Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
Volume 9, Issue 2
Displaying 1-10 of 10 articles from this issue
  • An Attempt of their Classification as a Function of the Recovery Time of Semantic Memory and Episodic Memory
    Kousuke Kanemoto, Jun Kawasaki, Akira Sengoku, Itsuo Kawai
    1991 Volume 9 Issue 2 Pages 97-104
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    One hundred and eight postictal confusional states following complex partial seizures in twenty two temporal lobe epileptics were examined. The test battery consisted of three questions concerning orientation, seven tasks of confrontation naming, four tasks of kana reading, and three tasks of kanji reading. These questions were given repeatedly until the target words were produced in all the questions. All the verbal reactions were tape-recorded and transcribed into written material. The recorded paraphasias were categorized according to the modified taxonomy of Lecours. The time required for the full recovery of orientation was used as a scale of the episodic memory impairment and that of naming and reading as a scale of the semantic memory impairment. As a result, four different types of postictal neuropsychological states were differentiated. In the first type, the test battery failed to show almost any disturbance of episodic as well as semantic memory. The episodic memory recovered much more slowly than the semantic memory in the second type. In the third type, the semantic memory recovered as slowly as the episodic memory. Patients with a unique constellation of paraphasias characterized by formal nominal paraphasias and neologisms closely related to formal nominal paraphasias constituted the fourth type. The former two types were related to the right temporal dysfunction and the latter two types to the left temporal dysfunction.
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  • Analysis of Ictal Depth EEG
    Kousuke Kanemoto, Akira Sengoku, Etsuko Uemura
    1991 Volume 9 Issue 2 Pages 105-112
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    We analysed recurrent utterances recorded four times during the simultaneous video-EEG monitoring in a candidate for the temporal lobe resection because of intractable temporal lobe epilepsy. The recurrent utterances occured as a manifestation of complex focal seizures and belonged to the type II verbal automatism. The analysis revealed several distinct features of the recurrent utterances: the recurrent utterances did not consist of simple reiteration of the same phrase, but recurred again and again in a variety of combination; neologisms were mixed with the recurring phrases; the verbal automatisms alwa ys ended in the recurring phrases; the staring phrases of verbal automatism were sometimes echolalia of the preceding conversations, which could perseverate during the course of verbal automatism; right hippocampal tonic discharge in depth EEC, electrodes corresponded with the recurrent utterances. These features contradicted Critchley's view of ictal speech manifestation as “tics audibles” and indicated the striking similarity between aphasic recurrent utterrance and the epileptic recurrent utterance.We proposed the disinhibition of the automatic use of words in aphasia and the stimulation of the automatic use of words in verbal automatism as a possible mechanism underlying recurrent utterances.
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  • Akira Sengoku, Jun Kawasaki, Kousuke Kanemoto, Itsuo Kawai
    1991 Volume 9 Issue 2 Pages 117-123
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    Fifty five patients with intractable temporal lobe epilepsy who had complex partial seizures more than once a month over one year despite anti-epileptic drug treatment were treated by monotherapy of phenytoin (PHT). The doses of PHT were increased principally until complex partial seizures were suppressed or toxic manifestations occurred. However, when the seizures are not controlled with over 30μg/ml of plasma concentration of PHT, the monotherapy was regarded as ineffective. As the result, 18 patients were controlled by PHT monotherapy for longer than 2 months at mean concentration of 20.8μg/ml. However, in about half of those patients the seizures were recurred after 6 months. On the other hand, the monotherapy was regarded as ineffective in 37 patients because of occurrence of side effects at mean concentration of 36.8μg/ml or unchanged seizure-frequency. For the ineffective cases with PHT monotherapy, the second drugs were added, and poly-therapy was effective only in one case. For the patients who had accompanied with secondarily generalized tonic-clonic seizures (sGTC) during monotherapy, the poly-therapy were effective for control of sGTC. It is concluded that the high-dose monotherapy of PHT is useful to treat the patients who had intractable temporal lobe epilepsy, and had not accompanied by sGTC.
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  • Comparison of Anticonvulsant Effects Among Indeloxazine Hydrochloride, Phenytoin, Diazepam and Imipramine
    Takehiko Anraku
    1991 Volume 9 Issue 2 Pages 124-131
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    The anticonvulsant effect of indeloxazine was investigated on the kindled seizure from the amygdaloid seizure, an assumed model of secondarily generalized seizures in human. Indeloxazine (0.25-10mg/kg i.p.) dose-dependently depressed the kindled seizure and shortened the evoked amygdaloid afterdischarge. A high dose of indeloxazine (40mg/kg i. p.), however, induced generalized seizures without electrical stimulations. Comparison of the effects of indeloxazine to those of phenytoin, diazepam and imipramine on the kindled seizures revealed that anticonvulsant actions of indeloxazine are similar to those of imipramine, but not to those of phenytoin and diazepam. This result suggests that indeloxazine may exert its action through the monoaminergic system in the brain.
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  • Tetsuya Yamada, Tohru Seki, Satosi Kimiya, Yasuo Tachibana
    1991 Volume 9 Issue 2 Pages 132-140
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    We analyzed 210 mailing answers of questionnaires to the families who have epileptic patients under treatment in out-patient clinics. The age at the survey was 1 year and 3 months up to 38 years (with a mean of 15. 1 years). The results are as follows. I. Q “How did you feel when you were informed that your child had epilepsy?”: “Wanted to cure it by all means.” 82%, “Could not believe it.” 60%, “Felt sorry for the children.” 60%. II. Q “Whether or not the patient was informed that he had epilepsy?” (excluding those who are less than 5 years old and/or mentally retarded): “Informed.” 33%, “accidentally informed” 8%, “Not informed” 44%, “No intention to inform” 15%. Those who were informed were older than those who were not informed. III. “Worries that the families have because of epilepsy.”: “The future of patients” 77%, “Prognosis of the disease” 59%, “Influence upon the siblings” 28%, “Neighbor's and relative's prejudice” 11%. Number of answers selected per cases was smaller in primary generalized epilepsies. IV. Q “Does he have good relationship with school mates?”: Yes 75%, No 25%. V. Q “Whether or not the patient's illness was informed his school?”: “Informed” 47%. A lot of families did not inform it to school.
    The families of epileptic patients have many problems of various kind because of epilepsy.These problems contain not only the conditions of the patients, such as seizure control, but also other conditions, such as influence upon siblings, prejudice of the society for their lifes. And the problems on school are also important for epileptic children.
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  • Kazumasa Otani, Nobuhiko Okamoto, Tetsuzo Tagawa, Yasuyuki Futagi, Hya ...
    1991 Volume 9 Issue 2 Pages 141-146
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    The antiepileptic effect of clorazepate dipotassium (CLP) was studied in 38 children with refractory epilepsy. CLP failed to produce any antiepileptic effects on 19 children with symptomatic generalized epilepsy except for 2 patients who showed a transient decrease in myoclonic seizures or atypical absences. Out of 13 patients with symptomatic partial epilepsy (SPE), long-term (more than 6 months) complete seizure control was obtained in 3 patients, and long-term excellent response (seizure frequency decreased by more than 75%) in 2 patients. Four patients with complete seizure control or excellent response in SPE had motor phenomena often evolving to secondarily generalized tonic-clonic seizures (ps-GTCS). Three patients with automatism obtained no response from CLP. In 6 patients with epilepsy undetermined whether partial or generalized (UDE), the patient with continuous spike-waves during slow wave sleep and 2 patients with generalized tonic-clonic convulsions (GTCC) showed long-term complete seizure control or long-term excellent response. These results suggest that CLP is effective for the control of SPE with convulsive (tonic or clonic) motor phenomena and ps-GTC, or UDE with GTCC.
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  • Toshiyuki Naruto, Masaaki Uno, Akira Aisaka, Tsunekazu Yamano, Morimi ...
    1991 Volume 9 Issue 2 Pages 147-153
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    It is well-known that visual stimulation induces epileptic seizures in some patients. However, the details of its mechanism are so far not clear. In a patient with photosensitive epilepsy, cognitive function was estimated by a method of distinguishing the presented numbers, whether each one was odd or even. It was also evaluated that the cognitive disturbances were due to whether visual stimulation as an inducer of epileptogenic activity or epileptic discharges themselves induced by the stimulation.
    The response time was significantly prolonged when the epileptic discharges were enhanced. On the other hand, the response errors were significantly increased while inducer stimulation were given regardless the incidence of the discharges.
    If the effect of the seizure inducing factor is only the result of excitement in the origin of epileptic discharges, all changes of the brain function during stimulation may depend on paroxysmal discharges. It is conceivable that visual stimulation gives an effect to another abnormal mechanism to activate or inhibit the origin of epileptic discharges.
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  • with Special Reference to Long-term Prognosis and Therapy of Temporal Lobe Epilepsy
    Kazumaru Wada
    1991 Volume 9 Issue 2 Pages 154-160
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    The author studied on the relation of early response in antiepileptic drug therapy, evaluated at the end of the second year of it, to the long-term prognosis of seizure, in 161 cases under observation for 10 to 20 years. A significant correlation was found between the early response and prognosis. Namely, good early response tended to result in favorable prognosis, and vice versa. Particularly, in idiopathic generalized epilepsy, the long-term prognosis was excellent in the cases who had no seizure in the first 2 years. On the other hand, in temporal lobe epilepsy, the prognosis was very poor in the cases with frequent seizures more than once a month in the second year of treatment and in those with organic etiology or with neuropsychiatric complications. In non-temporal lobe epilepsy, it was found that the early response to treatment had a more clear relation to long-term prognosis, compared with other epilepsy types. The author discussed the possibility of prediction of the long-term prognosis at the early stage of the treatment and the therapy of refractory epilepsies.
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  • Hisayoshi Takeshita, Kazuyoshi Matsuda, Kazuhisa Komatsu, Kuninao Ito, ...
    1991 Volume 9 Issue 2 Pages 161-168
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    Bipolar stainless steel electrodes were stereotaxically implanted into the right dorsal hippocampus (CAl) and stainless steel screws were anchored epidurally to both sides of the frontal bone of 9 male Wistar rats. Hippocampal Kindling was completed through daily electrical stimulation at afterdischarge thresholds. The fully kindled rats were exposed to immobilization stress using wire netting for 30 minutes 30 minutes after intraperitoneal injection of 5.5mg/kg of bemegride. Bemegride induced repetitive clonic seizures involving the head, forelimbs and trunk showing cortical rhythmic epileptic discharges lasting a few seconds. Behavioral observation and EEG recordings from the cortex and hippocampus were carried out for 30 minutes before the start of immobilization, for 30 minutes during immobilization, and for 50minutes after release from immobilization.
    Immobilization stress significantly decreased the frequencies of the epileptec seizures and cortical rhythmic epileptic discharges and significantly reduced the duration of the cortical rhythmic discharges in comparison with those during the preceeding non-immobilized period. Frequencies of the epileptic seizures and cortical rhythmic discharges further decreased immediately after release from immobilization, and then increased again. Conversely, frequency of sporadic spikes from the dorsal hippocampus was significantly increased during immobilization stress, and showed transient decrease immediately after release from immobilization followed by increase.
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  • Seiji Koide, Hiroshi Onishi, Masafumi Katayama, Sakae Yamagami, Yukio ...
    1991 Volume 9 Issue 2 Pages 169-172
    Published: October 31, 1991
    Released on J-STAGE: January 25, 2011
    JOURNAL FREE ACCESS
    Biologically active peptide, methionine enkephalin (ME) except cross-reactive substances from methionine enkephalin-like immunoreactivity, was quantified by a technique of high performance liquid chromatography coupled with radioimmunoassay in the brain of El mice (seizure-susceptible strain) to elucidate the relation between seizures and the opioid system. The El mice were divided into El (+) and El (o) depending on whether stimulated or not. The El (+) mice were tossed-up from 28 days after birth, first exhibited abortive seizures at 50 days of age and developed generalized convulsions after 75 days. The ME content in 25-day-old El mice was significantly decreased in the hippocampus and septal area, as compared with the corresponding regions in ddY mice (seizure-nonsusceptible strain; the mother strain of El). This content in both 50-dayold El (+) and El (o) mice was significantly reduced in the septal area and cerebral cortex. It was further shown that the ME content in both 150-day-old El (+) during interictal periods and El (o) mice was markedly decreased in the septal area, cerebral cortex and striatum. The decrease of ME in the El mouse brain was generally compatible with our previous studies concerning the up-regulation of opioid delta receptors in this species. These results suggest that the reduction of endogenous ME could be involved in the pathouenesis of seizures in the El mouse.
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