• Journal of Sleep Medicine
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• v.15 no.2
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• pp.43-47
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• 2018

Objectives: Obstructive sleep apnea (OSA) is common in people with epilepsy (PWE), and confers medical and seizure-related consequences when untreated. Positive airway pressure, the gold-standard for OSA management, is limited by tolerability. As serotonin is involved respiratory control and amelioration of seizure-induced respiratory events, this study aims to determine whether serotonin reuptake inhibitors (SRIs) may represent a potential therapeutic option. Methods: A retrospective study of 100 PWE and OSA ${\geq}18$ years of age was conducted. The primary outcome measure was OSA severity as function of SRI use, with rapid eye movement (REM)-related OSA as a secondary outcome. Results: Older age and depression were more common in those taking an SRI. There was no association between SRIs and OSA severity. However, the SRI group was less likely to have REM-related OSA. Conclusions: In PWE and OSA, SRI use is associated with reduced risk of REM-related OSA, and may represent a potential management strategy.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.358-361
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• 1997

This paper describes a multichannel epileptic seizure detection algorithm based on wavelet transform(WT), artificial neural network(ANN) and expert system. First, through the WT, a small number of wavelet coefficients is used to represent the single channel epileptic spike. Next, 3-layer feed-forward network employing the error back propagation algorithm is trained and tested using parameters obtained above. Finally, 16 channel expert system which is based on clinical experience is introduced as a artifact rejection and reliable detection. The suggested algorithm was implemented on personal computer(PC). Two main events i.e., epileptiform and normal activities, were selected from 32 person's EEGs(normal: 20, seizure disorder: 12) in consensus among experts. The result was that WT reduced data input size and ANN detected 97 of the 100 EEGs containing definite spike - sensitivity of 97%. Expert rule system was capable of rejecting a wide variety of artifacts commonly found in EEG recordings. It also reduced false positive detections of ANN.

• Journal of Ginseng Research
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• v.47 no.3
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• pp.390-399
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• 2023

Background: Gintonin (GT), a Panax ginseng-derived lysophosphatidic acid receptor (LPAR) ligand, has positive effects in cultured or animal models for Parkinson's disease, Huntington's disease, and so on. However, the potential therapeutic value of GT in treating epilepsy has not yet been reported. Methods: Effects of GT on epileptic seizure (seizure) in kainic acid [KA, 55mg/kg, intraperitoneal (i.p.)]-induced model of mice, excitotoxic (hippocampal) cell death in KA [0.2 ㎍, intracerebroventricular (i.c.v.)]-induced model of mice, and levels of proinflammatory mediators in lipopolysaccharide (LPS)-induced BV2 cells were investigated. Results: An i.p. injection of KA into mice produced typical seizure. However, it was significantly alleviated by oral administration of GT in a dose-dependent manner. An i.c.v. injection of KA produced typical hippocampal cell death, whereas it was significantly ameliorated by administration of GT, which was related to reduced levels of neuroglial (microglia and astrocyte) activation and proinflammatory cytokines/enzymes expression as well as increased level of the Nrf2-antioxidant response via the upregulation of LPAR 1/3 in the hippocampus. However, these positive effects of GT were neutralized by an i.p. injection of Ki16425, an antagonist of LPA1-3. GT also reduced protein expression level of inducible nitric-oxide synthase, a representative proinflammatory enzyme, in LPS-induced BV2 cells. Treatment with conditioned medium clearly reduced cultured HT-22 cell death. Conclusion: Taken together, these results suggest that GT may suppress KA-induced seizures and excitotoxic events in the hippocampus through its anti-inflammatory and antioxidant activities by activating LPA signaling. Thus, GT has a therapeutic potential to treat epilepsy.

• Korean Journal of Veterinary Research
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• v.58 no.2
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• pp.103-106
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• 2018

Three aged dogs, all over 15 years old, with multiple seizure events and various neurologic signs such as head turn and ataxia were brought to the referring hospital. Two cases were tentatively diagnosed with intracranial meningioma based on magnetic resonance imaging, and one case was histopathologically confirmed as meningioma at necropsy. All dogs improved after initiation of pulsed high-dose hydroxyurea (HU) treatment. Clinical sign relapses were managed by repeating high-dose HU without obvious side effects. Pulsed high-dose HU can be applied when clinical signs are refractory to the traditionally recommended dosage for intracranial meningioma in dogs.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.38-42
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• 2014

A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.861-867
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• 2000

Purpose : Neuronal migration disorder(NMD) is a major underlying pathology of patients with intractable epilepsy. The role of NMD on seizure susceptibility or epileptogenecity, however, has not been documented. Methods : External irradiation of total amount of 250 cGY was performed to the fetal rats on days 16(E16) and 17(E17) of gestation. After delivery, the rats of 230-260g were decapitated for the histopathologic study. Epileptog-enecity of the NMD was studied by observing electroclinical events after intraperitoneal kainic acid(KA) injection in the control rats and NMD rats. Results : Histopathologic findings revealed focal and/or diffuse cortical dysplasia consisting of dyslamination of the cerebral cortex and appearance of the cytomegalic neurons, neuronal heterotopia in the periventricular white matter, dispersion of the pyramidal layer and the dentate gyrus of the hippocampus, and agenesis of the corpus callosum. Abnormal expression of neurofilaments protein(NF-M/H) was characteristically observed in the dysplastic neurons of the neocortex and hippocampus. Early ictal onset and prolonged ictal activity on EEG and clinical seizures were observed from the NMD rats unlike with the control rats. Conclusions : Exteranl irradiation on the fetal rats produced NMD. And the rats with NMD were highly susceptible to kainic acid provoked seizures. This animal model would be useful to study the pathophysiology of clinically relevant NMDs.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1050-1054
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• 2000

Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.226-232
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• 2005

Peptic ulcer disease complicated with gastric outlet obstruction is rare in children. Even though NSAIDs have been reported to cause various adverse events, they are still regarded as safe and, therefore, widely utilized in children. In the past, pediatric patients who were at risk of seizure due to high fever, were treated with dipyrone (Metamizole sodium) injection which inhibits cyclooxygenase-1 and inhibit prostaglandin, to weaken the gastro-duodenal defensive mechanism. A case of an infant with multiple esophagogatroduodenal ulcers and bleeding caused by NSAID complicated with gastric outlet obstruction is reported in this paper.

• Clinical and Experimental Pediatrics
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• v.51 no.1
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• pp.62-66
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• 2008

Purpose : In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. Methods : From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video-EEG monitoring for more than 3 months. Results : Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was $7.2{\pm}5.8\;years$. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P<0.05). Psychogenic disorder was more frequent in female (n=6) than in male (n=2) but there was no statistical significance (P>0.05). Conclusion : Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.151-154
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• 2016

Increased plasma insulin levels are often observed in exogenous insulin overdose patients. However, plasma insulin level may decrease with time. We report a case of low plasma insulin level hypoglycemia after insulin lispro overdose. The patient was a 37-year-old man with no previous medical history who suspected insulin lispro overdose. Upon arrival, his Glasgow coma scale was 3 points and his blood sugar level (BSL) was 24 mg/dl. We found five humalog-quick-pen (insulin lispro) in his bag. There was no elevation of glucose level, despite an initial 50 ml bolus of 50% glucose and 150 cc/hr of 10% dextrose continuous intravenous infusion. He also suffered from generalized tonic-clonic seizure, which was treated with lorazepam and phenytoin. We conducted endotracheal intubation, after which he was admitted to the intensive care unit (ICU). There were recurrent events of hypoglycemia below BSL<50 mg/dl after admission. We repeatedly infused 50 ml 50% glucose 10 times and administered 1 mg of glucagon two times. The plasma insulin level was 0.2 uU/ml on initial blood sampling and 0.2 uU/ml after 5 hours. After 13 hours, his BSL stabilized but his mental status had not recovered. Diffuse brain injury was observed upon magnetic resonance imaging (MRI) and severe diffuse cerebral dysfunction was found on electroencephalography (EEG). Despite 35 days of ICU care, he died from ventilator associated pneumonia.