• The Journal of Korean Medical History
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• v.24 no.1
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• pp.111-117
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• 2011

"Classified Assemblage of Medical Prescriptions(醫方類聚)" is a valuable material which can explain about historical records of East Asian medicine till 15th century. We can also konw what were regarded as important idea by contemporary doctors of Korean in 'Chosun' dynasty. And, Epilepsy is the one of the olddest diseases with a humankind history for a long time. All the concetps of disease including epilepsy in East Asia has been developed and specilized. So, we can find out some valuable facts from Epilepsy section in "Classified Assemblage of Medical Prescriptions". First, 'Epilepsy' was mixed with 'Mad', 'Spasm' before 7th century but after than, it had been divided into in detail. Since 14th century, we can find out that it was separated with 'Spasm' completely. In conclusion, 'Epilepsy' concept in "Classified Assemblage of Medical Prescriptions" at 15th century is similar with mordern 'Epilepsy' concept. Second, We can find out that 'Epilepsy disease' was divided into 'Five epilepsy' before 7th century, and divided into 'external cause', 'internal cause', 'external & internal cause' in 12th century. And, it also was divided into 'yin' or 'yang' epilepsy. So, 'Epilepsy' concept in " Classified Assemblage of Medical Prescriptions" at 15th century can be divided into 'yin' or 'yang' generally, and also it is similar with 'Acute and slow shock'. Especially, 'yinyang' of epilepsy is related to organs & bouls, depth & shallow, interior & exterior, not cold & heat definitely. From now on, the researches about how it had been understood in East Asia can help to find out modern significance of Korean medicine. and, it would be helpful for comprehensive study about "Classified Assemblage of Medical Prescriptions" from these researches in each section.

• Clinical and Experimental Pediatrics
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• v.59 no.2
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• pp.74-79
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• 2016

Purpose: Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures. Methods: The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between the subsequent occurrence of epilepsy and clinical factors including seizure and fever-related variables were analyzed by multivariate analysis. Results: Twenty-five patients (10.0%) had additional afebrile seizures later and were diagnosed with epilepsy. The subsequent occurrence of epilepsy in patients with a history of febrile seizures was associated with a seizure frequency of more than 10 times during the first 2 years after seizure onset (P<0.001). Factors that were associated with subsequent occurrence of epilepsy were developmental delay (P<0.001), preterm birth (P =0.001), multiple seizures during a febrile seizure attack (P =0.005), and epileptiform discharges on electroencephalography (EEG) (P =0.008). Other factors such as the age at onset of first seizure, seizure duration, and family history of epilepsy were not associated with subsequent occurrence of epilepsy in this study. Conclusion: Febrile seizures are common and mostly benign. However, careful observation is needed, particularly for prediction of subsequent epileptic episodes in patients with frequent febrile seizures with known risk factors, such as developmental delay, history of preterm birth, several attacks during a febrile episode, and epileptiform discharges on EEG.

• The Journal of Korean Medical History
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• v.29 no.1
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• pp.79-87
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• 2016

Queen Jangyeol was proclaimed as the second wife of King Injo at the age of 15 in 1638. This study was carried out in order to confirm if Queen Jangyeol actually came down with epilepsy or if she pretended to do. The keywords, "Jungjeon" and "Junggungjeon" were searched among the articles from "Seungjeongwonilgi" in the 16th reign to the 27th reign of King Injo. After that, articles only related to convulsion were selected. The symptom of convulsion and the therapy were analyzed. King Injo gave an order, and royal doctors diagnosed the queen's illness as epilepsy in August in the 23th reign. The Queen was confined in Gyeongdeok in November, and took herbal drugs for treating the epilepsy. After the death of King Injo, she stopped taking the drugs. As the Queen's epilepsy took place consistently more than 1~2 times in a month, it is the generalized tonic-clonic seizure. Also, it is the epilepsy overlapping reiteration with the brain function disorder because the convulsion lasted throughout 1 hour. However, after King Injo died, she lived for long without the brain function disorder. So it is difficult to judge she actually came down with the epilepsy.

• Biomedical Science Letters
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• v.18 no.4
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• pp.428-434
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• 2012

Epilepsy is a chronic neurological disease showing a symptom of repeated seizures without any other physical disorders. Among the diagnostic examination for epilepsy, the electroencephalogram (EEG) has been known as an important test. This study aimed to investigate the EEG with photic stimulation in the pediatric epilepsy patients. They underwent digital sleep and waking EEGs or waking EEGs with photic stimulation. Epilepsy type, seizure history, and season of occurring seizure were analyzed. Epilepsy patients showed more response during the period of photic-on and eye close at the frequency of 10~20 Hz during the EEG activation procedure. Photoparoxysmal response (PPR) was shown in 206 patients out of total 1,551 epilepsy patients. PPR was appeared more frequently during summer and winter seasons, and especially in the patients who had a history of seizure. During the PPR, EEG pattern showed spike (77.18%), theta (9.71%), and spike + theta (13.11%). On the other hand, beta and theta waves were not significantly changed by photic stimulation. However, alpha wave was decreased and delta wave was increased by photic stimulation (P<0.05). These changes may be due to temporarily altered electrophysiological function of the epileptic patient's brain by the photic stimulation. There was no difference in the EEG pattern between the left and right side in the brain. In conclusion, condition of photic-on with closed eyes and frequency of 10~20 Hz during the procedure of EEG activation could be appropriate for obtaining a definite photoparoxysmal response in the electroencephalogram of the pediatric epilepsy patients.

• Korean Parent-Child Health Journal
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• v.18 no.2
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• pp.88-99
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• 2015

Purpose: This study was conducted to examine mother-child interactions and the quality of life of preschool children with epilepsy as perceived by mothers, and to investigate the relation between mother-child interactions and the quality of life of preschool children with epilepsy. Methods: Participants for this study consist of 92 mothers of children with epilepsy aged three to six years who were treated at university hospitals and a city hospital located in Seoul, Korea. The instruments used for this study were mother-child interactions of preschool children scale and the Korean version of the TAPQOL (TNO-AZL Preschool children Quality of Life). Results: The level of mother-child interactions for preschool children with epilepsy showed a mean score 125.91. The category of dyadic domain was rated the highest while the child domain category was rated the lowest. The level of mother-child interactions for preschool children with epilepsy showed a significant difference according to the mother-child relationship, birth history, seizure frequency, number of antiepileptic drugs and combined disabilities. The quality of life of children with epilepsy showed a significant difference according to the mother-child relationship, birth history, seizure frequency, number of antiepileptic drugs and combined disabilities. There is a statistically significant positive correlation between mother-child interactions and quality of life of preschool children with epilepsy. Conclusion: This study suggests that the mother-child interaction of preschool children with epilepsy showed a tendency to be led by mothers. In order to stimulate mother-child interactions, mothers should help their children enhance their reaction and participation.

• Journal of Korean Neurosurgical Society
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• v.62 no.3
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• pp.361-365
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• 2019

Epilepsy has been known to humankind since antiquity. The surgical treatment of epilepsy began in the early days of neurosurgery and has developed greatly. Many surgical procedures have stood the test of time. However, clinicians treating epilepsy patients are now witnessing a huge tide of change. In 2017, the classification system for seizure and epilepsy types was revised nearly 36 years after the previous scheme was released. The actual difference between these systems may not be large, but there have been many conceptual changes, and clinicians must bid farewell to old terminology. Paradigms in drug discovery are changing, and novel anti-seizure drugs have been introduced for clinical use. In particular, drugs that target genetic changes harbor greater therapeutic potential than previous screening-based compounds. The concept of focal epilepsy has been challenged, and now epilepsy is regarded as a network disorder. With this novel concept, stereotactic electroencephalography (SEEG) is becoming increasingly popular for the evaluation of dysfunctioning neuronal networks. Minimally invasive ablative therapies using SEEG electrodes and neuromodulatory therapies such as deep brain stimulation and vagus nerve stimulation are widely applied to remedy dysfunctional epilepsy networks. The use of responsive neurostimulation is currently off-label in children with intractable epilepsy.

• 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.55 no.5
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• pp.171-176
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• 2012

Purpose: The aim of this study was to investigate the natural history of epilepsy and response to anti-epileptic drug treatment in patients with Angelman syndrome (AS) in Korea. Methods: We retrospectively reviewed the clinical records of 14 patients diagnosed with epilepsy out of a total of 17 patients with a genetic diagnosis of AS. These patients were seen at the Department of Pediatric Neurology at Severance Children's Hospital from March 2005 to March 2011. Results: Fourteen (9 males and 5 females) subjects (82.3%) were diagnosed with epilepsy in AS. The most common seizure types were generalized tonic-clonic (n=9, 27%) and myoclonic (n=9, 27%), followed by atonic (n=8, 24%), atypical absence (n=4, 12%) and complex partial seizure (n=3, 9%). The most commonly prescribed antiepileptic drug (AED) was valproic acid (VPA, n=12, 86%), followed by lamotrigine (LTG, n=9, 64%), and topiramate (n=8, 57%). According to questionnaires that determined whether each AED was efficacious or not, VPA had the highest response rate and LTG was associated with the highest rate of seizure exacerbation. Complete control of seizures was achieved in 6 patients. Partial control was achieved in 7 patients, while one patient was not controlled. Conclusion: Epilepsy is observed in the great majority of AS patients. It may have early onset and is often refractory to treatment. There are few reports about epilepsy in AS in Korea. This study will be helpful in understanding epilepsy in AS in Korea.

• Clinical and Experimental Pediatrics
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• v.57 no.11
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• pp.496-499
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• 2014

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he showed gait disturbances, nystagmus, and excessive dizziness; his mental state, however, indicated he was alert, which did not fit the classical triad of Wernicke's encephalopathy. A diagnosis of Wernicke's encephalopathy was made only after brain magnetic resonance imaging and serum thiamine level analyses were performed. The patient's symptoms remained after 5 days of treatment with 100-mg thiamine once daily; thus, we increased the dosage to 500 mg 3 times daily, 1,500 mg per day. His symptoms then improved after 20 days of replacement therapy. This case report describes a pediatric patient who was promptly diagnosed with Wernicke's encephalopathy, despite only 2 suspicious symptoms, and who completely recovered after high doses of thiamine were given intravenously.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.22-28
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• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.