No abstract available.
Anxiety* ; Depression* ; Epilepsy, Temporal Lobe* ; Temporal Lobe*

Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder of neuromuscular transmission that is frequently associated with malignancy, particulary small cell carcinoma of the lung. To our knowledge, there was no report of LEMS in Korean listeratures and this might be the first case in this country. The patient is a 55 year old man with muscle weakness and fatigability of proximal lower limbs for 2 months. Bronchogenic carcinoma is confirmed radiologically and pathologically. The electrophysiological studies suppert the clinical diagnosis of LEMS with (1) low amplitude of evoked compound muscle potential to a single supramaximal stimulus on nerve, (2) significant decremental response at low rates of stimulation and (3) marked incremental response at high rates of stimulation.
Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Diagnosis ; Humans ; Lambert-Eaton Myasthenic Syndrome* ; Lower Extremity ; Lung ; Middle Aged ; Muscle Weakness

Role of intraoperative ECoG is uncertain and still controversial. We investigated the correlation of preexcision ECoG (pre-ECoG) patterns with MRI findings and the correlation of the presence or absence of residual spikes in postexcision ECoG (post-ECoG) with surgical outcome. We retrospectively studied 29 temporal lobectomized patients (follow-up period: > 16 mons). The ECoG was performed using two subdural strips on the mesiobasal and lateral temporal lobe. Topography and frequency of epileptiform discharges (ED) in pre-ECoG were analyzed and correlated with hippocampal atrophy only or hippocampal and lateral temporal atrophy in MRI. Among the 15 patients with hippocampal atrophy only, pre-ECoG showed mesial temporal dominant ED in 8 ( 53.3 %), diffuse ED in 3 ( 20.0 %) and lateral temporal dominant ED in 4 ( 26.7 %). In 14 patients with hippocampal and lateral temporal atrophy, mesial temporal dominant ED showed in 2 ( 14.3%), diffuse ED in 8 ( 57.1 %), and lateral temporal dominant ED in 4 ( 28.6%). Compared to patients with hippocampal atrophy only, there was statistically significant widespread epilepiiform discharges on the mesial and lateral temporal area in patients with hippocampal and lateral temporal atrophy( p<0.05 ). All of 6 patients without residual spikes and 19 out of 23 patients with residual spikes in post-ECoG were seizure free or aura only after surgery. But presence or absence of residual spikes post-ECoG is not statistically correlated with surgical outcome (p>0.3).
Atrophy ; Epilepsy ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Seizures ; Temporal Lobe

Schizencephaly is a congenital brain anomaly, a disorder of cell migration characterized by gray matter-lined clefts, which is caused by faulty migration of the subependymal neuroblasts. The cleft may be closed (Type I) or open by a cavity communicating with the lateral ventricle (Type II). We identified the characteristic features of schizencephaly on CTs in one patient and on MRIs in 15 patients. Age at detection ranged from 16 months to 37 years. Three patients had bilateral clefts and 13 patients had unilateral cleft. Twelve patients had closed lip cleft whlle four patients had open lip cleft. Small sized unilateral closed cleft, the most comrnon type, was found in ten patients. Three patients had multiple clefts. Clinically these patients presented with seizures in 15 patients, motor disturbance in six patients, speech impairment in five patients, developemental delay in four patients, and mental retardation in three patients. The presence and severity of these symptoms correlated with the size and location of the lesions. Associated cerebral anomalies included ventricular dilatation in seen patients, agenesis of septum pallucidum in seven patients, other neuronal migration disorder in four patients, agenesis or dysgenesis of corpus callosum in three patients, septo-optic dysplasia in two patients, abnormal extension of svlvian fissure in one patient, and arteriovenous malformation in one patient.
Arteriovenous Malformations ; Brain ; Cell Movement ; Corpus Callosum ; Dilatation ; Humans ; Intellectual Disability ; Lateral Ventricles ; Lip ; Magnetic Resonance Imaging ; Malformations of Cortical Development* ; Neuronal Migration Disorders ; Seizures ; Septo-Optic Dysplasia

Auditory brainstem potentials were.recorded from scalp electrodes in neonates ranging in gestational age from 33 to 43 weeks, The latencies of the various potential component decreased with maturation, Wave V, evoked by 90-100dB sensation level clicks, changed in latency from 7.18 msec at 33 weeks of gestation to 6.93 msce at 43 weeks of gestation. Central condcuction times( I-V interpeak latency) in the auditory pathway also decreased with maturation from 5.65 msec at 3,3 weeks to 5,35 msec at 43 weeks, Several kinds of patholgic condition including hyperbilirubinemia, bacterial meningitis and respiratory difficulty syndrome were also evaluated with auditory brainstem potentials, the application of all of these techniques could permit an objective definition of normal and will be helpful in abnormal infants.
Auditory Pathways ; Brain Stem* ; Electrodes ; Evoked Potentials, Auditory* ; Gestational Age ; Humans ; Hyperbilirubinemia ; Infant ; Infant, Newborn* ; Meningitis, Bacterial ; Pregnancy ; Scalp ; Sensation

Syringomyelia is caused by heterogeneous etiologies. Syringomyelia secondary to arachnoiditis complicated by tuberculous meningitis is rarely reported entity, which has not been reported in Korea. We present a patient who had recovered from tuberculous meningitis and developed some years later a progessive disorder of the spinal cord clinically resembling syringomyelia, which was subsequently confirmed by MRI. The patient was treated with syringo-subarachnoid shunt.
Arachnoid ; Arachnoiditis ; Humans ; Korea ; Magnetic Resonance Imaging ; Spinal Cord ; Syringomyelia* ; Tuberculosis, Meningeal*

This study was performed to evaluate, in complex partial seizure, the incidence and nature of MRI abnormality and the correlation between MRI and interictal nasopharyngeal EEG findings. MRI findings were also correlated with age of seizure onset, duration and clinical response to anticonvulsants. For this study, high field MR imaging and interictal nasopharyngeal EEG were performed in 122 patients with complex partial seizures. The patients were distributed in all age groups(mean age:26 years) and include 64 males and 58 females. The average duration of seizure disorder was 10.8 years. Abnormal MRI findings were discovered in 74 of 122 patients, in which mesial temporal sclerosis was most common(58.1%). And other abnormalities were neuroglial tumor(l3.5%), infectious lesion (10.8%), vascular lesion (6.8%), hemiatrophy (4.19@), cystic mass (2.7%) and others (4.1%). There were only slight difference in seizure duration(p<0.1) and anticonvulsant response(p<0.1) between abnormal and normal MRI groups in complex partial seizure patients. But there was no significant difference in age of onset between two groups(p>0.1).
Age of Onset ; Anticonvulsants ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Female ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Male ; Sclerosis ; Seizures

No abstract available.
Dermatitis, Allergic Contact

Cerebral arterial embolism which resulted in total occlusion of right proximal middle cerebral artery was occured in 33 years old female patients with severe mitral stenosis and atrial fibrillation during percutaneous mitral balloon valvuloplasty(PMV). The occluded artery could be detected by transfemoral carotid angiography and recanalized immediately by intra-arterial infusion of urokinase. There were no cerebral hemorrhage by CT scan after intra-arterial urokinase infusion and the patients discharged without any neurologic sequale 7 days after thrombolysis. We report a case of successful recanalization with intraarterial infusion of urokinase in patient with cerebral arterial embolism occurred during PMV.
Adult ; Angiography ; Arteries ; Atrial Fibrillation ; Cerebral Hemorrhage ; Embolism* ; Female ; Humans ; Infusions, Intra-Arterial* ; Intracranial Embolism ; Middle Cerebral Artery ; Mitral Valve Stenosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator*