• 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.

• The Journal of the Korea institute of electronic communication sciences
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• v.9 no.3
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• pp.387-392
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• 2014

Now a days, there are various application functions to transmit from vehicles to the Internet and vice versa. And the communication can be operated through a roadside infrastructure including with possible use of routing protocols. Specifically, autonomous vehicles for remote driving and monitoring requires transmitting of high depth of multimedia such as video. Especially in a populated urban area, an efficient network is vital because of handling a great amount of the data. Therefore, in this paper, efficient network topology for a crossroad in urban area is suggested by performance evaluation of vehicular networks using a wireless LAN and a routing protocol. For the performance evaluation, various vehicular network topologies are designed and simulated in OPNet simulator.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.129-132
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• 2016

Ictal tachycardia and bradycardia are common arrhythmias; however, ictal sinus pause and asystole are rare. Ictal arrhythmia is mostly reported in adults with temporal lobe epilepsy. Recently, ictal arrhythmia was recognized as a major warning sign of sudden unexpected death in epilepsy. We present an interesting case of a child with ictal sinus pause and asystole. A 27-month-old girl was hospitalized due to 5 episodes of convulsions during the past 2 days. Results of routine electroencephalography (EEG) were normal, but she experienced brief generalized tonic seizure for 3 days. During video-monitored EEG and echocardiography (ECG), she showed multiple myoclonic seizures simultaneously or independently, as well as frequent sinus pauses. After treatment with valproic acid, myoclonus and generalized tonic seizures were well controlled and only 2 sinus pauses were seen on 24-hour Holter ECG monitoring. Sinus dysfunction should be recognized on EEG, and it can sometimes be treated successfully with only antiepileptic medication.

• Journal of Biomedical Engineering Research
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• v.22 no.1
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• pp.81-90
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• 2001

본 연구에서는 디지털 영상 뇌파계(digital video electroencephalogram, Digital VEEG)에서 비디오 영상과 뇌전도 파형의 동기화된 편집 시스템을 구성한다. 이 시스템은 기존 아날로그 영상 뇌파계(analog video electroencephalogram)의 동기화 문제와 디지털 영상 시스템에서의 영상편집 문제를 해결하기 위하여 MPEG-I(이하 MPEG) 고압축 기술을 이용한 MPEG 인코딩 보드(encoding board)와 MPEG 편집 엔진(editing engine)을 각각 사용하였다. 시스템은 디지털 영상뇌파계모듈과 디지털 편집 모듈로 구성되며, 뇌전도모듈에서는 환자에게 연결된 전극을 통해 들어온 뇌파를 생체신호증폭기를 이용하여 증폭한 후 AD 보드(analog to digital board)를 이용 디지털화한다. 디지털 카메라로 촬영된 환자영상의 아날로그 영상신호(NTSC 신호)는 MPEG 인코딩 보드를 이용하여 고압축 디지털화한다. 이후 디지털화된 뇌전도신호와 MPEG 형식의 영상을 시간 동기화하여 두 개의 모니터에 각각보여준다. 편집 모듈에서는 영상신호와 뇌파신호를 어느 부분이든 간단한 조작으로 오려 붙이기(cut and paste) 기능을 이용할 수 있다. 본 시스템은 사용된 데이터 모두 디지털 기술을 이용하여 영상과 뇌파신호의 정확한 동기화 및 각각의 데이터의 오려 붙이기 기능을 가능케 하였으며, 이는 환자의 데이터를 관리 및 보관하는데 있어, 임상의에게 의미 있는 자료만을 모아서 효율적으로 관리할 수 있게 해준다. 이와 같은 장점을 갖는 디지 영상뇌파계 편집시스템을 구현하였다.

• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.52-57
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• 2008

Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.64-70
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• 1996

The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.

• The Journal of the Korea institute of electronic communication sciences
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• v.7 no.3
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• pp.671-677
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• 2012

A black-box program was implemented in order to monitor abnormal symptoms of human body irregularly occurring during sleep. The system consists of sensor probing body signals, auxiliary devices such as the alarm, lamp, network camera, and signal monitoring computer. Various types of sensors, PPG, ECG, EEG, temperature, respiration sensor, G-sensor, and microphone were used to more exactly identify the causes of abnormal symptoms. If a symptom occurs, the system records the patient's condition to provide information being utilized in the treatment. The sensors are attached on some locations of body being proper to check a specific type of abnormal reaction. Based on the normal range and type of measurement data, criteria of signal levels were set to distinguish abnormal reaction. An abnormal signal being probed, the program starts to operate the lamp, alarm, and network camera at the same time and stores the signal and video data.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.283-290
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• 2007

Objective : This study was designed to analyze seizure outcome and to investigate the prognostic factors for predicting seizure outcome according to the preoperative evaluations, surgical procedures, topectomy sites and histopathological findings in patients with extratemporal lobe epilepsy [ETLE]. Methods : This study comprised 63 patients with ETLE who underwent surgery. Preoperative evaluations included semiologic analysis, chronic video-EEG monitoring, and neuroimaging studies. Surgical procedures consisted of topectomy in 51 patients, corpus callosotomy in 9, functional hemispherectomy in 2, and vagus nerve stimulation [VNS] in 1. Histopathological findings were reviewed. Postoperative seizure outcomes were assessed by Engel's classification at the average follow up period of 66.8 months. Chi-square test was used for statistics. Results : Total postoperative seizure outcomes were class I in 51 [80%] patients, class II in 6 [10%], class III in 6 [10%]. Patients with structural abnormalities on neuroimaging study showed class I in 49 [88%] patients [p<0.05]. Patients with focal and regional ictal EEG onset revealed class I in 47 [90%] patients [p<0.05]. Semiologic findings, surgical procedures, topectomy sites and histopathological findings did not show statistical correlation with seizure outcome [p<0.05]. Conclusion : A good seizure outcome was obtained in patients with ETLE. The factors for favorable seizure outcome are related to the presence of structural abnormalities on neuroimaging study, and focal and regional ictal EEG onset.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.114-119
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• 2006

Objective : The authors investigate appropriate evaluation and surgical methods in treatment of the cerebral paragonimiasis accompanying epilepsy. Methods : Thirteen patients with the cerebral paragonimiasis accompanying epilepsy were included for this study. Preoperative evaluation methods included history taking, skin and serologic tests for Paragonimus westermani, neurologic examinations, computerized tomography, magnetic resonance imaging, amytal test, PET or SPECT, and video-EEG monitoring with depth and subdural grid electrodes. Seizure outcome was evaluated according to Engel's classification. Results : Surgical methods were temporal lobectomy including lesions in six, lesionectomy in five, and temporal lobectomy plus lesionectomy in two. Postoperative neurological complications were not noticed, and seizure outcomes were class I in 12 patients [92%], class II in one [8%]. Conclusion : In patients with a cerebral paragonimiasis accompanying epilepsy, further evaluation methods must be done to define the epileptogenic zone, and complete resection of the epileptogenic zone with different surgical methods should be performed for seizure control.

• Clinical and Experimental Pediatrics
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• v.52 no.7
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• pp.804-810
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• 2009

Purpose : We investigated whether ictal single-photon emission computed tomography (SPECT) with prolonged injection of technetium-99m (99mTc) ethyl cysteinate dimer during repeated spasms can localize the epileptogenic foci in children with infantile spasms. Methods : Fourteen children with infantile spasms (11 boys, 3 girls; mean age, $2.2{\pm}1.3$ years) were examined. When a cluster of spasms was detected during video electroencephalography (EEG) monitoring, $^{99m}Tc$ ethyl cysteinate dimer was slowly and continuously injected for 2 minutes to determine the presence of ictal SPECT. For 7 children, the ictal and interictal SPECT images were visually analyzed, while for the remaining 7 children, the SPECT images were analyzed using the subtraction ictal SPECT coregistered to magnetic resonance imaging (MRI) (SISCOM) technique. Subsequently, we analyzed the association between the ictal SPECT findings and those of other diagnostic modalities such as EEG, MRI, and positron emission tomography (PET). Results : Increase in cerebral blood flow on ictal SPECT involved the epileptogenic foci in 10 cases6 cases analyzed by visual assessment and 4 analyzed by the SISCOM technique. The ictal SPECT and video-EEG findings showed moderate agreement (Kappa=0.57; 95% confidence interval, 0.18-0.96). Conclusion : Ictal SPECT with prolonged injection of a tracer could provide supplementary information to localize the epileptogenic foci in infantile spasms.