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Pharmacological Treatment of Epilepsy in Elderly Patients
서종근,조용원,김근태,김동욱,양광익,이순태,변정익,노영주,강경욱,김대영 대한신경과학회 2020 Journal of Clinical Neurology Vol.16 No.4
The incidence and prevalence of epilepsy are highest in elderly people, and the etiologies of epilepsy in the elderly differ from those in other age groups. Moreover, diagnosing and treating epilepsy in elderly people may be challenging due to differences in clinical characteristics and physiological changes associated with aging. This review focuses on the pharmacological treatment of epilepsy in elderly patients.
서종근,김병건,주민경,조수진,정필욱,문희수,김병수,안진영,손종희,정재면,최윤주,문혜진,박성파 대한신경과학회 2022 대한신경과학회지 Vol.40 No.3
Background: Migraine patients have a higher frequency of suicidality than people without migraine. The aim of this study was to identify suicidality and its risk factors in migraine patients. Methods: We enrolled 358 migraine patients from 11 hospitals. We collected data regarding their clinical characteristics and the patients completes the questionnaires. We also interviewed patients with the Mini International Neuropsychiatric Interview (MINI)plus version 5.0.0 to identify their suicidality. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. Results: The frequency of suicidality in migraine patients was 118 (33.0%). Migraine patients with suicidality were more likely to have a major depressive disorder or generalized anxiety disorder than those without suicidality. Among variables, risk factors for suicidality in migraine patients were female (odds ratio [OR], 4.110; 95% confidence interval [CI], 1.55310.878; p=0.004), attack duration (OR, 2.559; 95% CI, 1.2105.413; p=0.011), Patient Health Questionnaire9 (OR, 1.111; 95% CI, 1.0381.189; p=0.002), and Generalized Anxiety Disorder7 (OR, 1.194; 95% CI, 1.1011.294; p<0.001). Conclusions: Suicidality in migraine patients is common. Therefore, clinicians who take care of migraine patients should be concerned about suicidality and its risk factors such as female gender, attack duration, depression or anxiety
특발성 파킨슨병에서 수면의 질, 우울감, 삶의 질 사이의 상호 관계
서종근,강경훈,이호원,박성파 대한수면연구학회 2014 Journal of sleep medicine Vol.11 No.1
경북대학교 의학전문대학원 신경과학교실, 경북대학교 뇌과학연구소 , 경북대학교 의학전문대학원 신경과학교실초록 요약 Objectives: Sleep disorder is common in patients with neurodegenerative diseases. Several studies showed that sleep quality impacts on cognitive function, psychiatric symptoms, and quality of life. The purpose of this study is to evaluate the interrelations of quality of sleep, depressive symptoms, and quality of life in idiopathic Parkinson's disease (IPD). Methods: We enrolled 69 patients with IPD who had visited our clinic. IPD was diagnosed by UK Parkinson's Disease Society brain bank clinical diagnostic criteria. We assessed by Pittsburgh Sleep Quality Index (PSQI), Korean Mini-Mental State Examination (K-MMSE), Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Short Form-36 (SF-36). Results: Poor sleep quality was defined by PSQI score 6 or above. Therefore, 36 patients (52.2%) of subjects had poor sleep quality. There were no significant differences in the demographics. The patients with poor sleep quality showed more cognitive dysfunction and depressive symptoms than those with good sleep quality. The PSQI scores significantly correlated with GDS and SF-36 scores. Also, quality of sleep exerted negative effect on quality of life and quality of life exerted negative effect on depressive symptoms. Conclusions: This study showed that there were significant interrelations among quality of sleep, depressive symptoms, and quality of life. Therefore, it is needed for evaluation and management of sleep disorders to improve quality of life in patients with IPD.
Comparison of Cognitive Effects of Lamotrigine and Oxcarbazepine in Epilepsy Patients
서종근,이다인,황양하,이호원,정두교,서정규,권순학,박성파 대한신경과학회 2007 Journal of Clinical Neurology Vol.3 No.1
Background and Purpose: This study compared the cognitive effects of 1 year of treatment with lamotrigine (LTG) and oxcarbazepine (OXC) in epilepsy patients. Methods: This retrospective study investigated 60 epilepsy patients undergoing neuropsychological tests who were either newly diagnosed or untreated in the preceding 6 months. The cognitive function in 30 patients receiving LTG monotherapy and 30 age-matched patients receiving OXC monotherapy was compared after 1 year. The neuropsychological scores at baseline and all of the epilepsy-relevant variables except seizure type did not differ between the groups. The mean daily dosages of LTG and OXC at 1 year were 93 mg and 825 mg, respectively. Results: The posttreatment list-learning performance was better in the LTG group than in the OXC group (p<0.05). The incidence of cognitive complaints did not differ between the two groups. The list-learning performance and Trail Making Test scores were better in each group after treatment. Conclusions: LTG and OXC monotherapies have similar, slightly beneficial effects on cognitive function, and are probably not harmful.
작은침샘 종양으로 인해 재발한 말초성 편측 안면마비 1예
서종근,김선영,박성파,서정규,이호원 대한임상신경생리학회 2008 Annals of Clinical Neurophysiology Vol.10 No.1
Since the majority of cases with unilateral peripheral facial palsy are idiopathic, radiological studies such as CT or MRI are not usually recommended for further evaluation. We report a patient with peripheral facial palsy caused by minor salivary gland tumor which was demonstrated by appropriate imaging study.
Suicidality and Its Risk Factors in Korean People with Epilepsy: A MEPSY Study
서종근,이장준,조용원,이세진,김지은,문혜진,박성파 대한신경과학회 2015 Journal of Clinical Neurology Vol.11 No.1
Background and Purpose People with epilepsy (PWE) are more likely to experience suicidality, with suicidal ideation and attempts, than people without epilepsy (PWoE). The aims of thepresent study were to determine 1) the characteristics of suicidality in Korean PWE, 2) whetherPWE with suicidality receive psychiatric intervention, and 3) the risk factors for suicidality. Methods Patients who consecutively visited epilepsy clinics at secondary- and tertiary-carehospitals were recruited (n=684), along with age- and sex-matched PWoE (n=229). The presenceof current major depressive disorder (MDD), generalized anxiety disorder (GAD), and/or suicidality was established using the Mini International Neuropsychiatric Interview-Plus Version 5.0.0. The Korean version of the Liverpool Adverse Events Profile (K-LAEP) was applied to detectadverse effects of antiepileptic drugs (AEDs). Results Suicidality was present in 208 (30.4%) of the 684 PWE. The rate of suicidality was 4.6times higher among PWE than PWoE, and 108 (15.7%) PWE had suicidal ideation and had attempted suicide. Among those who had attempted suicide, 40.7% had made at least two attempts.The most common method of suicide attempt was drug overdose (34.9%). Unfortunately, of the 208 PWE with suicidality, 136 (65.4%) did not receive psychiatric intervention. The risk factors for suicidality were MDD [odds ratio (OR)=6.448, 95% confidence interval (CI)=3.739–11.120, p<0.001], GAD (OR=3.561, 95% CI=1.966–6.452, p<0.001), item scores of 3 or 4 on the K-LAEP (OR=2.688, 95% CI=1.647–4.387, p<0.001), and a history of febrile convulsion (OR=2.188, 95% CI=1.318–3.632, p=0.002). Conclusions Suicidality is more prevalent in PWE than in PWoE. Clinicians should monitorpsychiatric disorders and the adverse effects of AEDs in PWE in an attempt to reduce the incidence of suicidal ideation or suicide attempts in this patient population.