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Online ISSN : 1884-7668
Print ISSN : 0029-0831
ISSN-L : 0029-0831
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Volume 46, Issue 5
Displaying 1-8 of 8 articles from this issue
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  • Importance of measuring blood level of lamotrigine for optimum dosing schedule
    Kimio Minagawa, Toshihide Watanabe, Reiki Oyanagi, Shinobu Fukumura
    2014 Volume 46 Issue 5 Pages 345-349
    Published: 2014
    Released on J-STAGE: December 25, 2014
    DOIhttps://doi.org/10.11251/ojjscn.46.345
    JOURNAL FREE ACCESS
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      Objective: It is sometime difficult to achieve effective blood levels of lamotrigine (LTG) by the methods of administration presented in the product labeling (PL). We highlighted the importance of measuring LTG blood levels, and proposed a method of adjusting the optimum dosage of LTG based on the pharmacokinetic interaction. Method: Four types of maintenance dose of LTG were determined whether LTG was administrated in combination with valproate sodium and/or enzyme-inducing antiepileptic drugs or with agents except for them. This method is compared with the method presented in the PL. We exhibited the clinical course of three patients who took LTG according to our method since the blood levels were not elevated enough by the method shown in the PL. Results: The maintenance dosage described in the PL was lower than that in our methods. The blood levels in these three patients were increased enough to be effective after the therapy by our method. Conclusions: Measuring the LTG blood level is important to create an optimum dosing schedule. Since the maintenance doses of LTG presented in PL may be inappropriate, they should be adequately adjusted by reference to the LTG blood level.
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  • Developmental change in facial recognition by premature infants during infancy
    Yukihiko Konishi, Takashi Kusaka, Tomoko Nishida, Kenichi Isobe, Susum ...
    2014 Volume 46 Issue 5 Pages 350-353
    Published: 2014
    Released on J-STAGE: December 25, 2014
    DOIhttps://doi.org/10.11251/ojjscn.46.350
    JOURNAL FREE ACCESS
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      Objective: Premature infants are thought to be at increased risk for developmental disorders. We evaluated facial recognition by premature infants during early infancy, as this ability has been reported to be impaired commonly in developmentally disabled children. Methods: In premature infants and full-term infants at the age of 4 months (4 corrected months for premature infants), visual behaviors while performing facial recognition tasks were determined and analyzed using an eye-tracking system (Tobii T60 manufactured by Tobii Technologics, Sweden). Results: Both types of infants had a preference towards normal facial expressions; however, no preference towards the upper face was observed in premature infants. Conclusions: Our study suggests that facial recognition ability in premature infants may develop differently from that in full-term infants.
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  • West syndrome associated with epileptic negative myoclonus
    Takashi Shibata, Harumi Yoshinaga, Makio Oka, Katsuhiro Kobayashi
    2014 Volume 46 Issue 5 Pages 354-358
    Published: 2014
    Released on J-STAGE: December 25, 2014
    DOIhttps://doi.org/10.11251/ojjscn.46.354
    JOURNAL FREE ACCESS
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      We report a 10-month-old girl who had brief epileptic negative myoclonus during the course of West syndrome. She began to have epileptic spasms in series at the age of 8 months. Video-electroencephalograph (EEG) monitoring revealed that she also had brief epileptic negative myoclonus when she was 10 months old. Brief atonia of limbs occurred in isolation or in a cluster during drowsiness or sleep. The ictal EEG exhibited diffuse polyspikes and waves or diffuse high-voltage slow waves that were overlapped by low-voltage fast waves. 3 to 4 hundred milliseconds of silent periods were observed in the bilateral deltoid electromyograms, which correspond to the EEG patterns.
      The occurrence of other types of seizures, partial seizures in particular, accompanied by epileptic spasms has been fully investigated. This is the first case report of a patient with West syndrome whose coexisting epileptic negative myoclonus was confirmed by a silent electromyogram pattern.
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  • A case of large arteriovenous malformation in the frontal lobe complicating attention-deficit/hyperactivity disorder
    Yukiko Nakamura, Makiko Shimazaki, Yumiko Komatsu, Mami Miwa, Fumio Be ...
    2014 Volume 46 Issue 5 Pages 359-362
    Published: 2014
    Released on J-STAGE: December 25, 2014
    DOIhttps://doi.org/10.11251/ojjscn.46.359
    JOURNAL FREE ACCESS
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      We report a 4-year old boy with a large arteriovenous malformation (AVM) exhibiting attention-deficit hyperactivity disorder (AD/HD). He presented with hyperkinesis at the age of 3 years and jacksonian seizure at 3 years 11 months, when he was diagnosed as AVM by cranial computed tomography. Magnetic resonance imaging revealed an AVM of 6 cm in diameter in the left frontal lobe. After 1 year, the AVM developed a varix, and both were surgically removed. We speculate that the prefrontal area was affected by direct compression from AVM and chronic ischemia due to steal phenomenon. Although AD/HD is rarely caused by parenchymal lesions, such as AVM, physicians should carefully investigate causative lesions.
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  • A case of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episode/Leigh overlap syndrome
    Jun Matsui, Tomoyuki Takano, Fukiko Ryujin, Yuko Anzai, Seiichiro Yosh ...
    2014 Volume 46 Issue 5 Pages 363-366
    Published: 2014
    Released on J-STAGE: December 25, 2014
    DOIhttps://doi.org/10.11251/ojjscn.46.363
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      We experienced a case in which mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) was identified as complications following the onset of Leigh syndrome along with a 10191 T>C mutation of the mitochondrial gene. The case pertains to a 26-year-old woman. The disease appeared when she was 11 years old due to divergent strabismus, at which point a diagnosis of juvenile Leigh syndrome was made. Many infraction images not conforming to the vessel region were observed upon a brain MRI which was performed at 26 years of age, thus leading to her being diagnosed with MELAS as a complication. Upoon bibliographical consideration, it was speculated that the clinical features of MELAS/Leigh overlap syndrome clearly differ from Leigh syndrome in terms of age of onset, symptoms, and prognosis. Pleiotropic genetic factors including heteroplasmy were presumed to be involved in the diverse phenotype of overlap syndrome.
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