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RISS 인기검색어
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- 발행기관 : Korean Epilepsy Society (검색결과 4 건)
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Could Cannabidiol be a Treatment Option for Intractable Childhood and Adolescent Epilepsy?
Koo, Chung Mo,Kang, Hoon-Chul Korean Epilepsy Society 2017 Journal of epilepsy research Vol.7 No.1
<P>Epilepsy is an important disease that affects brain function, particularly in those under 3 years old. Uncontrolled seizures can affect cognitive function and quality of life. For these reasons, many trials have been conducted to investigate treatments for pediatric epilepsy. Currently, many antiepileptic drugs are available for the treatment of epilepsy, but cases of intractable epilepsy continue to exist. In the past, cannabis has been tested as a potential treatment of intractable epilepsy. Since 2013, 10 epilepsy centers in America have conducted research regarding the efficacy of cannabis to treat epilepsy. Cannabis has many components, including cannabidiol (CBD) and Δ<SUP>9</SUP>-tetrahydrocannabinol (THC). THC has psychoactive properties exerted through its binding of the cannabinoid receptor (CBR) whereas CBD is a CBR antagonist. The inhibition of epilepsy by CBD may therefore be caused by various mechanisms, although the detailed mechanisms of CBD actions have not yet been well defined. In most studies, trial doses of CBD were 2–5 mg/kg/day. Several such studies have shown that CBD does have efficacy for treatment of epilepsy. Reported adverse effects of CBD were mostly mild, including drowsiness, diarrhea, and decreased appetite. Severe adverse reactions requiring treatment, such as status epilepticus, have also been reported but it is not clear that this is related to CBD. Furthermore, many previous studies have been limited by an open-label or survey design. In future, double-blind, controlled trials are required and the use of CBD to treat other neurological problems should also be investigated.</P>
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Woo, Min-Hee,Shin, Jung-Won,Oh, Seung-Hun,Kim, Ok Joon Korean Epilepsy Society 2018 Journal of epilepsy research Vol.8 No.1
<P>Several seizure-like symptoms are difficult to differentiate from epileptic convulsion, and then if they were misdiagnosed, they could be led to grave prognosis. A 41-year-old man was referred to the emergency room due to unconsciousness. Brain computed tomography (CT) revealed acute subdural hemorrhage along the left frontal lobe, and intraparenchymal hemorrhage in the left temporo-occipital lobe. After emergent decompressive craniectomy, he recovered an alert mental state but became progressively drowsy. Four days later, virtually continuous tonic upward eyeball deviation was observed. He had been taking antiepileptic drugs following an occipital lobectomy 20 years prior due to intractable epilepsy, and we assumed these upward eyeball deviations were symptoms of non-convulsive occipital lobe status epilepticus. Hence, doses and classes of antiepileptic drugs were modified, but clinical manifestations did not improve. Follow-up brain CT revealed newly developed hydrocephalus and compression of the mesencephalon. His symptoms fully resolved after a ventriculo-peritoneal shunt operation. In this case report, we describe the case of a patient exhibiting tonic upward eyeball deviation induced by hydrocephalus that was not associated with a seizure.</P>
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Seizure-Related Cortical Volume Alterations in Alzheimer’s Disease: A Preliminary Study
Hahm, Jarang,Kim, Kwang Ki,Kim, Dong Wook Korean Epilepsy Society 2018 Journal of epilepsy research Vol.8 No.1
<P><B>Background and Purpose</B></P><P>Alzheimer’s disease (AD) leads to cognitive dysfunction and neuronal loss, both of which can be exacerbated by seizures. For the treatment and diagnosis of AD, it is imperative to identify the cortical characteristics of comorbidities of AD such as seizures. The present study investigated the alterations in cortical volumes in patients with comorbid AD and seizures.</P><P><B>Methods</B></P><P>In this retrospective study, magnetic resonance T1-weighted brain images were collected from six patients with early AD or amnestic mild cognitive impairment without seizures (AD-No Seizure, age: 66.17 ± 4.92 years) and six individuals with seizures (AD-Seizure, age: 80.33 ± 4.63 years). The gray matter volumes estimated from the T1 images were compared between the groups using nuisance variables (e.g., age). Subsequently, a correlation analysis was performed to investigate the relationship between cortical structure and global cognitive function.</P><P><B>Results</B></P><P>AD-Seizure group showed volumetric alterations compared with AD-No Seizure group. In the volumetrically altered regions, correlation analysis revealed that the AD-Seizure group showed a positive correlation between the mini-mental state examination (MMSE) score and cortical volume, with smaller volumes than the AD-No Seizure group in the right parahippocampal gyrus, left angular gyrus, and middle temporal gyrus. The AD-No Seizure group showed negative correlations with MMSE score in the volume of right inferior frontal gyrus and cerebellar culmen and a positive correlation with the volume of the left middle frontal gyrus.</P><P><B>Conclusions</B></P><P>Our findings revealed that smaller temporal region volumes are predictive of cognitive dysfunction in AD patients with seizures. Given that these temporal areas overlap with regions showing abnormal brain activities in AD patients with seizures, these results suggest synergistic effects of AD and seizures on cortical volume and cognitive function.</P>
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Lee, Eun Mi,Kang, Joong Koo,Oh, Jungsu S.,Kim, Jae Seung,Shin, Yong-Wook,Kim, Chang-Yoon Korean Epilepsy Society 2014 Journal of epilepsy research Vol.4 No.2
<P>Catatonia is one of the main symptoms of anti-N-Methyl-D-aspartate receptor (NMDAR) encephalitis. However, it is unknown whether metabolic changes observed with <SUP>18</SUP>F-Fluorodeoxyglucose positron-emission tomography (FDG-PET) are correlated with the severity of the catatonic symptoms and clinical course. Three patients with anti-NMDAR encephalitis showing variable degrees of catatonia were performed with FDG-PET scans during the acute and recovery phase. PET findings showed hypermetabolism in the frontotemporoparietal regions and bilateral basal ganglia in the patient with mild catatonia, but more widespread hypermetabolic regions including the thalamus and brainstem were observed in the patients with more severe catatonia. Follow-up PET scans in one patient showed mild hypermetabolism in the right basal ganglia that correlated with mild rigidity and tonic posturing in the left extremities. Extent of cerebral metabolic changes correlates with the severity of catatonia accompanied by behavioural, motor, autonomic, and breathing abnormalities in anti-NMDAR encephalitis.</P>
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