Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
Volume 20, Issue 3
Displaying 1-4 of 4 articles from this issue
Original Article
  • Tomihiro Imai, Hiroyuki Matsumoto
    Article type: Original Article
    2002 Volume 20 Issue 3 Pages 159-166
    Published: 2002
    Released on J-STAGE: December 07, 2002
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    Posturography was conducted in four epileptic patients with blood antiepileptic drug (AED) levels within standard therapeutic ranges. Electronystagmograms (ENGs) were also recorded to examine any drug-induced oculomotor dysfunction. EEG, brain CT and MRI showed no specific abnormalities related to dizziness. However, posturography revealed an abnormal body sway, including increased area of sway and Romberg ratio, even when ataxia was not detected in routine neurologic examination. Posturography was abnormal only when the blood levels of phenytoin or carbamazepine were relatively elevated, and normalized when the blood levels decreased. The results indicated that the dizziness reflected mild, transient cerebellar ataxia related to AED doses. ENGs demonstrated no positive correlation between dizziness and oculomotor dysfunction. We conclude that posturography is clinically useful for quantitative evaluation of dizziness that may occur in epileptic patients on long-term AED treatment.
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Case Reports
  • Ichiro Kohira, Yotaro Ninomiya, Akio Takeda, Norihiko Obata
    Article type: Case Report
    2002 Volume 20 Issue 3 Pages 167-173
    Published: 2002
    Released on J-STAGE: December 07, 2002
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    We report a case of a 35-year-old woman who was admitted to our institution in status epilepticus. She had been epileptic for 34 years, suffering from episodes of both focal and generalized convulsion. On admission she was having facial motor seizures which secondarily developed to tonic-clonic convulsions of the right arm and leg every 2 minutes. She had already been treated with intravenous phenytoin 750mg and acetazolamide 500mg. At this point she was treated with intravenous propofol 200mg and midazolam 10mg, which completely suppressed the seizures. And then, she was intubated and ventilated with intravenous midazolam infusion. Her right side tonic-clonic convulsions were aborted, but her facial motor seizures continued over the next two days. So, we administered propofol infusion, which completely suppressed the remaining seizures. Seventeen days after the first successful treatment, she again developed status epilepticus. Treatment with intravenous propofol alone quickly ceased the second episode of status epilepticus. The second episode of status epilepticus was treated completely with propofol alone. This case report suggests that propofol may be useful for treatment of refractory status epilepticus which is uncontrolled by intravenous phenytoin and midazolam.
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  • Takato Morioka, Tadao Kawamura, Kimiko Fukui, Eiko Hirokawa, Shunji Ni ...
    Article type: Case Report
    2002 Volume 20 Issue 3 Pages 174-179
    Published: 2002
    Released on J-STAGE: December 07, 2002
    JOURNAL RESTRICTED ACCESS
    A 28-year-old female with factitious disorder “Münchhausen syndrome” after left anterior temporal lobectomy for intractable temporal lobe epilepsy was reported. Two years after left anterior temporal lobectomy and 6 months after additional hippocampectomy, she factitiously opened her operative wound in the left temporal region, pretending that maladaption of the wound was attributed to the head trauma during her “epileptic seizures (pseudoseizures)”. Furthermore, she mixed her blood with her urine to forge hematuria, injured her vagina to forge gynecological disease, and performed bloodletting to forge anemia. This abnormal psychological process could be interpreted as one of the manifestation of postoperative distress conditions, in which the reversed rehabilitation process of learning to live without handicap of epilepsy was failed. In considering the surgical indication for intractable epilepsy and at the postoperative follow-up, postoperative development of Münchhausen syndrome should be noted.
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  • Junko Tanaka, Isao Yoshida, Takashi Mimaki
    Article type: Case Report
    2002 Volume 20 Issue 3 Pages 180-184
    Published: 2002
    Released on J-STAGE: December 07, 2002
    JOURNAL RESTRICTED ACCESS
    We reported a case with oliguria and edema induced by clobazam (CLB). He received the treatment with valproic acid and phenytoin to improve an intractable generalized epilepsy with a cerebral palsy and a severe mental retardation. At 38 years of age, he started to have an additional treatment with CLB (10mg/day). His convulsions successively disappeared, however, one month later, oliguria and edema were manifested in his lower extremities. One week after discontinuation of CLB, oliguria and edema disappeared. Six month later, because his convulsions were frequently observed, CLB was re-administrated in a dose of 2mg/day and its dose was gradually increased. At the dose of 7.5mg/day his convulsions significantly diminished but edema was manifested again. Two weeks after discontinuation of CLB, his edema disappeared again. These observations suggested the possibility that the treatment with CLB may induce oliguria and edema.
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