EpiTrack is a neuropsychological test developed to assess cognitive function in patients with epilepsy. The test mainly measures attentional and executive functions, and can be easily performed in about 15 minutes. In this study, we developed a Japanese version of EpiTrack and examined its reliability and validity. The Japanese version, which also catered to other neuropsychological tests, was administered to 218 healthy subjects (healthy group) and 51 patients with epilepsy (clinical group). The cutoff values (29/30 points) were determined based on the mean and standard deviation of EpiTrack scores and ROC analysis. The percentage of subjects or patients whose EpiTrack score was below the cutoff value was 10.1 % in the healthy group and 54.9 % in the clinical group respectively. EpiTrack scores showed the highest correlation with Kana-hiroi test, which measures attentional and executive functions. For test-retest reliability, Pearson's correlation coefficient was 0.76, indicating adequate reliability. In the clinical group, there was a significant negative correlation between the duration of epilepsy and EpiTrack scores. Thus, the Japanese version of EpiTrack is a reliable and valid test and can be used as a screening test to evaluate cognitive function in epilepsy patients.

Although interest in epilepsy care in Japan is growing, the current performance of epilepsy centers is unclear. To clarify the task required to improve epilepsy care in our country, we analyzed the annual reports of the Japan Epilepsy Center Association (JEPICA) from 2014 to 2020. The number of long-term video electroencephalogram (VEEG) monitoring per epilepsy center showed significant increasing trend. The number of epilepsy surgeries ranged from 900 to 1,100 per year, with a median of 19 to 26 per center, which shows no increasing trend. Compared to the figures reported by the National Association of Epilepsy Centers in the United States, the number of epilepsy centers per population in Japan is less than half, the number of VEEG cases is low, and the number of epilepsy surgeries is estimated to be about 40%. Specialized epilepsy care in Japan is inadequate in terms of the number of epilepsy centers, the number of VEEGs performed, and the number of epilepsy surgeries performed. There are calls to facilitate the referral of patients to specialized facilities.

Corpus callosotomy is considered the most effective procedure for preventing tonic, atonic, and other seizures causing a fall. This study reports a case of a 6-year-old female, diagnosed with trisomy 21 following birth, wherein corpus callosotomy was effective for the treatment of atypical absence status epilepticus. She developed West syndrome at eight months of age. At 5 years, she experienced multiple seizure types, including tonic, myoclonic, and atypical absence seizures. She was hospitalized at 6 years 0 months, because of her inability to walk and difficulty in eating with the increase in atypical absence seizures to more than 100 times a day. The condition was intractable and corpus callosotomy was performed at 6 years and 1 month. The postoperative electroencephalogram revealed generalized spike-wave complexes localized to the right frontal area. Two years have passed since, and her seizures have disappeared. There have been several reports regarding the effects of corpus callosotomy on atypical absence seizures. This case suggests that corpus callosotomy may be a prominent treatment option for intractable atypical absence seizures.

A 23-year-old left-handed woman developed frontal lobe epilepsy at the age of 10 years. Seizure frequency was initially yearly, although it increased to hourly after employment. Focal aware seizures with asymmetrical tonic posturing were frequently induced by somatosensory stimulation using the right fingers. Scalp electroencephalogram (EEG) showed only low voltage fast activity at the vertex area, and brain magnetic resonance imaging (MRI) showed cortical thickness in the left supplementary motor area (SMA). Based on the clinical symptoms and functional brain images, the SMA proper was considered the main epileptogenic zone. Depressive symptoms occurred with increasing seizure frequency, causing her to quit her work. At the age of 23 years, she was brought to the emergency room with a fall injury. After several multidisciplinary collaborations, she underwent placement of chronic subdural electrodes and corticectomy of mainly the left SMA proper 2 months after admission. Histopathology showed focal cortical dysplasia type IIa. She restarted working after surgery without seizures for 3 years. In patients with childhood-onset adolescent and young adult intractable epilepsy, multidisciplinary collaboration from an early stage to discuss future-oriented treatment strategies and address the psychosocial aspects of the disease is important.