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Volume 32 (2014 - 201･･･
- Issue 3 Pages 509-
- Issue 1 Pages 1-
Volume 32, Issue 3
Displaying 1-8 of 8 articles from this issue
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Editorial
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Yuji Inoue2015 Volume 32 Issue 3 Pages 509-510
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSDownload PDF (137K)
Original Articles
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Kunihiko Araki, Takashi Matsudaira, Hitoshi Ikeda, Keiko Usui, Kiyohit ...2015 Volume 32 Issue 3 Pages 511-518
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSPatients with Down syndrome are now living longer, and the prevalence of late-onset epilepsy among them is increasing. We describe the clinical characteristics of late-onset epilepsy in four middle-aged patients with Down syndrome, including neurophysiologic and neuroimaging findings. The epilepsy was characterized by myoclonus and occasional generalized tonic-clonic seizures with progressive dementia in all patients. In two patients, interictal EEG showed poor background activity with generalized epileptiform discharges, and stimulation of the median nerve elicited giant somatosensory evoked potentials. The EEG showed right frontal slow waves in the first patient and right fronto-temporal sharp transients in the fourth. Neuroimaging revealed cortical and subcortical atrophy in all patients. The seizure types are generalized tonic clonic seizure and myoclonus. Valproic acid was effective in the former, and levetiracetam was effective in the latter, though transiently due to the progressive nature of this disorder. Such adult-onset epilepsy in Down syndrome is being recognized as an unique group, and we need to make a correct diagnosis and select an appropriate therapeutic option.View full abstractDownload PDF (606K) -
Sunao Kaneko, Robert Chan, Tomohiro Nakatsu, Katsumi Yoshida2015 Volume 32 Issue 3 Pages 519-532
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSA prospective, open-label, randomized, multicenter study was conducted to evaluate the efficacy and safety of levetiracetam monotherapy in Japanese patients aged ≥16 years with newly or recently diagnosed epilepsy with partial-onset seizures. Of 71 patients randomized to 1 of 2 treatment groups: response-based titration (1,000 mg/day to 2,000 mg/day) or forced titration (3,000 mg/day) group, 70 (1,000 mg to 2,000 mg/day, n=61; 3,000 mg/day, n=9) were evaluable. The analysis of the primary efficacy variable, 6-month seizure freedom rate in the 1,000 mg/day to 2,000 mg/day group was 73.8% (45/61). In the 3,000 mg/day group, 2/9 (22.2%) patients achieved 6-month seizure freedom. Treatment-emergent adverse events (TEAEs) were reported by 63/71 (88.7%) patients, which consisted of 54/61 (88.5%) in the 1,000 mg/day to 2,000 mg/day group and 9/10 (90.0%) in the 3,000 mg/day group. The most frequently reported TEAEs were nasopharyngitis in 33 patients (46.5%) followed by somnolence in 25 (35.2%), malaise in 8 (11.3%), and dizziness in 7 (9.9%). The safety profile of levetiracetam in monotherapy was similar to that of use in add-on therapy. These data suggest that levetiracetam monotherapy is efficacious and safe in Japanese patients aged #8805;16 years with newly or recently diagnosed partial-onset epilepsy.View full abstractDownload PDF (501K) -
Eri Moriguchi, Toshisaburo Nagai2015 Volume 32 Issue 3 Pages 533-540
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSA questionnaire survey was conducted, involving 106 parents of elementary or junior high school students (aged 6-15) with epilepsy undergoing outpatient treatment, to clarify the statuses of explanations to children about epilepsy and their medication adherence. The older the epileptic child, the more detailed the information they received; however, the name or details of the condition were fully explained in less than 70% of children, even if they were junior high school students. Children in whom seizures were not controlled were provided with significantly more detailed explanations than those in whom they were well controlled (p<0.05). Children's understanding of epilepsy increased with age or through detailed explanations about epilepsy (p<0.05). Seizure or medication management was occasionally inappropriate. These results suggest the necessity for medical professionals to promote appropriate recognition of epilepsy in children and their parents by: discussing methods to explain epilepsy to children in consideration of their ages with their parents; and continuously providing appropriate information to them.View full abstractDownload PDF (269K)
Case Reports
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Shin-ichi Magara, Akio Takahashi, Yoshiaki Saitoh, Eiji Nakagawa, Taka ...2015 Volume 32 Issue 3 Pages 541-547
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSWe report two children with epilepsy due to tumors at medial parietal lobe (MPL). Patient 1 and 2 are right-handed boys, whose MRI showed tumors at right precuneus and posterior cingulate gyrus. They had seizures with tonic posturing resembling supplementary motor area seizures in common, but also experienced various other seizure types. The cortex neighboring the tumor were identified as epileptogenic zones by intracranial EEG evaluation in both patients. All areas of right MPL was resected in patient 1, and anterior right MPL was resected in patient 2. The seizure reduction rates were about 50% in patient 1 and 100% in patient 2. In post-operative evaluation, patient 1 showed remarkable decline in the score of "Block design" in WISC-III and his ability of copying solid figures was very poor, although patient 2 showed no abnormality in WISC-III after resection of MPL. Precuneus has been considered to have a role in visuo-spatial recognition and movement planning and the resection of almost all right MPL presumably had harmful effect for this ability in patient 1, in contrast to the preserved visuo-spatial cognition in patient 2 with spared posterior MPL.View full abstractDownload PDF (771K) -
Eriko Tsukada, Ayano Kimura, Yuichi Kamei, Kazuhiko Segawa, Tomoko Oka ...2015 Volume 32 Issue 3 Pages 548-555
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSUnexpected sudden death in epilepsy is called SUDEP, which is widely noted recently. We report a case with epilepsy manifesting ictal asyatole induced by complex partial seizure, captured by polysomnography. The patient was a 66-years-old women. At 10 years, she began to experience convulsive seizures, which ended at 54 years. At 66 years, behavior of going outside in veranda at night was observed and polysomnography was performed for a diagnosis of parasomnia. Diffuse slow waves of high-voltage following central apnea, then asyatole lasted for 15 seconds. During this episode, she lay on the bed and repeated only eyes-opening and closing. This was considered as ictal asystole induced by complex partial seizure, and her antiepileptic-drugs were adjusted. As this case, we need to note fear of ictal asystle not only during convulsive seizures but also complex partial seizures. Moreover, it is important to set supervison staff, oximetry monitor, ECG and alarm for reduction the risk of SUDEP.View full abstractDownload PDF (797K) -
Tetsuya Miyagi, Yoshiyuki Kondo, Terunori Sano, Tomoko Okamoto, Takehi ...2015 Volume 32 Issue 3 Pages 556-563
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSRasmussen syndrome (RS) is a rare brain disorder leading to refractory seizures, progressive hemispheric cortical atrophy, cognitive dysfunction and unilateral cortical deficits. Most patients with RS have onset of refractory seizures at 2 to 10 years of age, and reports of adult-onset RS are limited. In this report, we present a case of adult-onset RS with refractory aphasic seizures. Despite full medical treatment, left hemispheric atrophy, mild motor aphasia and right hemiparesis continue to progress gradually. We report this case together with discussions.View full abstractDownload PDF (1222K) -
Hideaki Ishibashi, Hiroshi Shigeto, Toshiaki Onitsuka2015 Volume 32 Issue 3 Pages 564-567
Published: January 30, 2015
Released on J-STAGE: February 25, 2015
JOURNAL RESTRICTED ACCESSMyoclonic epilepsy is being increasingly recognized as a late onset complication in middle-aged or elderly patients with Down syndrome, in association with acute cognitive decline or dementia. We report a case of late onset myoclonic epilepsy in Down syndrome (LOMEDS) with acute cognitive decline, aged 45 year-olds. Although her intelligence condition remained poor with one to two-words sentences and difficult in following commands even after treatment, induction of levetiracetam and lamotorigin resulted in rapid, sustained seizure freedom and upgrading social activity with no adverse events. A combination of levetiracetam and lamotorigin appear to be effective for LOMEDS, and could be considered as first line agents for this special condition.View full abstractDownload PDF (364K)
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