• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.155-164
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• 2016

Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered important. In recent studies, antecedent cognitive impairment before the first recognized seizure and microstructural and functional alteration of the brain at onset of epilepsy suggest the presence of a common neurobiological mechanism between epilepsy and cognitive comorbidity. However, the overall impact of cognitive comorbidity in children with epilepsy and the independent contribution of each of these factors to cognitive impairment have not been clearly delineated. This review article focuses on the significant contributors to cognitive impairment in children with epilepsy.

• Clinical and Experimental Pediatrics
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• v.56 no.8
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• pp.327-331
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• 2013

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary therapies have an efficacy almost comparable to that of the KD. In addition, a diet rich in polyunsaturated fatty acids appears to increase the efficacy of diet therapy and reduce the complications of a high-fat diet. Here, we review the systematic information about lower-fat diets and better-quality dietary therapies and the current clinical status of each of these dietary approaches.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.529-532
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• 2006

Purpose : To study the spectrum of epilepsy in children with cerebral palsy. Methods : A total of 93 consecutive patients with cerebral palsy(CP) were retrospectively suited. Criteria for inclusion were a follow-up period of at least 2 years. The study examined the correlation between the incidence of epilepsy and seizure types in the different forms of CP. Other factors associated with epilepsy, such as age of first seizure, occurrence of abnormalities on brain imaging, and electroencephalogram were also analyzed. Results : The overall prevalence of epilepsy in children with CP was 46.2 percent. The incidence of epilepsy was predominant in patients with mixed, diplegic, and quadriplegic palsies : 55.5 percent, 51.6 percent, and 50.0 percent in frequency. The first seizure occurred during the first year of life in 48.8 percent of patients with epilepsy. Generalized tonic-clonic seizures were the most common seizure type(44.2 percent), predominant in diplegic patients(64.3 percent). On the other hand, infantile spasms and myoclonic seizures were the main cause of seizures among quadriplegic children(60 percent and 40 percent, respectively). The occurrence of epilepsy was more popular in the group with abnormal brain imagings; especially encephalomalacia and cortical atrophy. All children with epilepsy in this study showed abnormal electroencephalogram(EEG) findings: Generalized abnormalities were observed in 55.8 percent of children with epilepsy; more dominantly in quadriplegic children(80.0 percent); and 40 percent of children with diplegia showed focal abnormalities. Conclusion : Cerebral palsy is associated with a higher incidence of seizure disorders, which, in the majority, has its onset in the first year of life; brain imaging and EEG are most effective in spotting epilepsy in children with CP.

• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.336-343
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• 2019

Epilepsy surgery revealed dramatically improved seizure outcomes over medical therapy in drug-resistant epilepsy patients. Children with epilepsy, however, have multiple epileptic focuses which require multilobar resection for better seizure outcome. Multilobar resection has not only the several severe surgical complications, such as hydrocephalus and shunt-related craniosynostosis, due to intracranial volume reduction. Isolation method (disconnection surgery) was progressively studied over epileptic focus removal (resective surgery) for seizure control. This concept was first introduced for functional hemispherotomy, and its primary principle is to preserve the vital vascularized brain that is functionally disconnected from the contralateral healthy brain. Currently in most epilepsy centers, the predominant disconnection surgical methods, including functional hemispherotomy, are continually being refined and are showing excellent results. They allow the functional isolation of the hemisphere or multi-lobe, affected by severe epilepsy. This review describes recent findings concerning the indication, surgical technique, seizure outcome and complications in several disconnection surgeries including the functional hemispherotomy for refractory pediatric epilepsy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.4
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• pp.106-112
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• 2022

Objectives: We aimed to evaluate the clinical and psychological factors influencing depressive symptoms in children and adolescents with epilepsy. Methods: We administered self-reported questionnaires assessing children's depressive symptoms (Children's Depression Inventory, CDI) and anxiety (Revised Children's Manifest Anxiety Scale, RCMAS) to children and adolescents with epilepsy (n=87, age range=6-17 years). We asked their parents to complete questionnaires on epilepsy-related variables, parental stress (Questionnaire on Resources and Stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), family functioning (Family Adaptability and Cohesion Evaluation Scale, FACES), children's attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children's behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise multiple regression analysis was performed to identify predictive variables affecting depressive symptoms. Results: Family adaptability (r=-0.240, p=0.026), family cohesion (r=-0.381, p<0.001), children's attention problems (r=0.290, p=0.006), children's anxiety (r=0.714, p<0.001), children's behavioral problems (r=0.371, p<0.001), parental anxiety (r=0.320, p=0.003), and parental stress (r=0.335, p=0.002) were significantly correlated with children's depressive symptoms. Children's anxiety (β=0.655, p<0.001) and parental stress (β=0.198, p=0.013) were significantly related to their depressive symptoms (adjusted R²=0.539). Conclusion: Clinicians should detect and manage children's anxiety and parental stress, which may affect depressive symptoms in children and adolescents with epilepsy.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.3
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• pp.335-344
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• 2003

Purpose: The purpose of this study was to develop an educational program for parents of children with epilepsy. Method: The first step was to survey the need for information and social support for these parents. The second step was to design the educational program based on the survey results, literature review, and the theory of chronic sorrow that provided a framework for understanding and working with people suffering a loss of health. Result: The information which these parents were most anxiously seeking was information on the causes of seizures, appropriate steps deal with seizures, and appropriate and supportive parental re]e for their children. The educational program for parents of children with epilepsy included understanding the responses to loss, increasing the parents' knowledge about how to care for their children, managing their stress, enhancing the psychosocial adaptation of children, and encouraging the participation of the family. Conclusion: The educational program developed by the researcher can used with parents of children with epilepsy, and is expected to enhance the psychosocial adaptation of these children.

• Child Health Nursing Research
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• v.22 no.1
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• pp.54-60
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• 2016

Purpose: The purpose of this study was to evaluate levels and correlations of epilepsy specific knowledge, attitude and anxiety in mothers of children with epilepsy. Methods: Participants were 176 mothers of children with epilepsy living in B and Y cities. Data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients with the SPSS 21.0 program. Results: Participants scored 57.2 (${\pm}1.7$) out of 100 points on epilepsy-related knowledge; 35.6 (${\pm}5.0$) out of 48 points on attitude toward epilepsy; 58.1 (${\pm}15.3$) out of 85 on anxiety related to a child's epileptic condition. The participants had higher levels of epilepsy-related knowledge if their family monthly income was three million KRW or higher (t=-2.92, p=.004); if there was no side effect from the medication (t=-2.91, p=.004); and if the mothers' perception of the child's health was good (F=6.181, p=.001). There was a positive correlation between knowledge and attitude related to epilepsy (r=.321, p<.001), and a negative correlation between knowledge and anxiety (r=-.257, p=.001). Conclusion: Findings indicate that interventions which reduce mothers' anxiety by providing epilepsy specific knowledge and help to achieve more positive attitudes to better ways of coping with child's disease.

• Child Health Nursing Research
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• v.22 no.3
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• pp.163-171
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• 2016

Purpose: This study was done to explore disease factors in children with epilepsy, parental factors and resource factors that are related to parenting stress and identify effects of each factor on parenting stress. Methods: Participants were 131 parents who had children who visited a hospital or were hospitalized due to epilepsy. Data collection was done between September 17 and November 17, 2012, and self-report surveys were used. Results: In Stepwise multiple regression analysis, factors influencing parenting stress in children with epilepsy were marital communication, educational background of parents, parenting efficacy, children's development delay, drug treatment and surgical treatment as a method of epilepsy treatment. These factors explained 34.6% (F=13.22, p<.001) of the variance in parenting stress. Conclusion: The findings indicate that parental factors (educational background of parents and parenting efficacy) and resource factors (marital communication) have higher explanatory power than disease factors of the children. Thus, it is importance to assess the capacity of parents through self-evaluation, and to assess barriers to marital communication when developing parenting stress intervention programs. Furthermore, both parents should be involved in interventions for parenting stress.

• Clinical and Experimental Pediatrics
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• v.58 no.5
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• pp.194-198
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• 2015

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronically progressive or relapsing symmetric sensorimotor disorder presumed to occur because of immunologic antibody-mediated reactions. To understand the clinical courses of CIDP, we report variable CIDP courses in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval. Four patients who were diagnosed with acute-onset and relapsing CIDP courses at Severance Children's Hospital, Seoul, Korea, were enrolled in this retrospective study. We diagnosed each patient on the basis of the CIDP diagnostic criteria developed in 2010 by the European Federation of Neurological Societies/Peripheral Nerve Society Guidelines. We present the cases of four pediatric patients diagnosed with CIDP to understand the variable clinical course of the disease in children. Our four patients were all between 8 and 12 years of age. Patients 1 and 2 were diagnosed with acute cerebellar ataxia or Guillain-$Barr{\acute{e}}$ syndrome as initial symptoms. While patients 1 and 4 were given only intravenous dexamethasone (0.3 mg/kg/day) for 5 days at the first episode, Patients 2 and 3 were given a combination of intravenous immunoglobulin (2 g/kg) and dexamethasone (0.3 mg/kg/day). All patients were maintained with oral prednisolone at 30 mg/day, but their clinical courses were variable in both relapse intervals and severity. We experienced variable clinical courses of CIDP in children with respect to initial presentation, responsiveness to medical treatment, and recurrence interval.

• Korean Journal of Biological Psychiatry
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• v.26 no.2
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• pp.79-87
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• 2019

Objectives The aim of this study was to investigate the impact of clinical and psychological factors on the quality of life of children and adolescents with epilepsy and their families. Methods Children and adolescents with epilepsy and their families (n = 63, age range = 6-17 years) completed questionnaires on epilepsy-related variables, quality of life, children's depressive symptoms, children's anxiety, children's behavioral problems, children's attention problems, parental stress, and parental anxiety. Stepwise regression analysis was performed to determine the significant predictive variables that affect quality of life. Results In the correlational analysis, children's attention problems (r = 0.363, p = 0.004), parental anxiety (r = 0.377, p = 0.003), parental stress (r = 0.564, p < 0.001), and children's behavioral problems (r = 0.503, p < 0.001) showed a significant correlation with quality of life. Parental stress (β = 0.415, p = 0.001, adjusted R² = 0.345) and children's behavioral problems (β = 0.285, p = 0.02, adjusted R² = 0.345) were significantly related to the quality of life. Conclusions Clinicians should pay attention to parental stress and children's behavioral problems, which affect quality of life in families with pediatric epilepsy.