The reproducibilities of manual volumetry and measurement using digitizer of the amygdala and the hippocampus (AH) directly on MRI films were studied and compared with those of computer assisted volumetry. Twenty-nine patients with partial epilepsy were studied. Coronal and sagittal planes were taken using various spin echo sequences and spoiled gradient echo techniques. An oblique coronal pulse sequence did not always orient perpendicular to the long axis of the hippocampus. MRI films used in this study were not always taken with same conditions. Images were analyzed on a workstation using a thresholding and tracing method (computer assisted measurement, CAM) in seven patients. Direct volume measurement (DVA) was performed in 17 subjects. A transparent gragh paper delineated in millimeters was overlaid directlyon MRI films. Images were magnified using an image analyzer and each cross-sectional surface area was added in twelve patients (image analyzing assessment, IAA). In this study the AH complex was measured as a single unit to reduce arbitrary decisions in assigning anatomical boundaries. The left to right (L/R) ratio was used in this study. The mean coefficient of variation (CV) s of DVA method in 1.5mm slice thickness and IAA method in 3mm slice thickness were 3.1% and 3.6% respectively. The mean CV of CAM in 1.5mm slice thickness was 4.8%. So these two methods, DVA and IAA, were comparable to the CAM method in reproducibility. The CV of the DVA in 5mm slice thickness was relatively higher (mean 5.6%). These results were comparable to those previously reported in the literature. Even if the conditions of the MRI were different, the L/R ratios of the AH volume in the same patient were highly correlated, r=0.843 in DVA and r=0.877 in IAA. In conclusion, volume assessment of AH complex by using digitizer can be clinically reproducible and useful for preoperative evaluation of patients with epilepsy.

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This study examined the hypothesis of Reynolds that the a total number of seizures before treatment may be a key factor for seizure outcome. Three groups of amygdala kindled rats: the partial kindling group, the kindling group and the overkindling group with 30 stage 5 convulsions were used. After 50 days of stimulus-free intervals, seizure stages reduced in the partial kindling group and the kindling group with a kindled convulsions, while it was unchanged in the kindling group with 10 kindling convulsion. It is suggested that seizure susceptibility may increase after repetition of fully kindled convulsions in standard kindling procedures. In second, Timm score and neuronal density in the hilar polymorphic region of hippocampus were measured in these three kindling groups and control, which received 3Hz stimuli without induction of afterdischarges during the kindling sessions. No difference was found in the distribution of Timm granule between control and the kindling groups. The number of polymorphic neurons in the hilus reduced significantly in the kindling group as compared to control. Timm granule distribution in the over-kindled group increased more than other two kindling groups. It is shown that the mossy-fiber sprouting is not essential for the seizure development in amygdala kindling. It is also suggested that cell loss in the hilus may occur prior to the mossy fiber sprouting in the amygdala kindling.

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We investigated a prognosis of epilepsy on one hundred and thirty one severely mentally and physically handicapped cases. Some cases got seizure control near adolescence. On the other hand most of the cases could not get seizure control throughout their courses.
On the controlled group, main diagnosis was cerebral palsy, especially with spastic diplegia and athetosis. Many cases did not have the past history of brain damage. Main type of seizures was generalized tonic clonic seizure.
On the uncontrolled group, main diagnosis was cerebral palsy with severe spastic quadriplegia, which were caused during peri-or postnatal period. Types of the seizures were constituted a characteristic feature of mixed seizure, myoclonic seizure and atonic seizure, and classification of epilepsy was characterized of undetermined epilepsy.

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A 78-year-old man developed simple partial seizures after right occipital visual cortex infarction which was found by CT, MRI, had been recurrent for a period of four years.
He complained of sudden occurrence of visual elementary epileptic seizures consisting of complex visual hallucinations: laughing dogs or a colored flower garden in his left hemifield. An interictal EEG showed sharp-and-slow like activity in the left or right occipital area. VEP showed disturbances of function of the right occipital visual cortex. These complex visual hallucinations were epileptic in origin, because the images were usually silent and brief, but recurrent.
Carbamazepine was effective for treating this simple partial seizure. These symptoms may be of occipital lobe origin, and the lesions of temporal and parietal lobes were also implicatied.

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We report a case of unusual epileptic seizures caused by cerebral venous angioma. A 25-year-old woman had suffered from pharmacoresistant seizures for 19 years. Her attacks began with a tingling sensation in the sole of the left foot and continued with muscular weakness of the left foot for several hours. This sensation suddenly marched from the sole to the thigh of the left leg, and was followed by tonic-clonic movements in the four extremities. Consciousness was preserved during the seizures. Neurological examination revealed no abnormality except for weakness of the left gastrocnemius muscular strenght. After intravenous administration of gadolinium, brain MRI showed strong enhancement of the tubular structures, which extended from the right parietal lobe to the ventricular wall. Contrast angiography revealed a venous angioma in the right parietal lobe. IMP-SPECT disclosed decreased cerebral blood flow in the area adjacent to the venous angioma. An EEG recording demonstrated sharp waves at Cz and Pz at interictal periods, and diffuse spike rhythms followed by a 7-Hz diffuse spike and wave complexes during the tonic-clonic seizures.
This series of seizures began with localized somatosensory and paralytic seizures caused by the venous angioma, often leading to sensory Jacksonian march and finally to what appeared to be generalized tonic-clonic convulsion. We considered that the seizure discharges spread through the Rolandic sensory strip and to the supplementary motor seizure which involves all of the four extremities with preserved consciousness.

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