No abstract available.
Classification* ; Epilepsy*

No abstract available.
Epilepsy* ; Genetics*

No abstract available.
Classification* ; Epilepsy*

No abstract available.
Classification* ; Seizures*

No abstract available.
Classification* ; Epilepsy*

The gamma knife radiosurgery (GKS) is a safe and effective neurosurgical approach in the treatment of arteriovenous malformation (AVM). Seizures after GKS are rarely reported, but epilepsia partialis continua (EPC) has not been reported yet. We report a patient with EPC accompanied with cerebral edema after GKS in AVM. A 50-year-old man was admitted for EPC, dysarthria and monoparesis 20 days after GKS due to AVM. Brain MRI showed increased cerebral edema around AVM in the left premotor area. Symptoms were relieved by IV dexamethasone and antiepileptic drugs (AEDs). 15 weeks later, EPC recurred and aphasia and right hemiplegia were rapidly aggravated. The follow up brain MRI showed markedly increased cerebral edema compared with previous MRI. EPC was well controlled by AEDs, but aphasia and hemiplegia were not responsive to IV dexamethasone until trying oral prednisolon. We think that cerebral edema induced by EPC, as a complication of GKR, might aggravate hemiparesis.
Anticonvulsants ; Aphasia ; Arteriovenous Malformations ; Brain ; Brain Edema ; Dexamethasone ; Dysarthria ; Epilepsia Partialis Continua* ; Follow-Up Studies ; Hemiplegia ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Radiosurgery* ; Seizures

PURPOSE: In the pediatric patients who have medically intractable epilepsy the callosotomy is useful to prevent the propagation of seizure from one hemisphere to the other. The indications of callosotomy are drop attack, life threatening primarily or secondarily generalized seizure, medically refractory mixed seizure types such as Lennox-Gastaut syndrome. In addition, the retarded children are not contraindicated. The anterior callosotomy is used to perform to control medically intractable epilepsy which is believed to have some advantages to total callosotomy. But, we propose that the anterior callosotomy does not seem to be superior to total callosotomy for the prevention of the propagation of seizure or complication. We describe a series of 21 patients with medically intractable epilepsy who underwent total callosotomy in one stage. METHODS: The diagnoses in these patients included Lennox-Gastaut syndrome, atonic seizure, infantile hemiplegia, and no obvious solitary seizure focus on chronic video/EEG monitoring to characterize seizures, electrographic activity, and postictal behaviors. Preoperatively 16 patients suffered from disabling drop attacks or intense head drop seizures which caused frequent physical injuries. Other types of seizures are 12 generalized tonic-clonic seizures, 7 complex partial seizures, 1 absence seizure, and 7 myoclonic seizures. Male:Female=14:7, Age: 2-22 years (Mean: 9.4 years). The follow-up period ranged from 0.8 to 3.8 years (median 2.4 years). Seizure outcome, parental assessment of daily function, and parental satisfaction with outcome were assessed postoperatively. RESULTS: Drop attacks disappeared completely during the entire follow-up period in 13 patients and decreased to less than 10% of baseline in five. The corpus callosum of the one patient were not completely sectioned in Diffusion Tensor Image, tractography. Other types of seizures resolved completely in 14 patients and decreased in 7. 2 patients experienced a transient disconnection syndrome, but completely resolved within four weeks. Overall daily function improved and parents were satisfied with the surgical outcome in all patients except three who experienced recurrent of drop attacks after operation. There was no sign of significant and persistent neurological deficits in any case. CONCLUSION: Results of total callosotomy in patients with medically intractable epilepsy with diffuse epileptic foci were favorable in most cases. The procedure was particularly effective against drop attacks causing physical injuries and impaired quality of life in these patients.
Child ; Corpus Callosum ; Diagnosis ; Diffusion ; Epilepsy* ; Epilepsy, Absence ; Follow-Up Studies ; Head ; Hemiplegia ; Humans ; Parents ; Quality of Life ; Seizures ; Syncope

PURPOSE: Positive ratio of routine EEG in adult epilepsy was widely known, but small number was reported in child epilepsy. Thus, we studied the difference of positive ratios between ages. METHODS: We reviewed the clinical records of 756 patients, who visited the pediatric neurology clinic with more than 2 afebrile seizures except neonatal seizures, from March 1997 to December 2004. Excluded were children with previous history of antiepileptic medication or failure of EEG. Clinical aspects and EEG findings of left 609 patients were evaluated retrospectively. RESULTS: Median age of EEG examination was 7.0 years (range, 3 months to 19.8 years) and male was 339. Number of child under 2 years was 112, 2-4 was 96, 5-9 was 233, 10-14 was 160 and over 15 was 8. All 279 positive past history was known in 222 persons, 98 of them had previous febrile seizures, 37 had CP or MR, 11 had neonatal seizures, 11 had birth asphyxia, 28 was prematurity. Waking EEG was checked in 398, sleep EEG in 547. Abnormal findings were found in 443 (72.7%). Definite epileptiform discharges were found in 388 patients (63.7%), suspicious spike discharges in 37 (6.2%). Patients under 2 years had 50.0% positive ratio of epileptiform discharges, 2-4 had 62.5%, 5-9 had 85.8%, 10-14 had 66.3% and over 15 had 37.5%. CONCLUSIONS: High positive ratio of routine EEG was found in child epilepsy, thus routine EEG seems to be very useful for the first diagnostic examination in child epilepsy.
Adult ; Asphyxia ; Child* ; Electroencephalography* ; Epilepsy* ; Humans ; Male ; Neurology ; Parturition ; Retrospective Studies ; Seizures ; Seizures, Febrile

PURPOSE: Twenty percent or more of children with epilepsy may have attention deficit hyperactivity disorder (ADHD). The treatment of ADHD with epilepsy has been an important clinical issue. The aim of this study is to investigate the efficacy and safety of methylphenidate in children with epilepsy and ADHD. METHODS: The subjects were 38 children with ADHD accompanied by epilepsy diagnosed at Department of Pediatrics and Epilepsy Center, Sanggye Paik Hospital. They were examined with IQ testing and Conners scales at baseline before using methylphenidate, and follow-up study was repeated 1 year after methylphenidate. Efficacy was determined by Conners scales and IQ score results. Safety was determined by measuring changes in seizure frequency, and electroencephalographic findings. RESULTS: According to their parents and teachers' reports, methylphenidate improved ADHD symptoms in 24 children (63.2%). Three of them (7.9%) showed significant improvement in IQ scores and 7 children (18.4%) revealed significant improvement in cognitive function with rising IQ scores between 10 and 15 points. There were no worsening in seizure frequency, and electroencephalographic findings after methylphenidate. CONCLUSION: Methylphenidate is effective and safe treatment in children with epilepsy and ADHD, showing significant benefit on children's behavior and academic improvement in many cases.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Epilepsy* ; Follow-Up Studies ; Humans ; Methylphenidate* ; Parents ; Pediatrics ; Seizures ; Weights and Measures

PURPOSE: There is no apparent consensus about the successful policy of antiepileptic drug (AED) withdrawal, nor about definite factors to make patients remain seizure-free. We attempted to find out the predictive factors for seizure relapse after withdrawal of AED in patients with cryptogenic partial epilepsy. METHODS: This is a case-controlled and hospital-based observational study. A total of 91 crytogenic partial epileptic patients in whom seizure had been successfully controlled by AED monotherapy for more than two years were subjected to drug withdrawal. Patients with history of febrile convulsion, status epilepticus, and abnormal intelligence were excluded. Subjects were divided into two groups; the first group consisted of patients with seizure free more than 2 years after withdrawal of AED and another group with seizure recurrence during tapering or after drug withdrawal. The group with successful withdrawal had 48 patients, and, in 43 patients, seizure was recurred. Clinical profiles were compared between the two groups. RESULTS: There was no significant difference in gender, family history, age at onset, number of seizure attacks before AED initiation, duration of illness before treatment, and seizure or epilepsy classifications between the two groups. However, an abnormal EEG finding was associated with seizure relapse (Chi-square test p<0.05). On the other hand, the number of seizure attacks and the interval between the AED initiation and the time when a seizure free period was achieved had a correlation with seizure relapse, but was not statistically significant. CONCLUSIONS: Abnormal EEG findings was the predictive factor for seizure relapse after withdrawal from AED monotherapy in cryptogenic partial epilepsy.
Case-Control Studies ; Classification ; Consensus ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Hand ; Humans ; Intelligence ; Observational Study ; Recurrence* ; Seizures* ; Seizures, Febrile ; Status Epilepticus