Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
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Volume 28, Issue 1
Displaying 1-4 of 4 articles from this issue
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Editorial
Original Articles
  • Multicenter, Double-Blind, Randomized, Placebo-Controlled Study of Levetiracetam as Add-On Therapy in Japanese Patients with Uncontrolled Partial Seizures
    Kazuichi Yagi, Shigeki Kameyama, Sunao Kaneko, Mitsukuni Murasaki, Tos ...
    2010 Volume 28 Issue 1 Pages 3-16
    Published: 2010
    Released on J-STAGE: July 05, 2010
    DOIhttps://doi.org/10.3805/jjes.28.3
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    A double-blind, randomized, placebo-controlled, parallel group, multicenter study was conducted to evaluate the efficacy and safety of levetiracetam (LEV) for add-on therapy in Japanese patients with uncontrolled partial seizures despite the therapy with existing 1-3 antiepileptic drugs. On analysis of covariance on Loge transformed partial seizure frequency per week over evaluation period as the primary endpoint, percentage reductions over placebo were 20.9% (p<0.001) in LEV treated group (1,000mg/day+3,000mg/day), 18.8% (p=0.006) in 1,000mg/day group and 23.0% (p<0.001) in 3,000mg/day group and the reductions were statistically significant. Five out of 127 patients treated with LEV achieved seizure freedom, while none in the placebo group. Incidences of adverse drug reaction (ADR) during up-titration and evaluation period were 50.0% (35/70) in placebo, 56.9% (41/72) in 1,000mg/day and 54.9% (39/71) in 3,000mg/day group and there was no difference between placebo and LEV groups. The most commonly reported ADRs in LEV were somnolence and dizziness. These data suggest that add-on therapy of LEV is efficacious and safe in Japanese epilepsy patients with uncontrolled partial seizures at the doses of 1,000 and 3,000mg/day.
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  • Questionnaire Survey Regarding the Treatment of New-onset Geriatric Epilepsy -Expert Opinion Study-
    Mitsuhiko Yamano, Naoki Akamatsu, Sadatoshi Tsuji
    2010 Volume 28 Issue 1 Pages 17-23
    Published: 2010
    Released on J-STAGE: July 05, 2010
    DOIhttps://doi.org/10.3805/jjes.28.17
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    In order to clarify the current state of treatment of new-onset geriatric epilepsy in Japan, we conducted a questionnaire survey of Japan Epilepsy Society-certified physicians (clinical specialists). Questions regarded initial epilepsy treatment in elderly patients who either 1) had no preexisting conditions, or 2) were receiving medication for non-epileptic comorbidities. Data were aggregated based on the 2005 US Expert Consensus Guidelines. There were 74 responses. The results demonstrated that the drug of choice for both patient groups in Japan is carbamazepine. These findings differ from the US, where lamotrigine, levetiracetam (LEV), and gabapentin (GBP) are the recommended first-line treatments. However, the new antiepileptic agents LEV and GBP were also highly evaluated by many of the present respondents for use in elderly patients receiving medication for non-epileptic comorbidities, suggesting high expectations regarding the efficacy of these drugs.
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Case Report
  • MECP2 Duplication Syndrome in Male Patients with Severe Mental Retardation and Intractable Epilepsy
    Takashi Saitoh, Shozo Honda, Eiji Nakagawa, Sae Hanai, Hirofumi Komaki ...
    2010 Volume 28 Issue 1 Pages 24-31
    Published: 2010
    Released on J-STAGE: July 05, 2010
    DOIhttps://doi.org/10.3805/jjes.28.24
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    Loss-of-function mutations of MECP2 are known to cause Rett syndrome, which is characterized by mental retardation and stereotyped hand movements in females. Recently, it has been revealed that in males, the duplication of Xq28 including MECP2 caused mental retardation. Here, we present 2 cases of boys with MECP2 duplication syndrome. Patient 1, an 18-year-old boy, showed severe psychomotor retardation in infancy. Epilepsy developed at the age of 4 years and was medically intractable. Callosotomy performed at the age of 13 years resulted in transient improvement. Patient 2, a 16-year-old boy, showed psychomotor retardation along with epilepsy and recurrent respiratory infections since early childhood. The findings of physical examination and laboratory tests were not specific. Array-comparative genomic hybridization of the X chromosome revealed that patients 1 and 2 had duplication of Xq28 including MECP2 in the 0.5Mb and 0.6Mb regions, respectively. Most of the patients with MECP2 duplication show not only mental retardation but also intractable epilepsy. Therefore, MECP2 duplication must be suspected when a male patient presents with symptoms of mental retardation, intractable epilepsy, and recurrent infection.
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