Journal of the Japan Epilepsy Society
Online ISSN : 1347-5509
Print ISSN : 0912-0890
ISSN-L : 0912-0890
Current issue
Displaying 1-5 of 5 articles from this issue
Editorial
Original Articles
  • Hazuki Nonoyama, Kenjiro Kikuchi, Atsuro Daida, Yuko Hirata, Ryuki Mat ...
    2022 Volume 40 Issue 1 Pages 2-9
    Published: June 30, 2022
    Released on J-STAGE: July 04, 2022
    JOURNAL RESTRICTED ACCESS

    Post-encephalitic epilepsy is associated with intractable seizures that necessitate anti-seizure medications (ASMs) polytherapy. We retrospectively investigated the efficacy of ASMs in five patients with epilepsy that manifested after autoimmune-mediated encephalitis (AIME). "Effectiveness" was defined as >50% reduction in seizure frequency. The median follow-up duration was 2 years. The median age of AIME onset was 7 years, and epilepsy onset ranged between 1 and 116 days. Four of five patients had status epilepticus during the acute phase of AIME, and seizures persisted since the acute phase in three of five patients. All patients had focal impaired awareness seizures. Electroencephalography revealed multifocal epileptic discharges, particularly in the frontal and temporal areas, in all patients. With regard to seizure frequency, seizures occurred free in one, monthly in two, weekly in one, and daily in one patient. Lamotrigine was effective in two, lacosamide in one, levetiracetam in one, and perampanel in one patient. Phenobarbital, topiramate, valproate, nitrazepam, and clobazam were ineffective. With regard to adverse effects, levetiracetam led to behavioral issues, and topiramate and nitrazepam caused somnolence. Considering the adverse effects by patients with post-AIME epilepsy, ASMs that activate γ-aminobutyric acid may not be useful medication; however Na-channel antagonists and perampanel seem potentially effective.

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  • Yoji Ikuta, Masahiro Noda
    2022 Volume 40 Issue 1 Pages 10-17
    Published: June 30, 2022
    Released on J-STAGE: July 04, 2022
    JOURNAL RESTRICTED ACCESS

    A diagnosis of epilepsy limits the ability to obtain or renew a driver's license, which can have a significant impact on the daily life of patients with epilepsy of driving age. We have published a guide on "epilepsy and driver's license" on our website. Here, we examined the access to this article page during the first year of its publication to examine ways to collect information from patients. Of the people who accessed this page, 51.5% and 48.5% were men and women, respectively; while 53.7% of viewers were aged 25-44 years. According to region, the access of this page was higher in metropolitan areas. In the search query analysis, the total number of searches including "conceal," "do not declare," "found out," and "false declaration," had 13,193 impressions (7.3% of the total queries), and the click-through rate was high, at 7.7%. This study showed that there were many searches related to false statements. While it is necessary to provide correct information to patients to prevent tragic accidents caused by false confessions, it is also desirable to provide alternative transportation for patients.

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  • Norie Hara, Takuji Nishida, Yukitoshi Takahashi, Yushi Inoue
    2022 Volume 40 Issue 1 Pages 18-27
    Published: June 30, 2022
    Released on J-STAGE: July 04, 2022
    JOURNAL RESTRICTED ACCESS

    To clarify the importance and role of nurses with expertise in epilepsy care in Japan, we conducted interviews and questionnaire surveys with 30 epilepsy nurses certified by two epilepsy centers and 21 nurses working in 16 other regional core institutions for epilepsy. Certified epilepsy nurses have a relatively long experience in epilepsy care, and are engaged in a wide range of activities such as support for psychosocial aspects including family members, enlightenment/ education/ research, and collaboration with multiple professionals, in addition to adequate and safe observation of seizure symptoms. On the other hand, nurses of regional institutions often expressed concerns about response to seizures and EEG monitoring, and expressed positive views on the need of an epilepsy nurse education system and the introduction of a certified epilepsy nurse system. Certified epilepsy nurses have been shown to contribute to promoting epilepsy care and improving the quality of life of patients and their families/ caregivers, which has been proven in the literature. It is important for the entire organization to recognize the significance of fostering epilepsy specialist nurse and provide public support.

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Case Report
  • Hikaru Wakabayashi, Motoki Inaji, Satoka Hashimoto, Taketoshi Maehara
    2022 Volume 40 Issue 1 Pages 28-34
    Published: June 30, 2022
    Released on J-STAGE: July 04, 2022
    JOURNAL RESTRICTED ACCESS

    A 15-year-old right-handed girl presented with a generalized seizure at the age of 14 years, and a cavernous malformation was detected in the lateral left temporal lobe. She was initiated on levetiracetam, although her seizures were poorly controlled and she had weekly impaired awareness seizures. Scalp electroencephalography (EEG) showed independent spikes in the bilateral fronto-temporal regions; however, head MRI showed no hippocampal atrophy, and neuropsychological tests were within normal limits. Therefore, lesionectomy alone was performed with the strategy of prioritizing the functional preservation and treating the patient in two phases when the seizures persisted. Two years after the surgery, the seizures disappeared and the bilateral spikes were not observed on scalp EEG. In the case of temporal lobe epilepsy associated with a cavernous malformation with bilateral EEG abnormalities, seizure control by lesionectomy alone appears to be one of the treatment options for patients with a short duration of the disease.

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