Journal of the Japan Epilepsy Society

Original Articles

Treatment with Lidocaine for Status Epilepticus in Low-Birth-Weight Infants and Neonates

Hitoshi Yamamoto, Takashi Yoda, Hiroshi Murakami, Noriko Kamiyama, Nor ...

2004 Volume 22 Issue 2 Pages 96-100
Published: 2004
Released on J-STAGE: August 31, 2004

DOIhttps://doi.org/10.3805/jjes.22.96

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The efficacy of lidocaine (Lid) for status epileptics in low-birth-weight infants and neonates was studied retrospectively. Intravenous drip infusions of Lid (2-4mg/kg/hr) were performed in nine patients who had intractable seizures refractory to treatment with conventional anti-convulsants, such as diazepam, phenobarbital, or phenytoin. The gestational ages of patients were between 25 and 40 weeks and the birth-weights were 580 to 3,200 grams. The administration of Lid was very effective in five patients (56%) with hypoxic ischemic encephalopathy except one, and was not effective in four patients with intracranial hemorrhage, lissencephaly, or chromosomal abnormality. Cardiac arrhythmia was noted in one of the five cases three hours after Lid administration and the therapy was discontinued. The blood concentrations of Lid twenty-four hours after administration were 3.3 to 5.5μg/ml. Continuous intravenous Lid appeared effective in premature infants and neonates with intractable seizures.

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Three Infant Cases of Smad Interacting Protein 1 (SIP1) Abnormalities with Epilepsy

Kiyokuni Miura, Toshiyuki Kumagai, Yoshiko Suzuki, Akiko Matsumoto, Ju ...

2004 Volume 22 Issue 2 Pages 101-107
Published: 2004
Released on J-STAGE: August 31, 2004

DOIhttps://doi.org/10.3805/jjes.22.101

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Three infants (two males and one female) with Smad interacting protein 1 (SIP1) abnormalities characterized by severe mental retardation, delayed motor development and distinct facial features are presented. All 3 patients had epilepsy, and 1 had Hirschsprung disease. The patients developed complex partial seizures at the age of 3 years, 4 years 1 month and 2 years 1 month, respectively. The main clinical symptoms of complex partial seizures in 2 patients were nausea and/or vomiting. In 2 patients, epilepsy was preceded by febrile convulsion. All three had status epilepticus with or without fever. Enlargement of the inferior horn of the lateral ventricle and hypoplasia of the corpus callosum were detected by MRI in two patients. Typical EEGs in these patients were normal at first, followed by presentation of focal spikes, and finally continuous bilateral frontal dominant diffuse high voltage slow waves or spike-and-wave complexes at age 2 years 10 months, 5 years 3 months and 3 years 3 months, respectively. When we encounter a patient with characteristic face, mental retardation, complex partial seizures and specific EEG findings, we should consider a diagnosis of SIP1 abnormalities and follow the patients carefully, bearing in mind the possibility of status epilepticus.

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The Effects of Atypical Neuroleptics on Amygdala Kindling in Rats

Shinji Yoshimune

2004 Volume 22 Issue 2 Pages 108-115
Published: 2004
Released on J-STAGE: August 31, 2004

DOIhttps://doi.org/10.3805/jjes.22.108

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Although atypical antipsychotics are good choice for the treatment of epileptic psychosis, little is known about their effects on epileptic seizures except that they typically lower seizure -triggering threshold. The present study examined effects of both atypical and typical antipsychotics on fully kindled seizures in the rat. High dose of clozapine (50 mg/kg) reduced seizure stage scores and afterdischarge durations. High dose of olanzapine (20mg/kg) also shortened afterdischarge durations. As for other drugs, only quetia-pine showed elongation of forelimb clonus latency at high dose. Any other drugs, namely haloperidol, zotepine, risperidone and perospirone, did not show significant effects. It is well known that some antipsychotics reduce afterdischarge -triggering threshold. The present results, however, indicated that clozapine and olanzapine rather inhibit the duration or secondary generalization of amygdala -kindled seizures once seizures are provoked. The mechanism underlying the effects of clozapine and olanzapine still remains to be clarified.

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