No abstract available.
Nervous System*

PURPOSE: It was reported that gene locus for generalized epilepsy with febrile seizures plus(GEFS+) exist in chromosome 19q13.1, and has relationship with a 387 C G mutation in the SCN1B gene. This study is to determine whether there is the 387 C G mutation in the children with GEFS+ and simple febrile seizures(FS). METHODS: The sample group consisted of 16 patients with GEFS+ and 10 patients with FS who were diagnosed by our department of pediatrics from Jan. 1998 to Dec. 1999. The control group consisted of 15 children who do not have seizure disorders. Genomic DNA was extracted from peripheral blood and a segment of the SCN1B exon 3 was amplified by PCR technique. Purified PCR products were treated with restriction enzyme, Hin P1. The restriction pattern was analyzed by sequencing analysis. RESULTS: Sixty nine%(11 of 16) patients with GEFS+ had family history for epilepsy, and epilepsy phonotypes were generalized tonic-clonic seizures in 82%(13 of 16), on the other hand 12%(2 of 16) and 6%(1 of 16) had absences and atonic seizures respectively. EEG findings showed generalized spike and wave in the all patients with GEFS+. in this study, however we could not observe a 387 C-->G mitation of the SCN1B in the children with GEFS+ and febrile seizures. CONCLUSION: The gene for GEFS+ may have a heterogenetic characteristics, and there may be racial differences in mutation frequency. Expanded studies involving large number of different families are required.
Child ; DNA ; Electroencephalography ; Epilepsy ; Epilepsy, Generalized* ; Exons ; Hand ; Humans ; Mutation Rate ; Pediatrics ; Polymerase Chain Reaction ; Seizures ; Seizures, Febrile*

PURPOSE: Asphyxia is the most common cause of neurologic sequelae in perinatal period. We hoped to help other clinicians by investigating factors affecting neurologic outcome in asphyxiated term babas. METHODS: A clinical study of factors affecting neurologic outcome was made on 120 patients, who were asphyxiated term baby. They admitted to neonatal intensive care unit of Chungnam National University Hospital from January, 1995 to December, 1996. RESULTS: There was no significant correlation in neurologic outcome and gestational age, delivery type, sex, birth weight, one minute Apgar score. Five minute Apgar score had influence on neurologic outcome. Presence of acidemia had influence on neurologic outcome. Mental status and seizure influenced on neurologic outcome. Poor neurologic outcome was prone to come in the presence of prolonged duration of abnormal mental function or a repetitive seizure not controlled immediately. There was poor neurologic outcome in the patients who have abnormal findings on EEG, CT, and neurosonography. In addition, there was poor neurologic outcome in congenital heart disease patients. All of above had statistical significance. CONCLUSION: Now, we can obtain much benefit by monitoring clinical course such as five minute Apgar score, mental change, and seizure. And, we can obtain much benefit by monitoring acidemia and perform EEG, CT and neurosonography.
Apgar Score ; Asphyxia ; Birth Weight ; Chungcheongnam-do ; Electroencephalography ; Gestational Age ; Heart Defects, Congenital ; Hope ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Seizures

PURPOSE: Pediatric seizure patients have various etiologies and clinical outcome. To determine patient's treatment and prognosis, the etiology of seizure is important. Brain MRI is one method which shows many information. This study was performed to find out the efficacy of brain MRI in determining the etiology and clinical outcome in pediatric seizure disorder. METHODS: One-hundred thirty patients with seizures from January, 1996 to December, 1997 had brain MRI performed. All of them except four patients had EEG performed. We observed the initial data on brain MRI, EEG and clinical characteristics of seizure patients. RESULTS: 1) In one-hundred thirty patients, 50 patients (38.5%) had abnormal brain MRI findings. The frequency of abnormal finding was as follows : brain atropy (20), cerebrospinal fluid space dilatation (11), cerebrovascular accident (6), infection (3), cyst (2) and moyamoya disease (2) and others (6). 2) Frequency of seizure, EEG severity, cerebral hemisphere abnormality in brain MRI, and multiple lesions in brain MRI correlated with poor clinical outcome. 3) Severe abnormality of EEG correlated with possibility of abnormal brain MRI finding. CONCLUSION: Initial brain MRI, EEG and clinical characteristics were good indicators of pediatric seizure patient's clinical outcome.
Brain* ; Cerebrospinal Fluid ; Cerebrum ; Dilatation ; Electroencephalography ; Epilepsy* ; Humans ; Magnetic Resonance Imaging ; Moyamoya Disease ; Prognosis ; Seizures* ; Stroke

No abstract available.
Child* ; Diagnosis* ; Headache* ; Humans

No abstract available.
Fibrosis* ; Hypersplenism*

PURPOSE: To evaluate the efficacy and safety of levetiracetam adjunctive therapy for reducing the rate of seizure frequency in children with intractable pediatric epilepsy. METHODS: We reviewed the medical records of 86 patients with intractable pediatric epilepsy who visited our hospital between March 1989 and February 2009. Levetiracetam was included in the previous anticonvulsant regimen for at least 6 months and the reduction in the rate of seizure frequency was determined in follow-up examinations. We analyzed demographic data, seizure types, antiepileptic drug history, levetiracetam dose, adverse effects of levetiracetam therapy, treatment outcome, electroencephalogram findings, etc. RESULTS: More than 50% reduction in the seizure frequency was observed in 62 of the 86 (72.1%) patients; 44 patients (51.1%) became seizure free, while the seizure frequency increased in 5.8% patients. The associations between seizure reduction rate and age, associated diseases, seizure types, and seizure frequency before treatment were not significant. However, the duration of disease, dose of levetiracetam, duration and frequency of anticonvulsant administration before levetiracetam therapy were significantly correlated. Electroencephalogram findings and the cause of epilepsy showed partial correlation. Forty (46%) patients showed adverse symptoms; the symptoms in the order of their frequency were somnolence, hyperactivity, irritability, aggressiveness, tiredness, etc. CONCLUSION: The findings of our study provide the evidence that levetiracetam adjunctive therapy is efficacious and well tolerated in various refractory childhood epilepsy cases.
Child ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Humans ; Medical Records ; Piracetam ; Seizures ; Treatment Outcome

PURPOSE: This study was undertaken to investigate the traumatic brain injury(TBI) in childhood and to identify factors related with its prognosis. METHODS: The medical records of 256 children with traumatic brain injury were analyzed retrospectively, who were treated in Chungnam National University Hospital for more than 6 years from January, 1998 to December, 2003. Outcomes were classified by age, sex, cause, Glasgow Coma Scale(GCS), Glasgow Outcome Scale(GOS), sequelae and so forth. RESULTS: A total of 256 patients were identified. The male to female ratio was 1.9:1. The main cause of TBI was traffic accidents(67.1%), followed by falls(25.8%). The outcomes of TBI were determined by GOS, in which death occurred in 16 cases(6.2%), severe disabilities in 11 cases(4.3%), moderate disabilities in 24 cases(9.4%), and good recoveries in 205 cases(80.1%). Poor prognostic factors were low GCS, post-traumatic early seizure, high blood glucose levels and abnormal pupil reflexes(P<0.05). The sequelae of TBI were quadriparesis(3.5%), learning disability(3%), mental retardation(2.3%), hemiparesis(1.6%) and others. CONCLUSION: This study suggest that it is possible to predict poor outcomes of TBI children by assessing the clinical manifestations. A long term follow-up of seizures and other sequelae is essential to TBI children who have poor prognosis.
Blood Glucose ; Brain ; Brain Injuries* ; Child ; Chungcheongnam-do ; Coma ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Learning ; Male ; Medical Records ; Prognosis ; Pupil ; Retrospective Studies ; Seizures

PURPOSE: Long term oral medications of anticonvulsants are inevitable in pediatric epilepsy patients. Therefore special attention is needed for the complications caused by these medications. Hyponatremia is a well known complication of carbamazepine(CBZ) and oxcarbazepine(OXC), but researches in pediatric patients are rare. This is a study about the development of hyponatremia during the use of these two anticonvulsants in pediatric epilepsy patients and other factors also involved in it. METHODS: We studied serum sodium levels of 267 pediatric patients who were treated with either CBZ or OXC in our hospital from January 2003 to December 2006. Hyponatremia was defined as Na+<138 mEq. Moderate hyponatremia was defined as Na+<130 mEq. Factors thought to be involved in the development of hyponatremia were studied also. These included age, sex, EEG and radiologic test results, use of any other medications, etc. RESULTS: Among the 267 pediatric patients treated with CBZ or OXC, there were 18 cases (6.7%) of moderate hyponatremia and 28 cases(10.5%) of mild hyponatremia. Sex, age, type of seizure, EEG and radiologic test results did not affect the development of hyponatremia. But combination therapy with other anticonvulsants resulted in an increase of hyponatremia. CONCLUSION: We recommend that serum sodium levels should be checked regularly of the pediatric patients taking CBZ or OXC, especially patients treated with additional drugs (combination therapy).
Anticonvulsants ; Carbamazepine ; Electroencephalography ; Epilepsy ; Humans ; Hyponatremia ; Seizures ; Sodium

Objectives: The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. Methods: Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. Results: The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. Conclusions The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.