Citations
Epilepsy is an intractable disease, though many treatment modalities have been developed. Recently, noninvasive transcranial direct current stimulation (tDCS), which can change brain excitability, was introduced and has been applied for therapeutic purposes regarding epilepsy. A suppression of seizures was experienced by cathodal tDCS in a medication refractory pediatric epileptic patient. The patient was an 11-year-old female who had focal cortical dysplasia of the cerebral hemisphere. The patient was treated with antiepileptic drugs but the mean seizure frequency was still eight episodes per month. The tDCS cathode was placed at the midpoint of P4 and T4 in the 10-20 EEG system where the abnormal wave was observed on a sleep EEG. Two mA of tDCS was applied 20 minutes a day, five days a week for two weeks. During a two-month period after treatment termination, only six seizure attacks occurred, and the duration of each seizure episode also decreased. tDCS was applied under the same conditions for another two weeks. For two months after the second treatment session, only one seizure attack occurred, and it showed great improvement compared to the eight seizure attacks per month before the tDCS treatment. The medications were not changed, and there were no notable side effects that were caused by tDCS.
Citations
Method: Subjects were 89 patients with aneurysmal SAH who were undergone craniotomy and clipping of aneurysm. We evaluated the relationship between the incidence of seizure and the use of antiepileptic drug. And we sought to identify putative risk factors associated with seizure after SAH.
Results: Ten patients (11.2%) had one or more epileptic seizures. One patient had only preoperative seizure and nine patients including four patients who had prehospital or preoperative seizure developed seizures during follow up after surgery. All but two of these nine patients were receiving an antiepileptic drug at the time of seizure. Blood samples for antiepileptic drug plasma levels were taken more than once in 81 patients. Of total blood samples, therapeutic serum levels were achieved in 73.5% of the seizure group and in 68.6% of the no-seizure group (p＞0.05). Drug- related side effects occurred in 22.5% (20/89). Significant risk factors for seizure included early seizure (4/5) and rebleeding after surgical clipping of aneurysm (2/3).
Conclusion: We think that the preventive effect of anticonvulsant drug on late seizure is unclear in patients with aneurysmal SAH. (J Korean Acad Rehab Med 2003; 27: 840-844)
Method: We retrospectively studied 81 patients with postinfarction seizures to determine the clinical features (onset, type of seizure, etc.) with their clinical recordings, electroencephalographic (EEG), and computed tomographic (CT) or magnetic resonance imaging (MRI) findings.
Results: Patients comprised 49 men and 32 women with their ages ranged from 31 to 87 (mean 64.7) years. After cerebral infarction, 31 patients experienced seizures within 2 weeks and 50 patients more than 2 weeks. Generalized tonic-clonic and simple partial seizures were the most common type of seizure. 40 patients showed focal slowing on EEG. The most common location of the cerebral infarction was cortical area and frequently involved lobes were frontal and temporal lobes. The recurrent seizure was not associated with seizure onset duration, seizure type, EEG finding, or location of infarction. The size of cerebral infarction was significantly associated with recurrent seizure but not associated with first-attack seizure.
Conclusion: This results would be helpful for prevention and treatment of postinfarction seizures. (J Korean Acad Rehab Med 2003; 27: 1-6)
Objective: To investigate the effect of epilepsy and neonatal seizure on development in children with cerebral palsy (CP) or delayed development (DD).
Method: The subjects were 135 patients with CP or DD. Development was evaluated by Bayley Scale of Infant Development II (BSID II). Epilepsy was diagnosed on the base of clinical features, past history and electroencephalography.
Results: The incidence of epilepsy was 18.4% in CP, and 37.8% in DD. Spastic quadriplegia of CP has the highest incidence of epilepsy (38.4%). First seizure attack was occurred before 6 months old of age in 66.7% of CP with epilepsy and in 64.3% of DD with epilepsy. The prevailing type of epilepsy was generalized seizure in DD (57.1%), partial seizure in CP (50.0%). The group with epilepsy had lower psychomotor and mental development quotient on BSID II than the group without epilesy (p＜0.05). Polytherapy was more used to control epilepsy than monotherapy. Valproate (50.0%), phenobarbital (37.5%), carbamazepine (31.3%) were commonly used drugs for controlling epilepsy.
Conclusion: The epilpesy has a negative effect on psychomotor and mental development in the children with CP or DD.
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