Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
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Volume 27, Issue 1
Displaying 1-6 of 6 articles from this issue
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Editorial
Original Article
  • Usefulness of Topiramate for Childhood Intractable Epilepsy: Comparing by Seizure Type
    Shin-ichiro Hamano, Tomotaka Oritsu, Motoyuki Minamitani, Manabu Tanak ...
    2009 Volume 27 Issue 1 Pages 3-11
    Published: 2009
    Released on J-STAGE: June 30, 2009
    DOIhttps://doi.org/10.3805/jjes.27.3
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    To evaluate the usefulness of topiramate for the treatment of childhood intractable epilepsy, we performed a prospective open label study on 53 children and adolescents aged 0.4-18.6 years (average±SD, 9.2±5.1 years). They had intractable seizures ≥twice a month that persisted despite appropriate usage of ≥two antiepileptic agents. The initial topiramate dose was 1.4±0.7mg/kg and the dosages were titrated to 6.4±4.2mg/kg (average±SD). The responder rate (the rate of patients with ≥50% reduction in seizure frequency) was 25/53 (47.2%) in total. The responder rate in those with generalized seizure was 9/17 (52.9%), and that was compatible with the responder rate in those with partial seizure; 16/36 (44.4%). Fifteen patients had adverse experiences: somnolence occurred in 8 patients, hypohidrosis in 4, drooling, fainting, behavioral disturbance in one, respectively. These adverse effects were mild and disappeared without any other treatment except discontinuation of topiramate. Topiramate seems to be useful for children with generalized seizures as well as those with partial seizures, as adjunctive medication for childhood intractable epilepsy.
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  • Effectiveness of Gabapentin; An Add-on Open-label Multicenter Study
    Yasumichi Koide, Masayoshi Nagao, Katsuyuki Fukushima, Katsuhisa Uruno ...
    2009 Volume 27 Issue 1 Pages 12-21
    Published: 2009
    Released on J-STAGE: June 30, 2009
    DOIhttps://doi.org/10.3805/jjes.27.12
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    An open-label multi-center study was conducted to evaluate the effectiveness of gabapentin between September 2006 to February 2008. The study subjects consisted of 303 patients with various epilepsy and seizure types. More than 50% seizure reduction was obtained in 49 cases (16.2%). This result was almost compatible with those of phase III and long-term trial studies in Japan. The most common adverse effects were sleepiness and dizziness of slight degree, indicating a high tolerability. However, there were some cases with appearance/worsening of myoclonus and status epilepticus.
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  • Linguistic Validation of the Japanese Version of the Quality of Life in Epilepsy Inventory (QOLIE-31-P)
    Yushi Inoue, Dai Inayoshi, Yoshinobu Kasai, Teiichi Onuma, Mutsuo Sasa ...
    2009 Volume 27 Issue 1 Pages 22-32
    Published: 2009
    Released on J-STAGE: June 30, 2009
    DOIhttps://doi.org/10.3805/jjes.27.22
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    Although epilepsy is a disease that seriously affects the quality of life (QOL) of patients, few instruments appropriate for measuring the QOL of epilepsy patients are currently available in Japan. Therefore, QOLIE-31-P, the epilepsy-specific QOL questionnaire for adults that is highly reputed and widely used outside Japan, was translated in Japanese and validated linguistically. During the validation process, ten Japanese patients with epilepsy were asked to fill in the questionnaire and interviewed as to the appropriateness of the expressions used in the translated text. A few expressions had to be amended. Overall, the Japanese version of QOLIE-31-P was found to have content and face validity. The finalized version of QOLIE-31-P is expected to serve as a useful instrument for measuring the QOL in Japanese adults with epilepsy, although its psychometric properties remain to be validated.
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Case Report
  • A Case of Refractory Complex Partial Seizure Status Epilepticus that Dramatically Responded to Clorazepate Dipotassium
    Yuko Shimizu, Hiroshi Sakuma, Kenji Sugai, Yoshiaki Saito, Hirofumi Ko ...
    2009 Volume 27 Issue 1 Pages 33-38
    Published: 2009
    Released on J-STAGE: June 30, 2009
    DOIhttps://doi.org/10.3805/jjes.27.33
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    A six-year-old girl with mental retardation and a history of West syndrome had recurrent episodes of complex partial seizure status epilepticus (CPSE), characterized by decreased consciousness, vacant eyes and head nodding since early childhood. Electroencephalograms during CPSE revealed bursts of rhythmic high-voltage θ waves with fronto-central predominance, and Tc-99m-ECD single-photon emission computed tomography showed increased perfusion in the left frontoparietal areas and the left basal ganglia. Continuous infusion of midazolam was required to abolish CPSE on several occasions. However, the seizures became midazolam dependent, and many antiepileptic drugs did not succeed in allowing midazolam discontinuation. Benzodiazepines such as clonazepam and clobazam also had no benefit. However, clorazepate showed dramatic effectiveness, and she could be weaned off from three months of midazolam infusion with seizure freedom. Clorazepate is known for its efficacy in partial seizures and in epilepsy cases with psychic disturbances. Clorazepate may be an alternative drug for CPSE that is resistant to other antiepileptic agents.
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  • Stiripentol Changes Serum Concentration of Desmethylclobazam -Four Cases with CYP2C19 Polymorphism-
    Yoshinori Noguchi, Nobuyuki Mishima, Yukitoshi Takahashi, Yushi Inoue
    2009 Volume 27 Issue 1 Pages 39-44
    Published: 2009
    Released on J-STAGE: June 30, 2009
    DOIhttps://doi.org/10.3805/jjes.27.39
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    Stiripentol (STP; unapproved in Japan), a drug for severe myoclonic epilepsy in infancy (SMEI), is a strong inhibitor of cytochrome P450 (CYP) 2C19. We compared the level-to-dose-ratio (LDR) of desmethylclobazam (DCLB) derived from clobazam concomitantly used with STP to that without STP in two cases of homozygous extensive metabolizer (hmEM), one case of heterozygous EM (htEM) and one case of poor metabolizer (PM). In two hmEM cases, the LDR was 11 times and 1.7 times higher when combined with STP than without, respectively. In a htEM case, the LDR was 4.8 times higher with STP. In a PM case, the LDR with STP decreased to 60% compared with that without STP; the inhibitory effect was not observed. Because CYP2C19 is involved in the metabolism of several drugs including antiepileptic drugs and also because the ratio of PM in Japanese is as high as 20%, it is recommended to determine CYP2C19 polymorphism beforehand in order to predict possible interactions when using STP.
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