• Title/Summary/Keyword: 항경련제

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Assessment of the Relationship between Vigabatrin and Visual Field Defect in Children (항경련제 Vigabatrin이 시야에 미치는 영향)

  • Chung, Sa Jun;Chung, Yong Hwan;Cho, Eu Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1546-1550
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    • 2002
  • Purpose : The authors carried out this study to determine the relationship between vigabatrin (VGB) and visual field defect.. Methods : Seventy eight patients older than 8 years who had epilepsy which had developed and been diagnosed, and were receiving add-on therapy, were the subjects of this study. If suspicious results were obtained from the initial test with the Humphrey automatic perimeter, the patient was tested again with the Goldman perimeter. Follow-up examinations were performed on these patients after 6 months. Results : In this study, five of the 78 patients had suspicious primary test results, but upon the second examination they were all found to be normal. Thus there were no patients with visual field defects. Conclusion : VGB is a drug which may cause visual field defects, but in this study no patients presented with this symptom. Instead of limiting the use of VGB due to the adverse effect of visual field defect in the initial treatment of partial seizure and infantile spasm untreatable with other medication, if used with care it may not cause serious problems. Screening for visual defect is recommended, and in patients taking VGB regular examination is necessary.

Modulation of Cytochrome P-450 Induction by Long-Term Supplementation with Korean Red Ginseng to Rats (홍삼의 장기 투여가 흰쥐 간 대사효소 유도에 미치는 영향)

  • Lim, Heung-Bin
    • Korean Journal of Medicinal Crop Science
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    • v.15 no.6
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    • pp.437-443
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    • 2007
  • This study was carried out to investigate the effect of dietary supplementation with red ginseng water-extracts on the induction of microsomal cytochrome P-450 in rats. Phenobarbital (PB) and 3-methylcholanthrene (3-MC), P-450 inducers, were administered to 3- or 12-month old rats received red ginseng extracts (25 mg/kg) from 6 weeks to 12 months for 3 days. PB and 3-MC increased levels of P-450, P-450 reductase, ethoxycoumarin O-deethylase, benzphetamine N-demethylase and glutathione-S-transferase in the liver of rats. However, chronic administration of red ginseng significantly reduced these increase of enzyme levels induced by P-450 inducers. Chronic administration of red ginseng did not affect the induction of cytochrome $b_5$ and NADH cytochrome $b_5$ reductase by P-450 inducers. It is suggested that the induction of cytochrome P-450 system in the liver in relation to xenobiotics toxicity can be modulated by long-term supplementation with Korean red ginseng to rats.

DEVELOPMENTAL PSYCHOPHARMACOLOGY - DEVELOPMENTAL PHARMACOKINETICS, PHARMACODYNAMICS AND PHARMACOGENETICS - (발달학적 정신약물학 - 발달학적 약동학, 약역학 및 약물유전학 -)

  • Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.157-173
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    • 2003
  • The history of pediatric psychopharmacology is very short and the research on safety, efficacy and side effects is preliminary and long-term effect on growth and maturation is not well known yet. Clinical findings have shown that the responses to antidepressants, antipsychotics, CNS stimulants and steroids in children and adolescents might be different from adult populations. Based on these findings, this paper reviewed three issues, Firstly, in developmental pharmacokinetics. the author discussed the developmental factors affecting drug absorption, distribution, protein-binding, metabolism and excretion. Secondly, in developmental pharmacodynamics, developmental characteristics of dopamine, serotonin, norepinephrine receptors and their clinical implications were reviewed. Lastly, in pharamcogenetic part, the clinical utility of pharmacogenetics, pharmacokinetic aspects of pharmacogenetics, the pharmacodynamic aspects of pharmacogenetics, the association studies of dopamine-related alleles in neuropsychiatric disorders such as attention-deficit hyperactivity disorders or Tourette’s disorders, pharmacogenetic studies dopamine-related alleles and the pharmacogenetic studies of serotonin-related alleles. Based on these preliminary research, future pharmacogenetic applications in childhood and adolescent psychiatry were also discussed.

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Spontaneous teeth migration after periodontal treatment in the patients with drug-induced gingival enlargement (약물성 치은비대로 인한 병적인 치아 이동이 있는 환자에서 치주치료 이후 자발적 치아 이동을 보인 증례)

  • Choi, Youn-Kyung;Jung, Kyoung-Hwa;Kim, So-Yeun;Jeon, Hye-Mi;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young;Kwon, Eun-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.34-41
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    • 2017
  • Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.

Clinical significance of cerebrospinal fluid pleocytosis in pediatric refractory status epilepticus (소아 난치성 간질 중첩증에서 뇌척수액 백혈구 증가증의 임상적 의의)

  • Kim, Jung Mi;Kim, Young Mi;Kwon, Soon Hak
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1086-1092
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    • 2006
  • Purpose : Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children. Methods : From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy. Result : Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures. Conclusion : In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it.

Clinical Manifestation of Eosinophilic Meningitis in Korean Children: A Single Institution's Experience (단일기관에서 소아 호산구성 수막염의 임상특징 분석)

  • Byun, Jung Hee;Choi, Seong Yeol;Kim, Dong Soo;Kim, Ki Hwan
    • Pediatric Infection and Vaccine
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    • v.22 no.1
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    • pp.23-28
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    • 2015
  • Purpose: The aim of this study was to investigate the clinical manifestations and laboratory characteristics of eosinophilic meningitis in Severance Children's Hospital. Methods: We examined 6,335 children under the age of 18 years old who had visited the tertiary hospital in Seoul, Korea, and had received cerebrospinal study results between January 2007 and July 2012. The medical records of the patients identified as eosinophilic meningitis were retrospectively reviewed. Results: Eosinophilic meningitis was diagnosed in 39 patients (0.6%). The mean age was 6 years (range 0-18 years) and the sex ratio was 1.3:1 (22 males and 17 females). The underlying diseases and past history were neurologic disease (n=36, 92%). Eosinophilic meningitis was diagnosed in thirty-five patients who had undergone postoperation neurosurgery (90%). The most common symptoms were fever (50%), headache (20%), vomiting (15%), seizure (10%), and dizziness (5%). The average duration for recovery was five days, and intravenous antibiotics or steroids were used. Conclusions: Manifestations of eosinophilic meningitis are similar to other types of meningitis. The most common cause of eosinophilic meningitis in children was neurosurgery. Eosinophilic meningitis should be considered for patients showing fever and headache after neurosurgery. Through careful investigation, use of improper antibiotics could be avoided.

A Case of Atypical Thrombotic Microangiopathy (비전형적 혈전성 미세병증 1례)

  • Oh, Ji Young;Park, Se Jin;Kim, Ki Hwan;Lim, Beom Jin;Jeong, Hyeon Joo;Ki, Jung Hye;Kim, Kee Hyuck;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.149-153
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    • 2013
  • We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.

A Case Report on Post-stroke Epilepsy Treated by Korean Medicine with Uwhangchungsimwon and Jingansikpungtang-gagambang (뇌졸중 후 발생한 뇌전증 환자에 우황청심원과 진간식풍탕가감방을 활용한 한의 치료 증례 보고 1례)

  • Park, Jiwon;Kim, Seo-Hee;Lee, Jieun;Im, Jisung;Lyu, Yeoung-Su;Jo, Eun-Heui
    • Herbal Formula Science
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    • v.28 no.4
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    • pp.451-458
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    • 2020
  • Post-stroke epilepsy (PSE) slows the recovery process and reduces the quality of life of stroke survivors. Antiepileptic drugs are empirically prescribed to prevent PSE. However, the long-term use of antiepileptic drugs increases the risk of atherosclerosis, and up to 25% of patients have drug-resistant epilepsy. Herein, We report a patient with PSE who was treated with Korean medicine including Jingansikpungtang-gagambang and Uwhangchungsimwon. A 51-year-old patient had a past medical history of cerebral infarction that occurred in 2014. His first seizure occurred in January 2020 and he was diagnosed with PSE through a brain magnetic resonance imaging. The patient had a partial seizure with secondary generalization. After the initiation of taking Korean medicine, both the rate of progression to generalized seizures and the frequency of seizures was progressively and significantly reduced. This case report suggests that Korean medicine-based treatment may be safe and effective for PSE.

Topiramate can reduce the number of episodic attacks in cyclic vomiting syndrome : a case report (Topiramate 투여로 호전된 주기성 구토증 1례)

  • Yum, Mi-Sun;Bae, Keun Wook;You, Su Jeong;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.386-389
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    • 2007
  • Cyclic vomiting syndrome (CVS) is a paroxysmal, recurrent vomiting disorder of unknown pathophysiology and target organ. It has been hypothesized that CVS shares the same mechanism as migraine. We describe here a 5-year-old boy with CVS characterized by episodic vomiting attacks. These recurrent vomiting episodes began at 3 years of age, occurred every month and lasted for 5 days at a time. At the time of admission, no abnormal physical or neurological findings were observed and laboratory findings, including brain MRI and endoscopic examination, revealed nothing specific. The vomiting episodes were self-limited but recurrent and severely interrupted his daily life. When this patient was treated with topiramate, he showed a marked increase of symptom-free periods.

A Case of Intramedullary Spinal Tuberculoma and Multiple Brain Tuberculoma Associated with Pulmonary Tuberculosis (폐결핵 치료중 발현된 척수내결핵종 및 다발성 뇌결핵종 1예)

  • Lee, Hyang-Ju;Kim, Chung-Tae;Cho, Dong-Il;Rhu, Nam-Soo;Cho, Phil-Za
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.237-245
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    • 2000
  • Tuberculomas in the spine are estimated to be 15 to 50 times less common than those occurring in the cranium. We experienced a case of intramedullary spinal tuberculoma and brain tuberculoma associated with pulmonary tuberculosis. A 39-year-old male was referred to the National Medical Center via emergency room because of urinary difficulty lower limb weakness for 3 days. He had been treated with anti-tuberculosis regimens against pulmonary tuberculosis for 20 days. Spinal MRI revealed intradural intramedullary tuberculoma at T5. On the 21st day at the hospital, a generalized seizure attacked him. Brain MRI revealed multiple tuberculoma in both hemispheres, brainstem and cerebellum. He was treated anti-tuberculosis regimens and corticosteroids for 9 months. His condition improved clinically and radiologically. We report this case with a review of the literature.

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