Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
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Volume 32, Issue 1
Displaying 1-9 of 9 articles from this issue
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Editorial
Original Articles
  • Current Medical Care for Epilepsy Patients during Transition from Child to Adult Health Services in Japan
    Shoji Yoshikawa, Toshiaki Sato, Toshisaburo Nagai
    2014 Volume 32 Issue 1 Pages 3-12
    Published: 2014
    Released on J-STAGE: July 11, 2014
    DOIhttps://doi.org/10.3805/jjes.32.3
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    Most children with epilepsy carry the disorder over to adulthood. However, the status of the medical care transition from childhood to adulthood is unknown in Japan. The study's aim was to clarify the current situation regarding this transition of medical care for people with epilepsy. We conducted a questionnaire survey about the transition from childhood to adult health care services. The subjects were families from a patient advocacy group for children with epilepsy. We analyzed the data of the transition outcomes of 136 parents. The survey's result indicated that almost half of the adul epilepsy patients who developed epilepsy in childhood (under 15 years of age) were receiving medical care for child health-care services. It was suggested that transitional care could assist with independence through increased information and acceptance regarding their disorder. One important transition factor that emerged was the need for individuals to tansfer to an epilepsy specialist. Additionally, participants expressed strong anxieties regarding changed attending physician. Thus, via transitional care, anxieties pertaining to such changes could be decreased through the introduction of an epilepsy specialist and provision of epilepsy management information.
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  • Evaluation of Pharmacokinetics, Safety and Efficacy of Topiramate in Children with Localization-Related Epilepsy
    Yoko Ohtsuka, Hideo Shigematsu, Harumi Yoshinaga, Noriyuki Akasaka, Ei ...
    2014 Volume 32 Issue 1 Pages 13-24
    Published: 2014
    Released on J-STAGE: July 11, 2014
    DOIhttps://doi.org/10.3805/jjes.32.13
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    We evaluated the pharmacokinetics, safety and efficacy of topiramate (TPM) 1 to 9mg/kg/day as an adjunctive therapy to other antiepileptic drug(s) in 27 Japanese children (2 to 15 years old) with symptomatic or cryptogenic localization-related epilepsy. Trough concentrations increased almost dose-dependently within the dose range of 1 to 9mg/kg/day after repeated oral administration of topiramate twice daily. Maximum drug concentration (Cmax) and area under the plasma concentration-time curve (AUC) were approximately 1.5 times higher and approximately 1.8 times larger, respectively, in children not receiving concomitant enzyme-inducing antiepileptic drug(s) than in those concomitantly receiving such drug(s). The major adverse drug reactions were somnolence, decreased blood bicarbonate, decreased appetite, and decreased weight. The median percentage reduction in epileptic seizure rate during the pharmacokinetic study was 41.2%. Pharmacokinetics in Japanese children were almost the same as those reported for a foreign pharmacokinetic study in epileptic children. No adverse drug reactions forcing a discontinuation of treatment were observed.
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  • Changes in Body Mass Index during Topiramate Therapy in Children
    Hideo Enoki, Takuya Yokota, Tohru Okanishi, Ayataka Fujimoto, Takamich ...
    2014 Volume 32 Issue 1 Pages 25-30
    Published: 2014
    Released on J-STAGE: July 11, 2014
    DOIhttps://doi.org/10.3805/jjes.32.25
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    We evaluated the effect of topiramate (TPM) on body constitution in 40 children with epilepsy aged from 1 to 14 years, retrospectively. Individual body mass index (BMI) was transformed to the standard deviation score (SDS), and we derived gender- and age-specific value for each subject. BMI SDS was -0.49±1.80 (mean±SD) at the baseline, -0.92±2.01 at six months and -1.13±2.39 at 12 months. ANOVA revealed a significant reduction in BMI SDS from baseline to follow-up (p=0.0170). From baseline to six months, BMI SDS increased in 12/40 patients (30%) and decreased in 28/40 (70%). We evaluated the effects of gender, age, epileptic syndrome classification, dose of TPM, number of preceding anticonvulsants, concomitance with valproic acid and baseline BMI SDS. None of the factors revealed a significant effect on BMI SDS. In conclusion, BMI SDS is a useful value to evaluate changes in body constitution in children. The growth of children being treated with TPM should be carefully observed.
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Case Report
  • Effectiveness of Add-on Primidone for Refractory Myoclonus Associated with Benign Adult Familial Myoclonus Epilepsy: A Case Report
    Taichi Mogi, Daiki Yoshikawa, Daichi Sone, Yoshiko Murata, Masako Wata ...
    2014 Volume 32 Issue 1 Pages 31-38
    Published: 2014
    Released on J-STAGE: July 11, 2014
    DOIhttps://doi.org/10.3805/jjes.32.31
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    We report a case of refractory tremulous myoclonus associated with benign adult familial myoclonus epilepsy (BAFME), which was controlled by the addition of primidone. A 39 year-old woman had a rich family history of epilepsy and tremulous myoclonus. Tremor in her hand appeared at 17 years of age, and generalized convulsion started at age 24. Epilepsy was diagnosed at age 29. Valproic acid and clonazepam were started, but hand tremor did not improve, and convulsions continued at yearly frequency. At age 36, levetiracetam was added and generalized convulsion disappeared. Therefore after, hand tremor worsened, and tremor in lower limbs and the trunk appeared. She was referred to our hospital at age 39. Detailed examinations led to a definitive diagnosis of BAFME. After primidone was added by referring to the American Academy of Neurology guideline on the treatment of essential tremor, tremulous tremor was controlled. This case suggests that primidone known to be effective for essential tremor may also be expected to control tremulous myoclonus.
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