The causes of a transient loss of consciousness (TLOC) are divided into syncope, epileptic seizures, cerebrovascular diseases and functional disorders such as hyperventilation (HV) syndrome, psychogenic pseudosyncope. The differential diagnosis of TLOC is may be difficult due to lack of history, misleading features, or confusion over the definition of syncope. We have experienced a rare case of HV syncope that TLOC developed after HV from mental stress, and differentiated by head-up tilt table test with transcranial doppler.
Diagnosis, Differential ; Epilepsy ; Humans ; Hyperventilation* ; Syncope* ; Tilt-Table Test* ; Unconsciousness

Vigabatrin (VGB) is one of the most frequently prescribed new anti-epileptic drugs in the world since 1989. It has minimal side effects and fewer drug interactions with other anti-epileptic drugs. Recently, concern of the prevalence and pathophysiology of visual impairment with VGB has been increased since the reports of visual field constriction in patients treated with VGB. We report a 46-year-old man with a visual field defect who has been suffering from complex partial seizures for 29 years. Brain magnetic resonance image (MRI) and electroencephalogram (EEG) were non-specific. The frequency of seizures was about 5 times a month for the past 5 years. VGB, in a dose of 1500 mg/day, was prescribed as an add on drug in addition to carbamazepine. 19 months after VGB treatment, the patient complained of visual dimness especially in the lower half of the visual field. He expressed it as "waving". He had no metabolic derangement. Fundus examination, visual evoked potential, and electroretinogram showed normal findings. A visual field analysis showed a bilateral field defect in the lower half. A follow up visual field analysis, 6 months after the withdrawal of VGB, revealed a slight improvement of visual field defects which were noted without significant clinical improvement. This case implicates that visual field defects due to VGB may be partially reversible.
Brain ; Carbamazepine ; Constriction ; Drug Interactions ; Electroencephalography ; Evoked Potentials, Visual ; Follow-Up Studies ; Humans ; Middle Aged ; Prevalence ; Seizures ; Vigabatrin* ; Vision Disorders ; Visual Fields*

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).
Dermatitis* ; Dermatitis, Contact ; Female ; Hepatitis ; Humans ; Incidence ; Liver ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Skin ; Skin Tests ; Vitamin K 1* ; Vitamins*

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).
Dermatitis* ; Dermatitis, Contact ; Female ; Hepatitis ; Humans ; Incidence ; Liver ; Liver Cirrhosis, Alcoholic ; Liver Diseases ; Skin ; Skin Tests ; Vitamin K 1* ; Vitamins*

Eccrine poroma is a common benign tumor originating from the epidermal sweat duct units. It occurs primarily on feet and hands. However there have been some sporadic cases occurring in other areas, including the scalp. Eccrine poroma occurs mostly in people over 40 years of age, although it can occur at any ages. In general, eccrine poroma lacks melanin pigment clinically and melanocytes on microscopic examination, but either black or yellow skin, melanin granules and melanocytes can be found dispersed within the tumor. We report a case of pigmented eccrine poroma occuring on the scalp of 14-year-old girl. In our case, the patient was much younger than those of the usual onset age and the lesion was located on an unusual occuring site. In addition, the lesion contained melanocytes and melanins.
Adolescent ; Age of Onset ; Child* ; Female ; Foot ; Hand ; Humans ; Melanins ; Melanocytes ; Poroma* ; Scalp* ; Skin ; Sweat