초극소 저출생 체중아에서 발생한 Listeria Monocytogenes에 의한 조발형 패혈증 1례

문진화,오성희,문수지,Moon, Jin Hwa,Oh, Sung Hee,Moon, Soo Jee 대한소아감염학회 2000 Pediatric Infection and Vaccine Vol.7 No.2

저자들은 재태기간 26주에 조기 진통으로 분만 후 사망한 초극소 저출생 체중아에서 L. monocytogenes에 의한 패혈증과 이에 의한 사망을 관찰하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Listeria monocytogenes is one of the important causes of neonatal sepsis and listerial neonatal infection manifests in two forms : Early-onset sepsis syndrome, associated with spontaneous abortion, still birth, preterm labor, granulomatosis infantiseptica, respiratory distress, sepsis, hemodynamic compromise and late-onset listerosis mainly associated with meningitis. Cases of neonatal listerosis reported in Korea have been rare and all were full term newborns. We, herein, report a case of early-onset sepsis due to L. monocytogenes in a extremely low birth weight infant who were born in a critical condition and succumbed in the second day of life despite the intensive care.

신생아 패혈증의 원인 및 항생제 감수성

문진화,오성희,김학원,문수지,최태열,Moon, Jin Hwa,Oh, Sung Hee,Kim, Hak Won,Moon, Su Jee,Choi, Tae Yeol 대한소아감염학회 2002 Pediatric Infection and Vaccine Vol.9 No.2

목 적: 본원 신생아실 및 신생아 중환자실에서 10년간 발생한 신생아 패혈증을 조사하여 환아들의 특징, 패혈증의 원인균 및 항생제 감수성의 변화를 파악하고 신생아 패혈증을 치료하는데 도움되고자 하였다. 방 법: 1989년부터 1998년까지의 10년간 본원 신생아실 및 신생아 중환자실에 입원하였던 환아 15,144명에 대해 의무기록을 확인하여 신생아 패혈증으로 진단된 환아를 선별하였다. 조사 기간을 1989년부터 1993년까지(전반기)와 1994년부터 1998 년까지(후반기)로 나누어 패혈증으로 진단된 환아 들의 임상적 특징, 균의 종류와 빈도, 항생제 감수성의 변화 양상을 관찰하였다. 결 과 : 신생아 패혈증은 총 15,144명 중 170명에서 진단되어 1.1%(전반기 91명, 1.2%, 후반기 79명 1.0%)이었으며, 186회(전반기 99회, 후반기 87회)에 걸쳐 200개의 균주(전반기 109균주, 후반기 91균주)가 분리동정 되었다. 평균 발병시기는 생후12.3일로 전반기 8.8일, 후반기 16.3일이었고, 조발형은 전반기 34.7%, 후반기 23.0%로 나타나 전반기에 더 빨리 발병하였다. 분리된 균주는 그람양성균 132회 (66.0%), 그람음성균 60회(30.0%), 진균 8회(4.0%)이었으며, Coagulase negative Staphylococcus(CNS)가 총 69회(34.5%)로 가장 많은 빈도를 나타내었고, Staphylococcus aureus(S. aureus) 36회(18.0%), Klebsiella pneumoniae(K. pneumoniae) 17회(8.5%), Enterococcus 12회(6.0%), Enterobacter cloacae(E. cloacae) 8회(4.0%), Escherichia coli(E. coli) 6회(3.0%), Pseudomonas aeruginosa(P. aeruginasa) 5회(2.5%) 등의 순이었다. 진균으로는 Candida parapsilosis, Candida albicans, Trichosporon pullulans 가 분리되었다. CNS, S. aureus 및 Acinetobacter baumannii(A. baumanii), Candida는 전반기에 비해 후반기에 더 많이 분리 동정되었으며, CNS 및 S. aureus의 methicillin 및 1세대 cephalosporin에 대한 항생제 감수성은 전반기에 비해 후반기에 감소하였고 aminoglycosides에 대한 감수성은 후반기에 증가하였으며, vancomycin 내성균은 분리되지 않았다. K. pneumoniae, Enterococcus, E. coli 및 P. aeruginosa는 전반기에 비해 후반기에 감소하였으며 K. pneumoniae는 1세대 cephalosporin에 대해 전, 후반기 모두 낮은 감수성을 보였고 tobramycin과 gentamicin에는 후반기에 감수성이 증가하였으며 amikacin, ceftriaxone, trimethoprim-sulfamethoxazole에는 전, 후반기 모두 높은 감수성을 보였다. Enterococcous는ampicillin, penicillin 및 1세대 cephalosporin에 대한 감수성이 후반기에 감소하였으나 vancomycin 내성균은 분리되지 않았다. 결 론 : 지난 10년간의 신생아 패혈증의 발생 빈도는 1.1%이었으며, CNS와 S. aureus가 신생아 패혈증의 주 원인균이었고, 일차 항생제에 대한 감수성은 전반기에 비해 후반기에 감소하였으나 vanco- mycin 내성균은 발견되지 않았다. 신생아 패혈증의 주요 원인균으로 알려진 group B Streptococcus는 발견되지 않았으며, K. pneumoniae에 의한 신생아 패혈증은 후반기에 더 많이 발생하였으나 항생제 감수성은 감소되지 않았다. Background : To delineate the changes in the causative agents of neonatal sepsis and their antimicrobial susceptibilities in the neonatal intensive care unit and nursery of Hanyang University Hospital during the past 10 years. Methods : Hospital records of 15,144 patients hospitalized at the NICU and nursery of Hanyang University Hospital from 1989 to 1998 were reviewed and neonates diagnosed of neonatal sepsis were sorted and included in the study. The study period was divided into Period A(the first 5 years) and Period B(the second 5 years) to analyse causative agents and their antimicrobial susceptibilities. Results : Neonatal sepsis was diagnosed in 170 patients(1.1%{Period A 1.2%, Period B 1.0%}) among the total of 15,144 inpatients. Two hundred isolates(Period A 109 isolates, Period B 91 isolates) were identified in 186 blood cultures(Period A 99 cultures, Period B 87 cultures) from 170 patients(Period A 91 patients, Period B 79 patients). The average age at the onset of the disease, when the initial blood culture was drawn, was 12.3 days old(Period A 8.8 days, Period B 16.3 days), and the proportion of the early onset disease was 34.7% in Period A and 23.0% in Period B, indicating that neonatal sepsis developed earlier during Period A. Among the isolated organisms including Gram positive bacteria[132(66.0%)], Gram negative bacteria [60(30.0%)], and fungi[8(4.0%)], coagulase negative Staphylococcus(CNS) was the most common organism(69/34.5%), followed by Staphylococcus aureus(36/18.0%), Klebsiella pneumoniae(17/8.5%), Enterococcus(12/6.0%), Enterobacter cloacae(8/4.0%), Escherichia coli(6/3.0%), and Pseudomonas aeruginosae(5/2.5%). The isolated fungi were Candida parapsilosis, Candida albicans, and Trichosporon pullulans. CNS, S. aureus and Acinetobacter baumannii were isolated more frequently in Period A compared to Period B. Antimicrobial susceptibilities of CNS and S. aureus to methicillin and the first generation cephalo sporins were decreased in Period B compare to Period A, those to aminoglycosides were increased in Period B, and vancomycin resistant strains were not identified. K. pneumoniae, Enterococcus, E. coli, and P. aeruginosa were isolated less frequently in Period B, compared to Period A. For K. pneumoniae, antimicrobial susceptibilities to the first generation cephalosporins were low in both Periods A and B, those to tobramycin and gentamicin were increased in Period B, and those to amikacin, ceftriaxone, and trimethoprim-sulfamethoxazole were high in both Periods A and B. Antimicrobial susceptibilities of Enterococcous to ampicillin, penicillin, and the first generation cephalosporins were decreased in Period B, but vancomycin resistant strains were not identified. Conclusion : The occurrence rate of neonatal sepsis during the past 10 years in the NICU and nursery of the Hanyang University hospital was 1.1%, and the most common causitive agents were CNS and S. aureus, to which the antimicrobial susceptibilities to the first line drugs decreased in the later half of the study period with no vancomycin resistant isolates identified. Group B Streptococcus known to be the most common agent causing neonatal sepsis was not identified, and K. pneumoniae was isolated more commonly during the later half of the study period without decreased antimicrobial susceptibilities.

댄스스포츠 선수들의 환경적 변인에 따른 파트너 신뢰, 팀몰입 및 결속력의 차이

문진화(Jin Hwa Moon),김인형(In Hyung Kim) 한국사회체육학회 2006 한국사회체육학회지 Vol.0 No.27

뇌실 - 복강 단락술과 횡경막하 농양에 의한 흉막 삼출 1 예

문진화(Jin Hwa Moon),이수용(Soo Yong Lee),오재원(Jae Won O),이하백(Ha Baik Lee) 대한소아알레르기호흡기학회 1999 소아알레르기 및 호흡기학회지 Vol.9 No.3

Several different diseases may have an associated exudative pleural effusion. In a patient with a pleural effusion of unknown origin, a possibility of intra-abdominal abscess should always be considered, especially in a patient who has the past history of abdominal surgery or procedure. We describe a 5-year-old male patient who had been operated for congenital hydrocephalus with ventriculo-peritoneal shunt insertion at 15 months old, admitted to our hospital with complaints of headache and edema of valvular area. Brain CT scan revealed shunt disconnection, and he was operated for insertion of new shunt catheter. Seven days after first operation, he presented fever, abdominal pain and distension. Abdominal ultrasonography revealed bowel adhesion and peritonitis. Staphylococcus epidermidis was isolated by aspiration of shunt valve and reservior, repeatedly. He should have had another 2 operations of peritoneal lavage and catheter change for shunt infection associated peritonitis. Eight days after the 3rd operation, he complained newly developed left shoulder, left chest pain and fever up to 39℃. His chest x-ray revealed pleural effusion on the left side. Though antibiotic therapy was already being conducted, the left pleural effusion and fever aggravated. Repeated ultrasonography disclosed an occult left subphrenic abscess, explaining the fever and left pleural effusion on the radiograph. Fourth operation of abscess drainage and infected shunt removal with extraventricular drainage was done. After the operation, his fever and pleural effision were rapidly disappered, and postoperative CSF culture was negative. A review of ventriculoperitoneal shunt infection associated with subphrenic abscess and pleural effusion was discussed.

소아 무균성 뇌수막염 환자에서 뇌척수액 내 Interleukine-6, Interleukine-8, Interleukine-10 농도의 증가

최영진(Young-Jin Choi),나재윤(Jae Yoon Na),문진화(Jin-Hwa Moon),오재원(Jae-Won Oh),김창렬(Chang-Ryul Kim),설인준(In Joon Seol) 대한소아신경학회 2014 대한소아신경학회지 Vol.22 No.2

목적: Cytokine 은 다양한 신경계 염증성 질환들의 발현에서 중요한 역할을 한다. 본 연구의 목적은 소아 무균성 뇌수막염 환자들과 다른 급성 뇌증상을 보이는 환자들 간의 CSF 내Interleukine-6, IL-8, IL-10 의 농도의 차이를 평가하는 것이다. 방법: 2012년 9월부터 2013년 7월까지 급성 뇌증상으로 한양대학교 구리병원 소아청소년과에 입원하여 CSF 검사를 시행한 환자들의 의무기록을 후향적으로 조사하였으며, 냉동 보관된 CSF로 interleukine 검사를 시행하였다. 환자들을 급성 뇌증, 뇌전증, 열성경련, 두통, 영아발열, 무균성 뇌수막염의 6가지 그룹으로 나누어 각각의 임상특징과 검사결과를 분석하였다 결과: 총 87명 환자의CSF 검체를 조사하였다. IL-6, IL-8, IL-10의 농도는 무균성 뇌수막염 환자군에서 다른 질환군보다 대부분 의미있게 증가되어 있었다(P<0.005). CSF IL-6 (r=0.576, P=0.000), CSF IL-8 (r=0.329, P=0.003), CSF IL-10 (r=0.523, P=0.000) 모두 CSF WBC와 의미 있는 상관관계가 있었다. 무균성 뇌수막염 환자군 중 CSF 내 enterovirus 양성군(CSF entero+)이 enterovirus 음성군(CSF entero-)에 비하여 IL-6, IL-8, IL-10이 더 의미있게 증가되어 있었으며(P<0.05), 또 CSF entero+와 IL-10 검출 사이에는 의미있는 연관성이 있었다(χ2=6.827, P=0.033). 결론: 무균성 뇌수막염 환자들은 다른 급성 신경계 증상 환자들에 비하여CSF IL-6, IL-8, IL-10의 발현이 더 높았다. 또 enterovirus에 의한 무균성 뇌수막염의 병리기전은 그렇지 않은 무균성 뇌수막염 환자들에 비하여 IL-6, IL-8, IL-10의 발현과 더 많은 연관성이 있을 것으로 생각된다. Purpose: Cytokines play important roles on the expression of various neuronal inflammatory disease and insults. The purpose of this study was to evaluate the levels of interleukine (IL)-6, IL-8, IL-10 in cerebrospinal fluid (CSF) in children with aseptic meningitis and compare them with those of the patients having other acute neurological symptoms. Methods: We retrospectively reviewed the medical records of the children who admitted in the pediatric department of Hanyang University Guri Hospital for acute neurological symptoms and had CSF examinations from September 2012 to July 2013. We classified them into six groups as acute encephalopathy, epilepsy, febrile convulsion, headache, infantile fever, and meningitis. We analyzed the clinical and laboratory data from them. Results: A total of 87 CSFs of the patients were available. The levels of CSF IL-6, IL-8, and IL-10 were significantly increased in the group with aseptic meningitis group as compared to the other groups (P<0.05). CSF IL-6 (r=0.576, P=0.000), IL-8 (r=0.329, P=0.003), and IL-10 (r=0.523, P=0.000) were all significantly correlated with CSF White bood cell (WBC) count. Among the patients with aseptic meningitis, CSF enterovirus positive patients (CSF entero+) showed significantly increased IL-6, IL-8, IL-10 levels than CSF enterovirus negative patients (CSF entero-) (P<0.05). In addition, the CSF entero+ and the increase of IL-10 were significantly correlated (x2=6.827, P=0.033). Conclusion: In patients with aseptic meningitis, the CSF IL-6, IL-8 and IL-10 were more expressed than in other neurological disease group. Among them, the enteroviral meningitis may be more related with IL-6, IL-8 and IL-10 expression than in other causes of aseptic meningitis.

국내 6개 지역 종합병원에 내원한 소아 알레르기 환자에서의 혈청 Immunoglobulin E 농도에 관한 연구

김주화 ( Joo Hwa Kim ),최경빈 ( Kyung Bin Choi ),문진화 ( Jin Hwa Moon ),이하백 ( Ha Baik Lee ),김성원 ( Sung Won Kim ),국명희 ( Myung Hee Kook ),김자경 ( Ja Kyung Kim ),김우경 ( Woo Kyung Kim ),박용민 ( Yong Min Park ),이소연 ( S 대한소아알레르기호흡기학회 2012 소아알레르기 및 호흡기학회지 Vol.22 No.1

Purpose: We investigated the change in serum total immunoglobulin E (IgE) and allergen-specific IgE according to allergic diseases and age. Methods: Allergic markers of children under 18 years of age with allergic diseases for the last 5 years were collected from 12 hospitals nationwide. The total data was 9,710. Data about levels of serum total IgE and allergen-specific IgE to 15 common allergens were collected. Results: In children with asthma, serum total IgE was higher in older age than in younger age until age 7 to 12 years, at which time the level was highest (paper radioimmunosorbent test, 526.7 IU/mL; UniCAP, 339.9 IU/mL). The level was lower in older age than that during younger age. This change was similar to that in children with allergic rhinitis and atopic dermatitis. The level was highest at ages 7 to 12 years in children with allergic rhinitis, and at age 10 to 12 years in children with atopic dermatitis. In children with both asthma and allergic rhinitis, as well as in children with all three diseases, the change in serum total IgE was similar to that of children with an isolated disease. The highest level in children with all three diseases was higher than that in children with an isolated disease. The analysis of allergen-specific IgE positivity showed that food allergens were dominant before the age of 2 years, and that aeroallergens such as house dust mites were dominant. Conclusion: Serum total IgE in Korean children with allergic diseases was higher in older age than in younger age until the ages of 7 to 12 years, and then the change in total IgE by age was the opposite.

양팔의 저림과 틱 유사증세로 내원한 소아 경추 추간판 탈출증 1례

오혜린(Hea Lin O),문진화(Jin Hwa Moon),염명걸(Myung-Kul Yum),설인준(In Joon Seol),박동우(Dong Woo Park) 대한소아신경학회 2012 대한소아신경학회지 Vol.20 No.1

신체 활동량이 많은 소아에서 경추부 손상은 눈에 띄는 외상이 없고, 증상이 뚜렷하지 않은 경우 진단이 어려울 수 있다. 저자들은 양측 팔저림과 경부 틱유사증상을 주소로 내원한 8세 여아의 경추부 자기공명촬영검사에서 경추 추간판 탈출증을 발견하였고, 추간판 탈출증의 증상으로 틱 유사증상이 나타날 수 있는 것을 경험하였기에 이를 보고하는 바이다. Intervertebral disc herniation is rare in children and is reportedly related with disc calcification and traumatic injury. We report an 8 years old girl, who complained of tingling sensation in both arms and intentional tic like neck stretching for about 1 month. She had got unnoticed whiplash Injury 2 weeks before symptoms. She also had been taking lessons for taekwondo for one and half year. Physical examination was unremarkable. Her symptoms got aggravated over the next 4 weeks. Plain vertebral x-ray showed no abnormalities, but cervical spinal MRI revealed disc central herniations at C 5-6 and C 6-7 levels. We concluded that her paresthesia and tic like motion were related with cervical disc herniation from hyperflexion neck injury.

유아 스마트 기기 사용 관련 요인들과 자기조절 능력 발달과의 상관관계

조상연(Sang Yeun Cho),소혜진(Hye Jin So),임성민(Sung Min Lim),고민숙(Min Sook Koh),송길연(Kil Yun Song),문진화(Jin-Hwa Moon) 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.3

Purpose: To investigate the relationship between the smart devices usage-related factors and self-regulation ability development in early childhood. Methods: Parental questionnaires of 187 children aged 3–6 years were analyzed. The metrics included smart device usage frequency (times/week, scored as uFreq), smart device usage time (hours/day, scored as uTime), parental scale for appropriate smart device usage level (scored as uLevel), the Korean-developmental screening test (K-DST), and the scale for self-regulation ability in young children (scored as SRS, and including four sub-categories: self-appraisal, self-determination, behavior inhibition, and emotionality). The correlations were analyzed by total age group and by each age. Results: In the total age group analysis, uFreq and uTime were negatively correlated with mean SRS (rs= -0.366, -0.330; P<0.001) and sub-category SRS (rs= -0.186 to -0.370; P<0.05). Mean uLevel score was positively correlated with mean SRS (rs=0.406; P<0.001) and most of the mean sub-category SRS (rs=0.174 to 0.362; P<0.05). In 3-year-old children, the mean SRS was strongly negatively correlated with uFreq (rs=-0.751; P<0.001), negatively correlated with uTime (rs=-0.518; P<0.001), and positively correlated with mean uLevel score (rs= 0.533; P=0.013). Such correlations seemed to decrease at the age of 4–6 years. Conclusion: Self-regulation ability was significantly correlated with smart device-related factors and was the highest in the 3-year-old children. Encouraging appropriate smart device usage will be helpful for self-regulation development of young children.

유아 스마트기기 사용 및 이용수준 현황

노주형(Joo Hyung Roh),이진(Jin Lee),고민숙(Min Suk Koh),김용주(Yong Joo Kim),설인준(In Joon Seol),문진화(Jin Hwa Moon) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.3

목적: 스마트기기의 보편적인 사용으로 많은 영유아들이 이를 손쉽게 접하게 되었다. 그러나 영유아기 아동들의 스마트기기 사용 현황과 그 영향에 대해서는 아직 체계적인 연구결과가 많지 않다. 본 연구의 목적은 유아들의 스마트기기 사용현황과 이용수준을 재파악하고자 하는 것이다. 방법: 연구대상은 구리시와 남양주, 서울의 어린이집 4곳에 등원 중인 만 3-5세 유아 130명(남:여=71:59) 이었으며, 질문도구지에 대한 부모의 응답을 분석하였다. 질문도구는 앞선 연구들에서 사용되었던 ‘유아의 스마트기기 사용 현황에 대한 질문지’와 ‘부모용 유아 스마트기기 이용수준 척도’를 이용하였다. 결과: 최초의 스마트기기 사용시기는 만 1-2세가 가장 많았으며 (37.7%), 사용빈도는 주 1-2 회가 가장 많았고(35.4%), 하루 중 총 사용시간은 주중(57.6%) 또는 주말(53.8%) 모두 1시간 미만인 경우가 많았다. 주 사용목적은 동영상 시청이었다(73.9%). 대부분의 어머니들이 스마트기기의 사용자제를 위한 노력을 시도하고 있으며(66.1%), 유아에게 미치는 영향은 부정적으로 평가하였다(53.0%). 미디어이용수준척도의 평균점수는 3.34점으로(1-5점 척도) 보통 정도의 이용수준을 보였다. 추가적으로 사용빈도(F), 최대사용시간(Tmax)을 이용하여 이 두 값의 곱인 FxTmax 값을 구하고 이를 인구학적 변수에 따라 비교하였다. 형제가 있는 경우 그렇지 않은 경우보다 Tmax 가 의미 있게 더 높았으며, 5세 유아 군이 3세 또는 4세 유아군에 비하여 Tmax 또는 FxTmax 값이 의미 있게 더 높았다. 결론: 유아의 성장에 따라 스마트기기 사용시간의 조절과 바람직한 이용수준에 대한 지도가 더 필요하며, 스마트기기 사용이 유아의 발달에 미치는 영향에 대한 추가적인 연구가 필요하다. Purpose: With the widespread use of the smartphone, many preschool children have gained easy access to the smartphone or tablet PC (Personal computer). However, there are not much studies about the current status of smartphones usage or in-fluence. The purpose of this study was to re-evaluate the current state of the smart-phone usage and utilization levels in preschool children. Methods: Total 130 preschool children between 3-5 years old were enrolled from four daycare centers at Guri, Namyangju and Seoul (M:F=71:59). We used 1) the questionnaires for usage of smartphones and 2) the scales for use of smartphones by parents, which developed by preceding publications. Results: The most common age at first use of smartphones was between 1 and 2 years old (37.7%) and the most common frequency of using smartphones was 1-2 times a week (35.4%). Most children used smart devices less than an hour both in weekday (57.6%) and weekend (53.8%). The main purpose of usage was watching videos (73.9%). Average score of smart device utilization level was 3.34 (1-5 points scale), which showing moderate level. In addition, we analyzed the frequency of usage (F), maximal usage time (Tmax), and the product of F and Tmax (FxTmax) score by demographic data. The children having siblings showed significantly higher Tmax. 5 years old group showed higher Tmax and FxTmax than 3 or 4 year old group. Conclusion: As preschool children grow up, more guidance for the smartphone usage time and desirable usage level will be needed. The effects of smartphone usage and diverse developmental outcome should be further investigated.

소아 측두엽 간질의 임상 양상

정고운(Go Un Jeong),조안나(An Na Cho),이진숙(Jin Sook Lee),박지윤(Jee Yoon Park),문진화(Jin Hwa Moon),황희(Hee Hwang),황용승(Yong Seung Hwang),김기중(Ki Joong Kim),채종희(Jong Hee Chae) 대한소아신경학회 2006 대한소아신경학회지 Vol.14 No.2

목 적 : 비교적 전형적인 임상양상을 보이는 성인의 측두엽과는 달리 소아의 측두엽 간질은 정보가 부족하다. 소아의 측두엽 간질의 정의가 내려져 있지 않고 전기생리현상과 임상양상, 병리 소견과의 상관관계도 명확하지 않다. 난치성 측두엽 간질로 수술을 받은 소아 환자를 대상으로 임상 양상, 뇌신경영상, 뇌파 및 수술 소견 등을 기술하였고 소아 측두엽 간질의 특징을 정의하고 뇌파와 병리 소견 사이의 관계를 비교해보고자 하였다. 방 법 : 1995년 1월부터 2005년 12월까지 서울대학교 병원에서 난치성 간질로 수술을 받았던 17세 이하의 측두엽 간질환자 중에서 Engel class II 이상이었던 18명을 대상으로 하여 이들의 연령 및 성별 분포, 경련 발작의 임상적 특징, 원인 질환, 수술 치료 및 경과 등에 대해 조사하였다. 모든 환아에서 MRI, SPECT, PET 검사 소견과 뇌파, 병리 소견을 비교하였다. 결 과: 소아의 난치성 측두엽 간질의 수술 요법은 성적이 우수하였다. 소아의 측두엽 간질은 성인과 달리 외측두엽 간질이 대부분(61.1%)이었고 원인 질환이 두 가지 이상인 경우(44.4%)가 흔하였다. MRI는 병리 소견을 예측할 수 있는 지표가 되지 못하였다. 발작 양상은 전형적인 측두엽 간질보다 복잡하였고 손의 이긴장증이나 강직, 고개 돌리기는 편측화에 도움이 되었다. 뇌파 소견과 병변이 항상 일치하는 것은 아니었고 이는 외측두엽 간질에서 보다 뚜렷하였다. 발작파가 델타파로 시작하는 경우 외측두엽 간질을 의심할 수 있었고 측두엽의 앞쪽에서 시작하는 경우에는 내측두엽 간질을 시사하였다. 신경절교종은 규칙적인 베타파로 시작하는 경향이 있었다. 결 론: 소아의 측두엽 간질은 성인보다 복잡한 임상 양상을 보이며 원인 질환이 다양하여 쉽게 편측화, 국소화할 수 없다. 따라서 정밀한 국소화를 통해 절제 부위를 정하기 위해서는 임상 양상, 신경방사선학적 소견, 뇌파 소견 등을 종합적으로 평가해야 할 것이다. Purpose : Temporal lobe epilepsy(TLE) is now recognized as a distinct syndrome in adults. The seizure evolution in adult patients is well characterized, manifesting initially with an aura, behavioral arrest, automatism, and secondary generalized tonic-clonic seizures. In contrast, relatively few studies are available for the pediatric age group. In the present study, we investigated children undergoing temporal lobectomy for refractory seizures and correlated the pathologic findings with clinical presentations. Methods : The records of the pediatric patients admitted at the Seoul National Children's Hospital for epilepsy surgery between January 1995 and December 2005 were reviewed. Then, eighteen patients were included in this study. The clinical records were reviewed in terms of the patient profiles imaging findings, surgical techniques, and pathologic findings. The seizure outcomes were described according to the Engel's classification. Results : The postsurgical outcomes were favorable. Lateral temporal epilepsy was more common in childhood than in adulthood. Dual pathology was commonly found. Arm dystonia or tonic arm elevation have a lateralizing value. Head turning may have a lateralizing value based upon a time sequence. The brain MRI was less predictable for pathologic findings. The ictal EEG cannot always have a localizing value. Delta beginning in the ictal rhythm may suggest lateral lobe epilepsy. Anterior temporal beginning of the ictal location may suggest mesial temporal lobe epilepsy. Ganglioglioma tends to cause rhythmic beta activities at the beginning of the ictal event. Conclusion : TLE in childhood shows more complex and atypical clinical manifestations and have more variable etiologies. No single presurgical investigation can be a good predictable value to localization or lateralization.