Clinical characteristics of 10 patients we experienced in addition to 64 patients thus far reported in literature having reflex seizures induced by non-verbal higher cerebral activities were summarized as follows: 1) onset age at around 14, 2) clinical seizures of generalized nature, especially characterized by myoclonic jerks involving arms occasionally combined with or evolving to generalized convulsions, 3) generalized epileptic discharges predominating in the central area activated almost exclusively by posing nonverbal neuropsychological tasks, 4) the precipitating factors include a combination of complicated processes of sequential spatial thinking and voluntary motor activities (including ideation of the voluntary acts) involving fingers and/or arms such as: calculation, drawing, construction, writing, game playing, complex finger manipulation. 5) concentration of attention and stress associated with thinking and voluntary acts were facilitating factor.
The transcoding processes of thinking into voluntary acts may be affected in this type of idiopathic reflex epilepsy. The rarity of language-induced epilepsy including reading epilepsy and conversely the relatively high incidence of non-verbally induced epilepsy in Japanese population will require further studies on a transcultural and linguistic basis.

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The effect of intracarotid injection of sodium amobarbital on the depth EEGs of the hippocampus was studied in 12 patients with intractable temporal lobe epilepsy. All patients in this series were diagnosed as having an epileptogenic focus mainly in a unilateral hippocampus. The number of epileptic paroxysms appearing in depth EEGs for 1 minute before and after injection of amobarbital was counted and analysed.
The number of paroxysms in the hippocampus on the injection side significantly (p<0.01) increased by administration of amobarbital irrespective of lateralization of epileptogenic focus. The rate of increase of paroxysms in the epileptogenic hippocampus was compared with that in the hippocampus without epileptogenicity, but there was no statistically significant difference.
The paroxysms in the hippocampus on the opposite side of the injection significantly (p<0.05) increased by amobarbital administration, only when the hippocampus was epileptogenic. The analysis of the change in depth EEGs in the hippocampus on the opposite side of the injection was therefore considered to be helpful to some extent for determining the lateralization of epileptogenicity.

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We measured the platelet count (Plt, mean platelet volume (MPV), platelet distribution width (PDW), platletcrit (Pct), RBC distribution width (RDW) and serum antiepileptic drug levels in 152 outpatients attending our neurology clinic (45 patients receiving VPA monotherapy, 34 receiving PB monotherapy, 13 CBZ monotherapy, 49 nonmedicated), and obtained MPV nomograms.
In patients given VPA monotherapy, we recognized the following features:
1) Statistically significant (p<0.01) decrease of Plt.
2) Statistically significant (p<0.01) increase of MPV.
3) Deviation of MPV nomogram.
There was no correlation between Plt, MPV or serum level and the duration of VPA medication. PDW and Pct showed no change.
In patients given PB and CBZ monotherapy, there was no change in Plt, MPV, PDW, Pct or the MPV nomogram.

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In order to examine the correlation between serum levels of carbamazepine-10, 11-epoxide (CBZE) and side-effects in epileptic patients, serum levels of carbamazepine (CBZ) and CBZE were measured simultaneously by high performance liquid chromatography. Subjects consisted of 24 patients (36 samples) with side-effects of neurological disturbances (side-effects group) and 46 patients (74 samples) without side-effects (no side-effects group).
Results were as follows:
1) The mean serum level of CBZE in the side-effects group was significantly higher than that of the no side-effects group. 2) As for the population mean of serum levels of CBZE, 95% confidence intervals were 2.19<μ<2.71 in the side-effects group and 1.04<μ<1.27 in the no side-effects group, respectively. 3) In all samples in the no side-effects group, serum levels of CBZE were under 2.2μg/ml. 4) In 18 of 33 samples in the side-effects group, serum levels of CBZE were high, ranged from 2.2 to 4.5μg/ml, while serum levels of CBZ and phenytoin were within the therapeutic range. 5) As for 2 patients in the side-effects group whose serum levels of CBZ and CBZE were examined chronologically, the serum levels of CBZE increased at the time side effects appeared, although the levels of CBZ were within the therapeutic range.
These results suggest a positive correlation between the serum levels above 2.2μg/ml of CBZE and the side-effects.

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The effecs of alcohol intake on epileptic seizures still remained unclear. Here we report the effects of alcohol on the kindled seizures from amygdaloid complex which are established as a model of secondarily generalized seizures. Alcohol (0.5-2g/kg/day i. p. for 8 days) dosage-dependently depressed the seizure stages (classified by Racine) and shortened the duration of the afterdischarge of the kindled rats. A low dosage of alcohol (0.25g/kg/day i. p.), however, elevated the final electrical threshold (FET). After the pretreatment for 8 days by a high dosage (2g/kg/day/i. p.), FET was increased only the first day. These effects of alcohol on the kindling may be due to alcohol function depressing the GABA actions at the focal site.

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Regional blood flow in epileptic focus was measured intraoperatively by laser blood perfusion monitor in 5 patients with medically refractory post-traumatic epilepsy.
In order to determine the precise localization of epileptic foci, electro-corticogram was recorded using a newly devised multi-electrodes which can be easily fixed to surface the brain cortex only by surface tension of physical saline dripped on the electrodes and the cortical surface.
The regional blood flow in the epiletic focus ranged 40 to 58ml/100ml/min, mean value was 52.2ml/100ml/min. that decreasd up to 30% as compared with the mean value of 76.4ml/100ml/min in the normal brain cortex. These amount of blood flow, however, were not related to the epileptic activities on the electocorticogram. Whereas, the blood flow showed 38.8ml/100ml/min in the gliotic area without any spike activity. These findings could support the fact that interictal measurements by single photon emission computed tomography (SPECT) in patients with focal epilepsies demonstrated a regional hypoperfusion in 50-75% of patients.

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Magnetic resonance imaging (MRI) study was performed in 20 patients with intractable temporal lobe epilepsy. Twelve patients showed abnormalities consisting of an increased T2-weighted singal confined to a unilateral small hippocampus. These findings are compatible with mesial temporal sclerosis. Axial Ti-, T2-weighted and coronal T2-weighted images were indispensable to identify mesial temporal sclerosis. A high T2-weighted signal was observed on the right hippocampus of normal size in four patients. Three patients had MRI abnormalities considered to be foreign tissue lesions. Only one had no MRI abnormalities. These results indicate that MRI is a sensitive technique for detecting mesial temporal sclerosis, foreign tissue lesions and other lesions in patients with intractable temporal lobe epilepsy.
The history of prolonged childhood convulsions (more than 30 minutes) was observed only in the patients with MRI abnormalities suggesting mesial temporal sclerosis. These results suggest that mesial temporal sclerosis may be a cause of the temporal lobe epilepsy rather than a result of repeated epileptic seizures.

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Many kinds of studies were performed about liferelating factors in children with epilepsy through questionnaires to parents, teachers and doctors.
The purpose of this study was to find the differences between the school lives of children with epilepsy since 12 years ago up to the present by means of a teacher's point of view by questionnaires. A questionnaire was sent to 1, 335 teachers in 1990;(1, 040 teachers in 1978) in all elementary and junior high schools, and in all special municipal schools in Yokohama. Nine hundred and four evaluable answers (68%) were obtained in 1990;(751 answers (72%) in 1978). Small values were the result of the previous study in 1978.
As to the impression of epilepsy, most teachers commented as dangerous; 35%(31%), anxiety; 22%(19%), heredity; 17%(23%). There were teachers who had an opinion on epilepsy as insanity; 4%(9%) and incurable disease; 4%(6%), though they were not many.
The answer to the question; whether epileptic schoolchildren have or do not have a specific form of character (so-called epileptic characteropathy); positive answers decreased to 35% from 53%.
A higher proportion of teachers from the last time (59% from 37%) were informed about the children's illness by their families. But a lower proportion (18% from 9%) of teachers had a poor contact with doctors.
Only 38%(13%) of teachers allowed to join in group tours, and 39% of teachers permitted it with some reservations. The mean of the allowance rate of joining to sports in this study was significantly higher in the allowance of 14% more than in the previous study.
Many requests were presented; 467 subjects from 33% of teachers in 1990 (216 subjects from 24% of teachers in 1978). The most emphasized item (166 from 75) was the alarming failure of communications which could exist between attending doctors, school medical officers and teachers.

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