A clinical study was done on 161 patients (male 94, female 67) with the first onset of seizure over the age of 16 who were admitted to Keimyung University Hospital from 1979 to 1983 in order to analyze the causative factors, the age distribution at onset, the seizure pattern and E.E.G. findings. The results were summarized as follows. 1. The etiological factors of 161 seizure patients revealed metabolic encephalophaties 75 cases (46.6%), cerebrovascular disease 26 cases (16.2%), unknown cause 21 cases (13%), CNS infectious disease 17 cases (10.6%), posttraumatic seizure 12 cases (7.5%), brain tumor proved by brain biopsy 8 (5%) and hysteric seizure 2 cases in order of frequency. 2. Among the 75 cases of metabolic encephalopathies, the most common cause was drug intoxication (34 cases), followed by alcohol withdrawal seizure (21 cases), water intoxication (5 cases), uremia and hypocalcemia (4cases respectively), hepatic encephalopathies (3 cases) and then hypoglycemia and anoxia (2 cases respectively) in order of frequency. Among the 26 cases of cerebrovascular disease, spontaneous subarachnoid hemorrhage was presented in 9 cases, intracerebral hemorrhage and cerebral infarction in 7 cases respectively and arteriovenous malformation in 3 cases. Among the 17 cases of CNS infectious diseae, meningitis was presented in 9 cases, Japanese B encephalitis in 3 cases, paragonimiasis in 2 cases, and then cerebral cysticercosis, tuberculoma, and focal cerebritis in 1 case respectively. Among the 8 cases of brain tumor, meningioma was presented in 5 cases, oligodendroglioma, glioblastoma multiforme and epidermoid cyst in 1 case respectively. 3. The mean age at the onset of each causes of seizure revealed metabolic encephalopathies 38 yrs. CNS infectious disease 33 yrs, posttraumatic seizure 34 yrs, arteriovenous malformation 23 yrs, brain tumor 42 yrs, and cerebrovascular disease 54 yrs. 4. The most frequent seizure pattern of 161 patients was the generalized seizure in 126 cases (78.3%) followed by the partial elementary seizure in 29 case and the partial seizure with secondary generalization in 6 cases. The incidence of partial seizure was slightly higher than the generalized seizure in brain tumor and CNS infectious disease. 5. There were no correlation between the E.E.G. degree and causative factors of seizure.
Adult* ; Age Distribution ; Alcohol Withdrawal Seizures ; Anoxia ; Arteriovenous Malformations ; Biopsy ; Brain ; Brain Diseases, Metabolic ; Brain Neoplasms ; Cerebral Hemorrhage ; Cerebral Infarction ; Communicable Diseases ; Cysticercosis ; Encephalitis, Japanese ; Epidermal Cyst ; Female ; Generalization (Psychology) ; Glioblastoma ; Hepatic Encephalopathy ; Humans ; Hypocalcemia ; Hypoglycemia ; Incidence ; Meningioma ; Meningitis ; Oligodendroglioma ; Paragonimiasis ; Seizures* ; Subarachnoid Hemorrhage ; Tuberculoma ; Uremia ; Water Intoxication

A clinical study was done on 16 cases of cerebellar hemorrhage and 3 cases of cerebellar infarction which were diagnosed with brain CT scan at Keimyung university Dongsan hospital from July 1981 to June 1985 and conclusions obtained are as follows. 1. The incidence of cerebellar hemorrhage and infarction was 3.5% and 0.6% of all spontaneous intracranial parenchymal hemorrhage and infarction, respectively. 2. The most prevalent age group was 7th decade and sex ratio was higher in male in cerebellar stroke. 3. Major single percipitating factor of cerebellar stroke was hypertension. 4. Most of cerebellar stroke showed catastrophic or sudden onset type. 5. The most common initial symptoms of cerebellar stroke were nausea and vomiting, followed by headache and dizziness or vertigo, in order of frequency. 6. The most common neurologic signs on admission were impaired consciousness, constricted pupil with preserved light reflex and cerebellar signs. 7. The common site of cerebellar hemorrhage was right hemisphere, followed by vermis and left hemisphere, in order of frequency, and that of cerebellar infarction was right posterior hemisphere. 8. The better the consciousness on admission, the better the outcome of cerebellar stroke. 9. The following parameters indicated good prognosis with medical therapy, so called benign cerebellar hemorrhage: clear consciousness on admission, gradual onset type, less than 20cc of hematoma, no or mild hydrocephalus, no ventricular hematoma, no vermis involvement on CT scan.
Brain ; Consciousness ; Dizziness ; Headache ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Infarction ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Prognosis ; Reflex ; Sex Ratio ; Stroke ; Tomography, X-Ray Computed ; Vertigo ; Vomiting

A case is reported ofsystemic toxicity by topically applied podophyllin. The patient was a 18-year-old girl who was treated at private gynecological clinic with 25% podophyllin resin for multiple vulval condyloma acuminata. Her apparent podophyllin toxicity begun 4 hours after topical application, presenting gastrointestinal symptoms such as nausea, vomiting, diarrhea and abdominal distension, followed by tingling sensation on hands and feet with motor weakness predominantly of distal limbs. She had never experienced disturbance of consciousness or other CNS symptoms. The symptoms of severe peripheral neuropathy had been improved by 72 days followup when she had mild impairement of vibration and position sense and mild dorsiflexion weakness of the feet.
Adolescent ; Consciousness ; Diarrhea ; Extremities ; Female ; Follow-Up Studies ; Foot ; Hand ; Humans ; Nausea ; Peripheral Nervous System Diseases ; Podophyllin ; Podophyllum* ; Polyneuropathies* ; Proprioception ; Sensation ; Vibration ; Vomiting

Clincal studies were made on 166 cases of spontaneous subarachnoid hemorrhage (SAH), were admitted to the keimyung university Dongsan hospital from January 1981 to March 1984. The age and sex distribution, causes of SAH, clinical symptoms and signs, computed tomographic (CT) findings, aneurysmal site, number and size, comparison between the highest density on CT findings and site of aneurysm confirmed by angiography,relationship between CT class and clinical grade, complication, and relationship between hospital course and clinical grade on admission were analysed. The results summarized as follow. 1. The most prevalent age group was between 41-60 years of age, and above 61 years, 31-40 years and below 30 years of age in the order of frequency. Male to female ratio was 43.4 : 56.6. 2. The most common causes of 100 cases of SAH confirmed by cerebral angiography was cerebral aneurysm (75 cases), and the other causes were unknown cause (16 cases), arteriovenous malformation (6 cases), moyamoya disease (3 cases) in the order of frequency. 3. The clinical symptoms on admission in the order of frequency were headache, nausea and vomiting, brief loss of consciousness, dizziness, seizure, and urinary incontinence. The neurological findings showed stiffneck, hemiparesis, cranial nerve palsies, papilledema and/or hemorrhage on the fundus, and Babinski sign in that order. 4. CT findings (158 cases) revealed typical high densities consistent with SAH in 125 cases (79.1%), associated with the low density (13 cases), and visible cerebral aneurysm (5 cases), while negative findings were 33 cases (20.9%). 5. The most common site of aneurysm among the 75 cases of SAH confirmed by the cerebral angiography was the region of the anterior communicating artery (AcomeA) which accounted for 30 cases (35.3%), and posterior communicating artery (PcomeA) and middle cerebral artery (MCA) 23 cases (27%), respectively, the internal carotid artery 5 cases (5.9%), the anterior ecrebral artery (ACA) 2 cases (2.4%), the posterior inferior cerebellar artery and basilar artery 1 cases (1.2%), respectively in the order of frequency. Among the 75 cases of cerebral aneurysms, single aneurysms were 67 cases (89.3%) and multiple aneurysms were 8 cases (10.7%). The most common size of the aneurysms was 6-10 mm (47 cases), and below 5 mm (30 cases), and above 10 mm (8 cases) in the order of frequency. 6. Sixteen out of 27 cases of AcomA aneurysms present the highest density on CT scan in the anterior hemispheric fissure, 9 out of 22 cases of PcomA aneurysms in syulvian fissure and 6 cases in suprasellar cistern, and all cases of MCA aneurysm (21 cases) in the ipsilateral aneurysmal site. 7. Comparison between CT grade by Davis (1980) and clinical grade by Hunt-Hesse (1968) revealed that the 93 of 94 patients (pts) with CT class 1 or 2 belong to under clinical grade 3, the 17 of 64 pts with CT class 3 or 4 belong to clinical grade IV or V, and the 17 of 18 pts with clinical grade IV or V belong to CT class 3 or 4. 8. The most common complication was the hydrocephalus (30.1%), and cerebral arterial spasm (24.1%), SIADH (8.4%), and rebleeding confirmed by lumbar puncture and/or CT (4.2%), in the order of frequency. 9. One hundred and four pts (62.7%) out of total 166 patient with SAH were improved, whereas 39 pts (23.5%) were not improved or signed out without clinical improvement, and 23 pts (13.8%) were died. The 81 (77.9%) of 104 pts who were improved belong to clinical grade I or II on admission, the 18 (78.3%) of 23 pts who were expired belong to clinical grade III or IV, and the 19 (48.7%) of 39 pts who were signed out without improvement belong to clinical grade III to V.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Carotid Artery, Internal ; Cerebral Angiography ; Cranial Nerve Diseases ; Dizziness ; Female ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Inappropriate ADH Syndrome ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Moyamoya Disease ; Nausea ; Papilledema ; Paresis ; Reflex, Babinski ; Seizures ; Sex Distribution ; Spasm ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed ; Unconsciousness ; Urinary Incontinence ; Vomiting

Twenty-one myasthenic patients were treated with high-dose daily prednisone regimen at Seoul National University Hospital from May 1983 to January 1985. Observations in relation to dosage, drug schedule, clinical responses, and sideeffects led us to following conclusions concerning the management of myasthenia gravis with steroid. In addition, factors influencing the result were considered. 1) Among 21 patients, twenty(95%) showed clinical improvement of variable degrees. 2) Significant improvement could be expected especially in male patients, in older patients, and in those with duration of myasthenia gravis less than 6 months prior to treatment. Performance of thymectomy or thymothymectomy, thymic pathology, and clinical grade at the time of therapy were not considered to affect the outcome. 3) Ten cases (48%) suffered from initial exacerbations, most of which occurred within the first four days of treatment. Steroid-induced crises developed in four cases with preexisting brittle or severe generalized myasthenia. 4) Period taken to show the initial response and the maximum improvement varied widely but majority of them occurred within 15 days and 70 days respectively. 5) Off-day weakness during the alternate-day schedule required special cautions and, if persitent, immediate return to daily schedule was desirable. 6) Thymectomy prior to steroid treatment was not always necessary but, when both regimens were scheduled together, preparation therapy with steroid thought to be more favorable. 7) Aside from initial exacerbations side-effects during the treatment were not remarkable, all of which disappeared with reduction of dosage.
Appointments and Schedules ; Humans ; Male ; Myasthenia Gravis* ; Pathology ; Prednisone ; Seoul ; Thymectomy