OBJECTIVE & BACKGROUND: There have been reports on the lateralizing value of temporal lobe interictal epileptiform discharge(IED), yet it is a matter of debate till now. We studied our patients focusing on the degree of lateralization by which accurate lateralization was possible and also on the significance of bisynchronous IED(BIED) in the lateralization of temporal lobe epilepsy. METHOD: Fifty two patients were included in the study who were diagnosed as having medial temporal lobe epilepsy through video-EEG monitoring and brain MRI. Twenty four hour sleep-deprived interictal scalp EEG was checked for all of them. After that, we counted the number of independent IED(IIED) and BIED originating from anterior temporal areas. Then we tried to find a reasonable degree of IED above which correct lateralization of epileptogenic area was possible by using brain MRI as a standard. We also tried to find a significance of BIED in the lateralization of temporal lobe epilepsy by comparing the result excluding patients with BIED to that includig patients with BIED. RESULT: Lateralization of IED was over 80% accurate if the cutoff point was set at 70% and patients with BIED were included, but nearly 100% accurate of the cutoff point was set at 80% and patients with BIED were excluded. CONCLUSION: Influence of BIED on the accuracy of lateralization by IED is significant, and if the lateralization of IED is over 80% in patients with no BIED, the chance of true lateralization is very high.
Brain ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Magnetic Resonance Imaging ; Scalp ; Temporal Lobe*

Purpose: Coronavirus disease 2019 (COVID-19) can be associated with neurological complications. This study investigated the impact of COVID-19 outbreaks on seizure incidence and duration in children in Korea. Methods: We retrospectively analyzed medical records from Kyungpook National University Children’s Hospital, including 768 children with seizures during the peak COVID-19 outbreaks in March and August 2022, and compared patterns with the same periods in 2021. We examined demographic and clinical characteristics, causes of seizures, underlying conditions, seizure durations, and COVID-19 test results. Results: Out of 16,373,836 COVID-19 cases during the first peak, 25.6% were children (4,184,383), and during the second peak, 20.5% of 6,400,244 cases were children (1,314,331). No significant age differences were observed between either peak and the previous year. However, when compared to the previous year, febrile seizures (FS) were more common during both peaks (25.9% vs. 65.1% in the first peak; 34.3% vs. 59.2% in the second peak). The prevalence of FS was significantly higher in the COVID-19-positive group (84.1%) than in the COVID-19-negative group (51.9%). The incidence of new-onset seizures or breakthrough seizures showed no significant difference. Seizure duration and the incidence of status epilepticus (SE) showed no significant changes, but SE was more common in the COVID-19-negative group (17.1% vs. 6.2%). The clinical features of FS were similar in both groups. Conclusion COVID-19 appeared to increase the risk of FS in children, but there was no significant impact on the risk of breakthrough seizures or SE in children with epilepsy. Nevertheless, larger-scale studies are necessary.

BACKGROUND: Semiology of epileptic seizure is very important for diagnosis and treatment. However, little is known about the reliability of the observers' description. This study aims to determine the description reliability of seizures in the aspects of classification and lateralization. METHODS: We recorded 72 patients with habitual seizures during video-EEG monitorings. We, then, compared the ictal behaviors described by frequency observers and those recorded on the videotape to compare the accuracy of the observers' descriptions. Finally, we reviewed which aspects of the informants affected the reliability of the data. RESULTS: The classification of seizures based only on the observer-description was somewhat discordant from the videotape (correct classification: 82%) especially in dividing simple partial from complex partial seizures. Description of many ictal behaviors in presumed complex partial seizure such as oroalimentary automatism, motionless staring, tonic/clonic posture and version was accurate except for the hand automatism. A specified direction by the observer has a very high true positive rate. The accuracy of the description was related to the educational status of the observer. CONCLUSIONS: Semiology description by well-educated observers is may be reliable, but every physician should keep its limitation in mind and judge accordingly.
Automatism ; Classification ; Diagnosis ; Educational Status ; Epilepsy ; Hand ; Humans ; Medical History Taking ; Posture ; Reproducibility of Results ; Seizures ; Videotape Recording

Distinct from migraine with aura or hemiplegic migraine, a rare clinical entity of migraine-like headache, transient focal neurologic deficit and CSF pleocytosis (HaNDL) has been known. Although the etiology or pathogenesis is unknown, possibility of viral infection or inflammation has been suggested. We report a 25-year-old man diagnosed as HaNDL with literature review. (J Korean Neurol Assoc 19(3):302~304, 2001)
Adult ; Aphasia ; Headache* ; Humans ; Inflammation ; Leukocytosis* ; Migraine Disorders ; Migraine with Aura ; Neurologic Manifestations*

RATIONAELE: Secondary bilateral synchrony(SBS) is not an unusual finding to the EEGers, but its Significance is not well-delineated. We reviewed the clinical EEG, and neuroimaging characteristicts in patients with SBS. METHOD: Patients who were admitted for presurgical evaluation of intractable epilepsy were classified on the basis of video-EEG monitoring, prolonged interictal EEG, MRI, ictal SPECT, PET, and, in a few cases, the surgical results. We analyzed clinical, electrophysiological, and neuroimaging characteristics of patients with SBS by comparing them, with those without SBS. RESULTS: Among 319 patients who were admitted for presurgical epilepsy evaluation, 26 patients had SBS(8.2%). Medial temporal lobe epilepsy was predominant as a whole(140/319, 43.9%), but frontal lobe epilepsy(FLE) was main syndrome in the SBS group(16/26, 61.5%). Multifocal irritative zones were present in 12.5% of FLE with SBS group(2/16) and in 4.8% of FLE without SBS group(2/42). In FLE with SBS group, the location of ictal onset zone was parasaggital in 32%(5/16) and multifocal in 37%(6/16). There was a tendency to develop secondary generalized tonic clonic seizure in FLE with SBS group than in FLE without SBS group. Neuroimaging modalities revealed frontal abnormalities more accurately in FLE with SBS group than in FLE without SBS group. CONCLUSION: Frontal lobe as an epileptogenic zone is an important factor in generating SBS and SBS seems to facilitate seizure spreading to the contralateral hemisphere.
Electroencephalography* ; Epilepsy ; Epilepsy, Temporal Lobe ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Neuroimaging* ; Seizures ; Tomography, Emission-Computed, Single-Photon

Human papilloma virus (HPV) is known to be a major cause of cervical cancer. In Korea, although the mortality of cervical cancer has decreased, HPV infection rates are increasing rapidly in young women. One of the reasons for a high rate of human immunodeficiency virus (HIV) infection appears to be associated with a low frequency to visit gynecology clinics because of the uncomfortable sampling process for HPV testing. Therefore, it is necessary to develop a non-invasive method, such as urine testing to diagnose cervical cancer rather than use of the existing invasive method. This study aimed to test validity of HPV DNA detection in urine specimens that can be easily collected from women. Paired vaginal discharge and urine samples were collected prospectively from 203 women who visited the local hospital between January and August 2018 in Busan, Korea. By using the Virocheck® assay kit (Optipharm), we found that 17.2% (35/203) of vaginal discharge samples were HPV positive and 82.8% (168/203) were HPV negative. In urine samples, 15.8% (32/203) were HPV positive and 84.2% (171/203) were HPV negative. The co-incident rate for HPV DNA detection was 84.8% in both vaginal discharge and urine samples. These results suggest that the HPV DNA detection using urine samples might be an alternative way to diagnose HPV infection in a non-invasive way. This analytical approach can be utilized as a screening test to identify HIV-infected patients who need a follow-up process by using urine samples.
Busan ; DNA ; Female ; Follow-Up Studies ; Gynecology ; HIV ; Humans ; Korea ; Mass Screening ; Methods ; Mortality ; Papillomaviridae ; Prospective Studies ; Uterine Cervical Neoplasms ; Vaginal Discharge

We describe our experience regarding metronidazole-induced encephalopathy in a patient with acute lymphoblastic leukemia during chemotherapy. A 17-year-old girl was admitted to our institution with complaints of abdominal pain and mucoid stools. She was diagnosed with acute lymphoblastic leukemia and had been undergoing intensified chemotherapy protocol. During the fifth week of interim maintenance-1 therapy, she developed a fever and complained of chills. On stool examination, stool occult blood was positive and Clostridium difficile toxin A/B test was positive. She was started on metronidazole treatment for possible Clostridium difficile infection and other inflammatory gastrointestinal diseases. Ten days later, the patient complained of dizziness and nausea. A brain MRI was performed to make a differential diagnosis of any chemotherapy- induced CNS complication such as necrotizing leukoencephalopathy. The brain MRI showed features of metronidazole-induced encephalopathy. Metronidazole was discontinued and symptoms started to subside four days after. A follow-up brain MRI performed at four weeks showed that lesions of the dentate nucleus had disappeared.
Abdominal Pain ; Adolescent ; Brain ; Brain Diseases ; Cerebellar Nuclei ; Chills ; Clostridium difficile ; Diagnosis, Differential ; Dizziness ; Drug Therapy ; Female ; Fever ; Follow-Up Studies ; Gastrointestinal Diseases ; Humans ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Metronidazole ; Nausea ; Occult Blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

BACKGROUND: We aimed to study the regional cerebral PET activation patterns during memory tests in medial temporal lobe epilepsy (mTLE) patients and to see whether the activation study could lateralize memory dominance. METHODS: Participants included 6 right mTLE patients, 6 left mTLE patients, and 6 controls. Language was dominant in the left hemisphere in all the participants. PETs were performed while presenting a set of 30 line drawings of com-mon objects with 4 second intervals between each drawing. After 30 minutes, PETs were repeated while presenting a set of drawings with half of the obejcts changed. RESULTS: During the encoding, activated areas were dispersed in mTLE in the superior frontal gyrus, the primary sensory cortex, the premotor area, the supramarginal and angular gyri ipsilaterally or contralaterally, in addition to the inferior and middle frontal gyri activated in the controls. During the retrieval, activated areas were localized in the bilateral inferior frontal gyri and the right medial temporal area in the controls, but also in the premotor area, the primary sensory cortex, and the angular gyrus in mTLE. In the encoding and also in the retrieval, the activated fields of the prefrontal areas contralateral to the epileptogenic zone became wider compared to the controls and those ipsilateral to the epileptogenic zone became smaller. CONCLUSIONS: Cortical areas involved in the encoding and retrieval of the episodic memory are dispersed and contralaterally lateralized to the epileptogenic zone. Lateralization is most prominent in the prefrontal areas.
Brain Mapping* ; Brain* ; Electrons* ; Epilepsy, Temporal Lobe* ; Humans ; Memory ; Memory, Episodic* ; Positron-Emission Tomography* ; Temporal Lobe*

OBJECTIVES: This study was performed to examine the effects of the public attention to ‘crime of schizophrenia’ on the use of mental health services in patients with schizophrenia using big data analysis. METHODS: Data on the frequency of internet searches for ‘crime of schizophrenia’ and the patterns of mental health service utilization by patients with schizophrenia spectrum disorders by month were collected from Naver big data and the Health Insurance Review and Assessment Services in Korea, respectively. Their correlations in the same and following month for lagged effect were examined. RESULTS: The number of outpatients correlated negatively with public attention to ‘crime of schizophrenia’ in the same month. The lagged relationship between public attention and the number of admissions in psychiatric wards was also found. In terms of sex differences, the use of outpatient services among female patients correlated negatively with public attention in the same month while the number of male patients' admissions in both same and following month correlated positively with public attention. CONCLUSION: These findings suggested that public attention to ‘crime of schizophrenia’ could negatively affect illness behavior in patients with schizophrenia.
Crime ; Female ; Humans ; Illness Behavior ; Insurance, Health ; Internet ; Korea ; Male ; Mental Health Services ; Mental Health ; Outpatients ; Schizophrenia ; Sex Characteristics ; Statistics as Topic

The aim of this study was to determine the efficacy of a 3 tone plaque disclosing gel in assessing the risk of caries related to the population of Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus spp. quantified using a quantitative real-time polymerase chain reaction (qRT-PCR).15 healthy children of ages 9 – 12 years were randomly examined. The 3 tone plaque disclosing gel was applied on teeth surfaces, which changed the color to pink or red, blue or purple and light blue. Plaque was divided into 3 groups based on staining. Genomic DNA from each sample was subjected to a qRT-PCR assay for quantitative detection of target bacteria. The Kruskal-Wallis test was conducted for correlation between the color of plaque and the number of bacterial species.The levels of S. mutans, S. sobrinus, and Lactobacillus spp. were significantly different in the plaque samples of the 3 groups (p < 0.05). The proportion of S. sobrinus to S. mutans showed correlation to the color of plaque.The different color-dyed plaque was related to the number of acidogenic bacteria. The 3 tone plaque disclosing gel could be used as one of the indicators to assess the clinical risk of caries associated with the population of S. mutans, S. sobrinus, and Lactobacillus spp.
Bacteria ; Child ; Dental Caries ; Dental Plaque ; DNA ; Humans ; Lactobacillus ; Real-Time Polymerase Chain Reaction ; Streptococcus mutans ; Streptococcus sobrinus ; Tooth