A Case of Long-term Follow-up Rasmussen’s Encephalitis

Rasmussen encephalitis (RE) is a rare, severe, and progressive disorder characterized by focal motor seizures, epilepsia partialis continua, hemiparesis, and intellectual decline. Although clinical features of RE are heterogenous, the progression of the disease is generally divided into three stages which are prodromal, acute, residual stages. We report a 29-year-old woman who had shown typical progression of the disease but preserved cognitive function during a longterm follow-upope

The localizing and lateralizing value of auras in lesional partial epilepsy patients

PURPOSE: We investigated the localizing and lateralizing values of auras in patients with lesional partial epilepsy on an outpatient basis. MATERIALS AND METHODS: A total of 276 subjects were retrospectively selected for this study if they had a unilateral single lobar lesion based on magnetic resonance image (MRI) results, and their scalp electroencephalography (EEG) findings were not discordant with the MRI-defined lobar localization and lateralization. According to the lesion locations, subjects were considered as having mesial temporal (MTLE), lateral temporal (LTLE), frontal (FLE), parietal (PLE), or occipital (OLE) lobe epilepsies. Auras were classified into 13 categories. RESULTS: A hundred and seventy-six subjects (63.8%) had experienced at least one aura. FLE subjects had the fewest number of auras. Epigastric and psychic auras were frequent among MTLE subjects, while visual auras were common in those with PLE and OLE. Somatosensory auras and whole body sensations were more frequent in the subjects with PLE than those without. Autonomic auras were more common in MTLE subjects than in LTLE subjects. Dysphasic auras were more frequently found in left-sided epilepsies. Five pairs of aura categories showed concurrent tendencies, which were the epigastric and autonomic auras, autonomic and emotional auras, visual and vestibular auras, auditory and vestibular auras, and whole-body sensation and auditory auras. Autonomic and emotional auras had a concurrent tendency in left-sided epilepsies, but not in right-sided epilepsies. CONCLUSION: Our results support the previously known localizing value of auras, and suggest that dysphasic auras and the association of emotional and autonomic auras may have a lateralizing value.ope

약한상호작용의 CP대칭성의 깨어짐과 강한 상호작용의 CP 문제의 해

Thesis (doctoral)--서울대학교 대학원 :물리학과,1995.Docto

Intramedullary Spinal Cord Cavernous HemangiomasPresented With Radiculopathy

Cavernous hemangioma may exist in the spinal cord as well as intracranium. Intramedullary spinal cord cavernous hemangioma usually manifests with myelopathy. We report a case of intramedullary cavernous hemangiomas having presented with isolated radicular pain.ope

Simple Partial Status of Forced Thinking Originated in the Mesial Temporal Region: Intracranial Foramen Ovale Electrode Recording and Ictal PET

Forced thinking (FT) is a rare epileptic phenomenon which is usually seen in patients with frontal lobe epilepsy. We report a rare case of mesial temporal lobe epilepsy presenting FT as simple partial status epilepticus. A 50-year-old woman with left hippocampal sclerosis developed a prolonged episode of continuous FT for five days after she experienced a clustering of complex partial seizures during the period of preoperative video-electroencephalography (EEG) monitoring. The EEG demonstrated continuous focal ictal discharges in the left foramen ovale electrodes. Positron emission tomography showed focal glucose hypermetabolism in the left mesial temporal region. This case indicates that the anatomical substrate for the development of FT is located in the mesial temporal region as well as the frontal lobe, and prolonged FT can occur as a seizure manifestation.ope

Long-term efficacy and tolerability of topiramate as add-on therapy in refractory partial epilepsy: an observational study.

PURPOSE: To evaluate the long-term efficacy and tolerability of topiramate (TPM) as add-on therapy in patients with refractory partial epilepsy. METHODS: This is a retrospective, single-center, long-term observational study. Patients fulfilling the criteria of medical intractability proposed by Berg et al. were entered into the study if they were newly prescribed TPM as add-on therapy between January 2000 and June 2002. The usual starting dosage of TPM was 50 mg/day and optimal-dose adjustments were made according to individual clinical responses. Efficacy and tolerability were analyzed every year during 5-year follow-up in the "intention-to-treat (ITT) population." Retention rate was estimated by Kaplan-Meyer analysis. RESULTS: A total of 125 patients were included in the study and 107 patients (85.6%) were followed for 5 years. Retention rate was 87.2% at 1 year and 64% at 5 years. At the end of 5 years, the median seizure frequency reduction rate was 69.0% and responder rate was 43.2% in the ITT population. Cumulative seizure-free rate (SFR) was 30.4% and the terminal 1-year SFR was 12.8% in the ITT population (20.0% in completers) at 5-year follow-up. Adverse events (AEs) occurred in 39.2% of patients, including significant AEs leading to antiepileptic drug (AED) withdrawal in 14.4%. The most common AEs were anorexia (16.0%), weight loss (10.4%), and gastrointestinal symptoms (8.8%). Concomitant AEDs were reduced in 25.0% of the completers. DISCUSSION: Low-dose and slow-dose escalation of TPM in add-on therapy for patients with refractory partial epilepsy is effective and well tolerated in long-term, individualized clinical practiceope