Paradoxical Lateralization of Convulsive Movements in a Subtle Status Epilepticus

Background : Subtle status epilepticus (SE) is an end-stage of convulsive SE. This phenomenon might be a clinical expression of neuronal exhaustion caused by sustained electrical discharges. As subtle SE may show diverse clinical features, early detection depends on clinical suspicion. Case : A 68-year-old woman was presented with repetitive involuntary movement of right limbs after two generalized tonic-clonic seizures. She experienced right middle cerebral artery infarction 4 months ago, and after the event, left side hemiplegia sustained. These seizures were first-ever after the cerebral infarction. Orientation and verbal responses were fairly preserved but general cognitive function was minimally slowed. During the video-EEG monitoring, repetitive sharp waves were noted in the right hemisphere and these sharp waves occasionally spread to the contralateral side. Her right side involuntary movement was identifiable when the epileptic discharges were found on her right hemisphere. Conclusion : We suggested that this unexpected convulsive movement is a reflection of earlier exhaustion in the right hemisphere or deefferentation of right hemisphere because of preexisting neuronal damage.OAIID:oai:osos.snu.ac.kr:snu2002-01/102/2014017262/6SEQ:6PERF_CD:SNU2002-01EVAL_ITEM_CD:102USER_ID:2014017262ADJUST_YN:NEMP_ID:A079623DEPT_CD:801CITE_RATE:0DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Two Patients with Epilepsy Induced by Complex Thinking

Reflex epilepsies are distinct but not clearly understood clinical entity. Various cerebral activities induced by simple stimulation including visual, auditory, somatosensory stimulation, as well as diverse functional tasks such as reading, calculation, complex thinking are believed to be seizure-inducing factors. We experienced two patients whose seizures were readily precipitated by complex, strenuous thinking. Both patients was teen-aged boy at the onset of seizure(13, and 15 years of age each) with normal physical and mental growth. Although first seizure was precipitated by watching TV and playing puzzles in each patient, initial diagnosis was idiopathic generalized epilepsy, possibly juvenile myoclonic epilepsy(JME). For the first few years, seizures were infrequent but mostly precipitated by the tasks needs concentration such as playing computer games, decision-making, mathematics, reading, or during the examination. EEG revealed various thinking process including reading hard books, drawing complex figure, complex calculation induced epileptic discharges even if it usually needs certain period of concentration. Phenytoin, valproic acid, clonazepam, vigabatrin, and lamotrigine sometimes abated their seizures but none of these made them seizure-free. Complex reflex epilepsy induced by thinking was proposed to be a separate type of epilepsy or a variant of JME. Age, sex, stereotypic seizure-inducing factors, clinical course, and refractory epilepsies in these patients highly suggested this type of epilepsy as a variant of JME but its refractoriness and unique provocation still needs more speculation.OAIID:oai:osos.snu.ac.kr:snu2000-01/102/2014017262/4SEQ:4PERF_CD:SNU2000-01EVAL_ITEM_CD:102USER_ID:2014017262ADJUST_YN:NEMP_ID:A079623DEPT_CD:801CITE_RATE:0DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Spatio-temporal distribution & propagation of temporal lobe seizures: application of nonlinear mutual cross prediction

Background : Nonlinear mutual cross prediction (MCP) characterizes ynamic interdependence among nonlinear systems. MCP also reveal relative strength of the coupling between systems, thus provides information about the direction of interdependence. The aim of this study is to apply MCP algorithm to multi-channel EEG and to characterize spatio-temporal pattern of seizure. M e t h o d s : We analyzed MCP of EEG of three medically intractable temporal lobe epilepsy patients, who underwent temporal lobectomy (left 2, right 1). Asymmetry of nonlinear cross predictability between channels was investigated. Five epochs of interictal EEG free from epileptiform discharge(s) and of ictal EEG were analyzed. R e s u l t s : In interictal period, both frontal and occipital region appeared a weak driving force while awake and this driving force was further weakened during sleep. Before the onset of the seizure (preictal phase), the intensity of driving system became slightly stronger around seizure foci in 3 out of 8 seizures while no significant change was seen on the naked eyes. However this change was dim and not continuous. At the onset of seizure (ictal phase), 5 out of 8 seizures showed strong driving force around seizure foci. Three seizures without significant change initially had strong driving force as synchronous seizure discharges became built-up and spreading to surrounding areas in the middle of seizure. All seizures showed ipsilateral frontotemporal strong driving force and centroparietal response system, which was typical spatio-temporal distribution of MCP. Conclusion : MCP analysis may be a useful method for detecting spatio-temporal distribution and propagation pattern in temporal lobe epilepsy.OAIID:oai:osos.snu.ac.kr:snu2002-01/102/2014017262/2SEQ:2PERF_CD:SNU2002-01EVAL_ITEM_CD:102USER_ID:2014017262ADJUST_YN:NEMP_ID:A079623DEPT_CD:801CITE_RATE:0DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

A clinical study on the seizure and spontaneous lobar intracerebral hemorrhage

Background and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated the factors affecting development of epilepsy following spontaneous lobar ICH. Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospital with spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died within few days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epileptic seizure and died five and eight months later each. Medical history was obtained through medical record and by telephone interview. Statistical analyses were performed using Chi-square test, Students t - test, Fishers exact test. Results : Seizure occurred in 19 patients. As three patients had previous history of seizures, 16 patients(22.2%) showed first onset early- and late- seizures. Early seizure occurred in 14 patients(19.4%). Three out of 14 were heavy alcoholics. Five patients developed late recurrent seizure 61 days to 800 days after the early seizure. Late seizure with no acute seizure occurred in two patients. The types of seizure were diverse as generalized tonic clonic seizure(10), partial seizure with secondary generalization(5), and complex partial seizure(1). The common risk factors for lobar ICH were hypertension(HT), arteriovenous malformation(AVM), and excessive use of alcohol. We could not find any causes in 23 patients. Although size of hematoma, age of onset, sex, incidence of HT or AVM were not different between patients with seizure and without seizure, the history of excessive alcohol drinking was more frequent in patients with seizure. Five patients with late recurrent seizure had ICH involving temporal area. Conclusions : This study suggests that the risk of seizure in patients with lobar ICH was increase in chronic alcoholics and patient with late recurrent seizure had ICH frequently involving temporal area.OAIID:oai:osos.snu.ac.kr:snu2002-01/102/2014017262/4SEQ:4PERF_CD:SNU2002-01EVAL_ITEM_CD:102USER_ID:2014017262ADJUST_YN:NEMP_ID:A079623DEPT_CD:801CITE_RATE:0DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Reexamining the Pay Differentials-Organizational Outcomes Relationship in Korea : The Role of Organizational Identification

This research examines the effects of pay differentials on financial performance and employee turnover in Korea by considering a critical employee-based factor: organizational identification. Incorporating tournament theory and social identity theory, authors theorize that pay differentials increase financial performance and employee turnover without considering employees organizational identification. If considered, however, whereas the positive effects of pay differentials on financial performance will be weaker, the effects on turnover will be stronger. Using a sample of Korean cross-industry firms, results show pay differentials have a positive influence on only financial performance. Also, as predicted, while the positive relationship between pay differentials and financial performance became weaker, the relationship with turnover became stronger when employees organizational identification is high. Theoretical and practical implications for strategic pay structures are discussed

FISH(Fluorescence in situ hybridization)를 이용한 염색체 이상 분석에 관한 연구

학위논문(석사)--서울대학교 보건대학원 :보건학과 보건학전공,1996.Maste