Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
Volume 30, Issue 3
Displaying 1-5 of 5 articles from this issue
Editorial
Original Article
  • Etsushi Kato, Yukari Tadokoro, Tomohiro Oshima, Kousuke Kanemoto
    2013 Volume 30 Issue 3 Pages 487-495
    Published: 2013
    Released on J-STAGE: February 01, 2013
    JOURNAL RESTRICTED ACCESS
    We investigated the effects, adverse effects, and rate of discontinuation of seizures after 3 months of administration of levetiracetam in 119 patients with epilepsy who visited the Department of Neuropsychiatry, Aichi Medical University and Aichi Medical University Medical Clinic. The rate of discontinuation was 10.1%. In comparing rates of seizure frequency between the 3 months before and after administration and excluding patients who discontinued levetiracetam, disappearance of seizure occurred in 31.8%, <50% reduction in seizures in 71.0%, no change in 23.4%, and increase in seizures in 5.6% of patients. Adverse effects occurred in 24.4% of patients and included drowsiness, fatigue, irritability, dizziness, cold symptoms, and insomnia. Follow-up studies were conducted in 62 patients at 6 months and in 49 patients at 1 year. There were no cases of discontinuation caused by adverse effects after 3 months of administration, five cases of self-discontinuation, and one case of discontinuation due to insufficient effect. The continuation rate after 1 year was 76.6%. This study revealed that levetiracetam had a high rate of seizure inhibition and high tolerability and that levetiracetam was a very effective agent in the treatment of epilepsy.
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Case Reports
  • Takahiro Mitsueda, Masako Daifu, Takahiro Utsumi, Yoshifumi Nakaya, Yu ...
    2013 Volume 30 Issue 3 Pages 496-503
    Published: 2013
    Released on J-STAGE: February 01, 2013
    JOURNAL RESTRICTED ACCESS
    MRI could visualize epileptic foci, but few studies successfully delineated their propagation. We reported two patients with status epilepticus showing transient symmetrical high intensity area (HIA) by diffusion weighed image (DWI) in each hemisphere. The first patient was a 52-y-o woman, having treated for schizophrenia. She had generalized tonic-clonic seizure. Her generalized seizures frequently occurred up to eight times per hour for three days. Her EEG during status showed BIPLEDs. Her MRI study indicated symmetrical HIAs in the bilateral frontal lobes. The second patient was a 61-y-o man admitted for loss of consciousness. After generalized tonic seizure occurred delirium sustained for several hours. His EEG showed continuous slow waves regional in the right front-temporal area. His MRI study indicated HIAs in the bilateral frontal lobes and an old lobar infarction in the right temporal lobe. It suggested that his seizure arose from the right temporal lobe with secondarily generalization or propagation to the bilateral frontal lobes. The HIAs by DWI observed in both patients finally disappeared. EEGs became normal after anticonvulsant treatment. These transient abnormal MRI findings possibly reflected both seizure foci and the propagated areas via corpus callosum caused by excessive cellular excitation.
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  • Manami Akasaka, Atsushi Kamei, Nami Soga, Yukiko Toya, Shuji Kusano, M ...
    2013 Volume 30 Issue 3 Pages 504-510
    Published: 2013
    Released on J-STAGE: February 01, 2013
    JOURNAL RESTRICTED ACCESS
    The patient was a 4-year-11-month-old boy with epilepsy with myoclonic astatic seizures. At the age of 3 years and 4 months, he began to have epilepsy, for which valproic acid, clonazepam, and carbamazepine were ineffective, and ethosuximide (ESM) and zonisamide were effective. He was admitted to a local hospital because of protein-losing gastroenteropathy at age 4 years and 2 months. Although he improved with methylprednisolone pulse therapy and intravenous immunoglobulin, he was transferred to our hospital for control of his epileptic seizures, for which ethyl loflazepate was effective. Subsequently, at the age of 4 years and 7 months, he developed thrombocytopenia, followed by aplastic anemia. Although ESM was withdrawn, his bone marrow did not recover. After methylprednisolone pulse therapy and the immunosuppressant cyclosporine, he recovered completely 4 months later. The causative drug was confirmed to be ESM because it was found to inhibit the growth of granulocyte macrophage progenitor cells on an in vitro colony assay, and no drug other than ESM was changed in the acute and recovery phases. Since antinuclear antibody and anti-histone antibody were positive, an immune-mediated, drug adverse reaction was considered to have induced the aplastic anemia. A similar drug adverse reaction was also suspected to be the mechanism of the protein-losing gastroenteropathy.
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  • Yasuko Sawai, Nobuyuki Maruyama, Tohru Hoshida
    2013 Volume 30 Issue 3 Pages 511-516
    Published: 2013
    Released on J-STAGE: February 01, 2013
    JOURNAL RESTRICTED ACCESS
    Various cases of eating-induced epilepsy have been reported. A 7-year-old male 5 p-syndrome patient with symptomatic generalized epilepsy was admitted and long-term video electroencephalography monitoring was performed. He showed atypical absence, myoclonus, non-periodic and periodic spasms. His periodic spasms were characteristic because they were induced by eating. MRI showed slight hypoplasty of the left frontal operculum. The abnormal opercular formation observed in this case is consistent with the findings observed in previously reported cases of eating epilepsy. Furthermore, white matter degeneration in the pons and midbrain were suspected on the basis of the MRI findings. The brain stem degeneration observed in this case may be associated with the development of spasms.
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