Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
Volume 38, Issue 2
Displaying 1-6 of 6 articles from this issue
Editorial
Original Article
  • Yuko Hirata, Shin-ichiro Hamano, Satoru Ikemoto, Kenjiro Kikuchi, Reik ...
    2020 Volume 38 Issue 2 Pages 139-146
    Published: September 30, 2020
    Released on J-STAGE: September 30, 2020
    JOURNAL RESTRICTED ACCESS

    This study is a retrospective investigation of the effects of vigabatrin (VGB) on patients with simultaneous manifestation of epileptic spasms (spasms) and focal seizures. We enrolled 11 patients excluding tuberous sclerosis complex and evaluated the effect of VGB on seizures. The follow-up period was - 1-6.8 years, while the duration of VGB administration was 2 weeks to 1.3 years. Upon the administration of VGB, there was no cessation of spasms in the patients. However, a reduction in focal seizure frequency of more than 50% was observed in 9 patients, with 5 patients becoming seizure-free. VGB was discontinued in 10 patients, including 8 patients who showed more than 50% reduction of focal seizures. Focal seizures in these 8 patients were observed to relapse and/or increase. At final assessment, both seizure types disappeared in only 1 patient and remained uncontrolled in 7 patents. Spasms disappeared in 2 patients, and focal seizures disappeared in 1 patient. VGB demonstrated no efficacy against spasms but showed considerable effect against focal seizures in patients who suffered from both the seizure types simultaneously. Focal seizures relapsed and increased after VGB withdrawal, and the seizures and developmental outcomes were poor. We need to consider treatment strategy, continuity, and re-administration of VGB.

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Case Report
  • Mayumi Hirozane, Satsuki Watanabe, Masako Watanabe
    2020 Volume 38 Issue 2 Pages 147-154
    Published: September 30, 2020
    Released on J-STAGE: September 30, 2020
    JOURNAL RESTRICTED ACCESS

    A patient in his thirties with left temporal lobe epilepsy, who suffered from sentence production deficits and verbal paired associate impairment, benefited from rehabilitation using divergent thinking tasks. He did not suffer from aphasia but presented poor results in examinations using divergent thinking. The tests included the Sentence Forming Test (SFT), the Supplementary Tests for Standard Language Test of Aphasia (SLTA-ST), and the Standard Verbal Paired-Associate tests (S-PA). He also exhibited convergent thinking problem in the naming of low familiarity words in the Test of Lexical Processing in Aphasia. Rehabilitation consisted of one hour with a speech-language therapist and five homework assignments each week. In addition to eight kinds of divergent thinking tasks, we applied facilitating internal motivation theory by responding to his hopes, such as getting a job, and errorless learning to improve his self-esteem. After eight weeks of rehabilitation, his divergent thinking improved but his convergent thinking such as naming did not improve. The patient's scores in the SFT, SLTA-ST, and S-PA improved. We assumed that rehabilitation using divergent thinking tasks would be effective. Internal motivation and errorless learning improved his self-esteem so that he overcame the anxiety of speaking. The patient ultimately found a new job.

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Dissertation
  • Sadao Ichijoh
    2020 Volume 38 Issue 2 Pages 155-164
    Published: September 30, 2020
    Released on J-STAGE: September 30, 2020
    JOURNAL RESTRICTED ACCESS

    The International League Against Epilepsy (ILAE, 1917) presents a revised classification of seizure types. One of the changes includes "partial" i.e., temporal, frontal, parietal, and occipital seizures, that were used in a previous classification, have been grouped together as "focal" seizures. The authors of the second part of the classification (R.S.Fisher et al) mention that epilepsy could be a network disease and not only a symptom of local brain abnormalities, and that seizures could arise in neocortical, thalamocortical, limbic and brainstem networks.

    However, for a visual analysis of scalp voltage topography, a neuronal network and the physical laws of electric field theory ( "volume conduction" ) in the brain should be applied. In the limbic system the hippocampus is considered to be important diagnostically. I think discussion on this classification will be continued.

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