbation. Carabamazepine monotherapy aggravated the seizure frequency and resulted in nonconvulsive status epilepticus. These cases have not previously been reported in Korea.
Epilepsy, Generalized ; Eyelids* ; Female ; Humans ; Korea ; Seizures ; Status Epilepticus*

Genetic generalized epilepsies (GGEs) are a group of epilepsy syndromes caused by genetic factors. A few of GGEs conform to the Mendelian patterns, while most of them show polygene inheritance. Researchers initially found that most of the genes associated with GGEs are related to ion channels including voltage-gated sodium channels, potassium channels, calcium channels and chloride channels, and ligand-gated gamma-aminobutyric acid receptor channels. Further researches have shown that certain non-ion channel genes are also related to GGEs, and that de novo mutations and copy number variants also play an important role in the pathogenesis of GGEs. Application of next- and third-generation sequencing promoted delineation of the molecular genetics of the GGEs, but also brought more challenges. Genetic findings have provided an important basis for the elucidation of the pathogenesis, clinical diagnosis and precise treatment of GGEs. This paper provided a review for recent progress made in molecular genetics of GGEs.
Epilepsy, Generalized ; genetics ; Genetic Research ; Humans ; Ion Channels ; genetics

PURPOSE: To evaluate the application of MRI to the ILAE classification of epilepsies and epileptic syndromes in the setting of epilepsy clinic. METHODS: We reviewed epilepsy registry forms, EEG, and MRI of 300 patients who were consecutively registered to the Yonsei Epilepsy Clinic. The algorhithm of syndromic classification consisted of 3 steps ; 1) clinical diagnosis based on the clinical informations described in the registry form, 2) clinical-EEG correlations, and 3) clinical-EEG-MRI correlations. The interictal epileptiform discharges (IEDs) in EEG were divided into focal, multilobar/multifocal, and generalized. MRI-lesions were divided into focal and non-focal (multilobar/multifocal, and diffuse) lesions. The clinical-EEG, EEG-MRI, and MRI-clinical correlations were categorized as concordant, not discordant, and discordant. RESULTS: Among 300 patients evaluated, 249 patients were found to have epilepsies and both EEG and MRI. By clinical analysis, 190 of 249 patients were diagnosed as localization-related epilepsies (LRE), 24 patients were generalized epilepsies (GE), 34 patients were undetermined epilepsies (UDE), and one patient had alcohol related epilepsy. EEG revealed IEDs in 124 patients and altered the clinical diagnosis in 79 patients. MRI lesions were found in 106 patients with focal lesions in 65 patients and non-focal lesions in 41 patients. MRI lesions were found in 47 of 125 patients with negative EEG. Concordance rates of clinical-EEG, EEG-MRI, and MRI-clinical correlations in 54 patients with lobar epilepsies, who had positive EEG and MRI, were 39%, 54%, and 52%, respectively, and discordant rates were 17%, 11% and 7%, respectively. The complete concordance of all 3 correlations was found in only 33% of them. In 20 patients diagnosed as GE by clinical-EEG correlations, MRI lesions were found in only 3 patients and none of them changed the diagnostic categories due to MRI lesions. CONCLUSION: In lobar epilepsies, the sensitivity of MRI was quite comparable with EEG and the clinical-MRI correlation was superior to the clinical-EEG correlations. MRI provided additional and complimentary informations and should be incorporated to the ILAE-classification system as the category of 'lesional epilepsy'.
Classification ; Diagnosis* ; Electroencephalography ; Epilepsies, Partial ; Epilepsy* ; Epilepsy, Generalized ; Humans ; Magnetic Resonance Imaging*

PURPOSE: Electroencephalography (EEG) findings can play a critical role in a variety of decisions, including initiation and withdrawal of antiepileptic drugs (AEDs) therapy. Interictal epileptiform discharges (IEDs) are predictor of recurrent seizures. We investigated IEDs in EEG after AED therapy and related factors in epileptic children. METHODS: The subjects were 257 children [151 males and 106 females; age, 6.79 (3.40) years; duration of therapy, 2.48 (1.85) years] diagnosed with epilepsy at the Department of Pediatrics, Pusan National University Hospital between January 2001 and December 2007, who received AEDs for more than 6 months. EEG was performed at the intervals of 6-12 months. We divided patients into 4 groups according to IED detection before and after AEDs treatment. Related clinical factors, including gender, age at the start of treatment, seizure type, cause of seizure, AED frequency, seizure control, duration of AED therapy, and background activity were investigated in the 4 groups. RESULTS: Generalized epilepsy was relatively frequen in patients who did not show IEDs in last follow-up EEG. There were no clinically significant differences according to gender, age at the start of treatment, cause of seizure, AED frequency, seizure control, duration of AED medication, and background activity in the 4 groups (P>0.05). CONCLUSION: IEDs changed after AED treatment in one-third of the patients. Generalized epilepsy is positive factor for negative IEDs in last follow-up EEG.
Anticonvulsants ; Child ; Electroencephalography ; Epilepsy ; Epilepsy, Generalized ; Follow-Up Studies ; Humans ; Male ; Pediatrics ; Seizures