BACKGROUND: It is debatable whether psychiatric problems are overrepresented in the epileptic patient population. In addition, the significance of MMPI elevations in epileptic patients is still uncertain. This study attempted to find out MMPI profile characteristics of patients with medically refractory epilepsy (MRE). METHODS: MMPI was administered to 172 MRE patients and 139 normal controls. RESULTS: In terms of the mean value of MMPI scales, the MRE patients group had normal mean values comparable to the normal control group. However, the MRE patients could be classified into three subgroups by a multivariate cluster analysis, which include a subgroup with normal profile group (41% of patients), neurotic profile group (elevated Hs-D-Hy scales; 19% of patients), and psychiatric profile group (elevated Pa-Pt- Sc & Hs-D-Hy scales; 40% of patients). CONCLUSIONS: This study shows that the majority of MRE patients have abnormal MMPI profiles and suggests that psychiatric disorders or problems might be common in MRE patients. (J Korean Neurol Assoc 19(3):226~231, 2001)
Epilepsy* ; Humans ; MMPI* ; Psychotic Disorders ; Weights and Measures

BACKGROUND: We evaluated whether the time required for a seizure to spread contralaterally, interhemispheric propagation time (IHSPT) could be related to post-surgical outcome in temporal lobectomy. METHODS: We performed a retrospective study of 28 patients. All patients had previously undergone a phase I presurgical evaluation including MRI and video-EEG monitoring with scalp and sphenoidal electrodes, which strongly suggested the diagnosis of mesial temporal lobe epilepsy, but proved inadequate to lateralize the epileptogenic zone. All patients performed the video-EEG monitoring with bilateral subdural strip electrodes on their basal and mesial temporal area and unilateral temporal lobectomy with a minimum of 1-year follow up postoperatively. IHSPT was divided into two categories, 0~5.0 seconds, 5.1 seconds or longer. RESULTS: Sixteen patients (57.1%) were seizure free and 12 suffered persistent seizures. A prolonged IHSPT (> 5.0sec) significantly correlated with a favorable surgical outcome (P = 0.05). Hippocampal atrophy on MRI significantly correlated with prolonged IHSPT (P<0.05). CONCLUSIONS: Our result suggests that hippocampal atrophy on MRI and IHSPT can predict the surgical outcome and may be used as the selection criteria of temporal lobectomy for patients with intractable temporal lobe epilepsy.
Atrophy ; Diagnosis ; Electrodes* ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Patient Selection ; Retrospective Studies ; Scalp ; Seizures ; Temporal Lobe*

BACKGROUND: Primary aldosteronism describes a group of disorders characterized by long-standing aldosterone excess, with suppressed renin activity, resulting in hypertension and hypokalemia. The protean clinical and biochemical characteristics of this syndrome have important implications regarding its pathophysiology and responsiveness to treatment. METHODS: The cases of 12 primary aldosteronisms, diagnosed at Hanyang University Hospital between 1996 and 1999, were reviewed. RESULTS: The 12 cases were composed of 9 aldosterone-producing adenoma, 2 adrenal hyperplasia and a case of idiopathic hyperaldosteronism. There were 9 women and 3 men. The mean age was 46 yrs (range, 23 to 64 yrs). At the initial visit, the mean blood pressure was 160+/-26/104+/-14 mmHg, and one case of idiopathic hyperplasia had normal blood pressure. The mean serum K+ level was 2.6+/-0.5 mEq/L (range, 1.5 to 3.5 mEq/L). The mean plasma renin activity and plasma aldosterone concentration were 0.4+/-0.4 ng/ml/hr (range, 0.2 to 1.6 ng/ml/hr) and 407.5+/-199.8 pg/mL (range, 225 to 800 pg/mL), respectively. Different steps of diagnostic modalities were applied for the preoperative differential diagnosis. All patients, with the exception of the one with idiopathic hyperaldosteronism, were managed by a unilateral laparoscopic adrenalectomy, as they were all diagnosed under the impression of adrenal adenomas. Ultimately, 9 cases were proven to have adrenal adenomas. One hypertensive case, with hypokalemia, had adrenal hyperplasia, and the case with normotension was found to have adrenal nodular hyperplasia from the pathology. The size of the tumors ranged from 1.4 to 2.4 cm in diameter. Among the 11 cases that underwent an adrenalectomy, the blood pressures in 6 cases normalized after the operation, while the other 5, including the one with unilateral hyperplasia, were still in need of antihypertensives for the control of elevated blood pressures, even after the operation. The other case of idiopathic hyperaldosteronism was managed by the prescription of spironolactone. CONCLUSION: From these, it can be suggested that the clinical diversity of the syndrome, especially in the pathophysiology and response to operation, awaits the development of a better preoperative lateralization procedure
Adenoma ; Adrenalectomy ; Aldosterone ; Antihypertensive Agents ; Blood Pressure ; Diagnosis, Differential ; Female ; Humans ; Hyperaldosteronism* ; Hyperplasia ; Hypertension ; Hypokalemia ; Male ; Pathology ; Plasma ; Prescriptions ; Renin ; Spironolactone