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Original Article
Neurology
Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study
Hyejin Na, Sanghoon Lee, Seo Hee Kim, Young Ok Kim
Clin Exp Pediatr. 2024;67(4):213-220.   Published online March 19, 2024
Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)?
Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases).
Meaning: The COVID-19 pandemic affected CwG.
Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.
Infection
Pathogenetic and etiologic considerations of febrile seizures
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Neonatology (Perinatology)
Neonatal seizures: stepping outside the comfort zone
Menna Hashish, Mohamed Reda Bassiouny
Clin Exp Pediatr. 2022;65(11):521-528.   Published online April 4, 2022
· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns.
· Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics.
Neurology
Neonatal seizures: diagnostic updates based on new definition and classification
Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee
Clin Exp Pediatr. 2022;65(8):387-397.   Published online April 4, 2022
· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.
Update on benign convulsions with mild gastroenteritis
Yeong Seok Lee, Ga Hee Lee, Young Se Kwon
Clin Exp Pediatr. 2022;65(10):469-475.   Published online December 27, 2021
∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing.
∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary.
∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear.
Myths and truths about pediatric psychogenic nonepileptic seizures
Jung Sook Yeom, Heather Bernard, Sookyong Koh
Clin Exp Pediatr. 2021;64(6):251-259.   Published online October 17, 2020
• Psychogenic non-epileptic seizures (PNES) are events that look like epileptic seizures but are not caused by abnormal electrical discharges.
• PNES are a manifestation of psychological and emotional distress.
• Treatment for PNES does not begin with the psychological intervention but starts with the diagnosis and how the diagnosis is delivered.
• A multifactorial biopsychosocial process and a neurobiological review are both essential components when treating PNES
Is it really a seizure? The challenge of paroxysmal nonepileptic events in young infants
Seung Yeon Jung, Joon Won Kang
Clin Exp Pediatr. 2021;64(8):384-392.   Published online September 18, 2020
Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential...
Original Article
Respiratory syncytial virus-associated seizures in Korean children, 2011–2016
Teahyen Cha, Young Jin Choi, Jae-Won Oh, Chang-Ryul Kim, Dong Woo Park, In Joon Seol, Jin-Hwa Moon
Clin Exp Pediatr. 2019;62(4):131-137.   Published online October 23, 2018

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results: During this period, 1,193...
Neurology
Effects of lamotrigine on attention-deficit hyperactivity disorder in pediatric epilepsy patients
Seung-A Han, Eu Jeen Yang, Mi-Kyoung Song, Sun Jun Kim
Clin Exp Pediatr. 2017;60(6):189-195.   Published online June 22, 2017
Purpose

The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy.

Methods

Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, 9.1±3.4 years) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses...

Neonatology (Perinatology)
Experience and pharmacokinetics of Levetiracetam in Korean neonates with neonatal seizures
Jae Won Shin, Yun Seob Jung, Kyungsoo Park, Soon Min Lee, Ho Seon Eun, Min Soo Park, Kook In Park, Ran Namgung
Clin Exp Pediatr. 2017;60(2):50-54.   Published online February 27, 2017
Purpose

The aims of this study were to evaluate the safety and pharmacokinetics of levetiracetam (LEV) in neonates with seizures and to establish a population pharmacokinetics (PPK) model by using the software NONMEM.

Methods

A retrospective analysis of 18 neonatal patients with seizures, who were treated with LEV, including 151 serum samples, was performed. The mean loading dose was 20 mg/kg, followed by...

Case Report
Neurology
Paroxysmal kinesigenic dyskinesia in a patient with a PRRT2 mutation and centrotemporal spike discharges on electroencephalogram: case report of a 10-year-old girl
Sun Young Seo, Su Jeong You
Clin Exp Pediatr. 2016;59(Suppl 1):S157-S160.   Published online November 30, 2016

Coexistence of paroxysmal kinesigenic dyskinesia (PKD) with benign infantile convulsion (BIC) and centrotemporal spikes (CTS) is very rare. A 10-year-old girl presented with a 3-year history of frequent attacks of staggering while laughing and of suddenly collapsing while walking. Interictal electroencephalogram (EEG) revealed bilateral CTS, but no changes in EEG were observed during movement. The patient's medical history showed afebrile...

1p36 deletion syndrome confirmed by fluorescence in situ hybridization and array-comparative genomic hybridization analysis
Dong Soo Kang, Eunsim Shin, Jeesuk Yu
Clin Exp Pediatr. 2016;59(Suppl 1):S14-S18.   Published online November 30, 2016

Pediatric epilepsy can be caused by various conditions, including specific syndromes. 1p36 deletion syndrome is reported in 1 in 5,000–10,000 newborns, and its characteristic clinical features include developmental delay, mental retardation, hypotonia, congenital heart defects, seizure, and facial dysmorphism. However, detection of the terminal deletion in chromosome 1p by conventional G-banded karyotyping is difficult. Here we present a case of...

Review Article
Neurology
White matter injury following rotavirus infection in neonates: new aspects to a forgotten entity, 'fifth day fits'?
Jung Sook Yeom, Chan-Hoo Park
Clin Exp Pediatr. 2016;59(7):285-291.   Published online July 31, 2016

That rotavirus infection can cause neurological symptoms in young children has been well established. However, it is surprising why rotavirus infection has been overlooked as a cause of neonatal seizures for many years, despite significant research interest in neonatal rotavirus infection. Neonates are the age group most vulnerable to seizures, which are typically attributed to a wide range of causes....

Cognitive impairment in childhood onset epilepsy: up-to-date information about its causes
Eun-Hee Kim, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(4):155-164.   Published online April 30, 2016

Cognitive impairment associated with childhood-onset epilepsy is an important consequence in the developing brain owing to its negative effects on neurodevelopmental and social outcomes. While the cause of cognitive impairment in epilepsy appears to be multifactorial, epilepsy-related factors such as type of epilepsy and underlying etiology, age at onset, frequency of seizures, duration of epilepsy, and its treatment are considered...

Original Article
Neurology
Epilepsy in children with a history of febrile seizures
Sang Hyun Lee, Jung Hye Byeon, Gun Ha Kim, Baik-Lin Eun, So-Hee Eun
Clin Exp Pediatr. 2016;59(2):74-79.   Published online February 29, 2016
Purpose

Febrile seizure, the most common type of pediatric convulsive disorder, is a benign seizure syndrome distinct from epilepsy. However, as epilepsy is also common during childhood, we aimed to identify the prognostic factors that can predict epilepsy in children with febrile seizures

Methods

The study comprised 249 children at the Korea University Ansan Hospital who presented with febrile seizures. The relationship between...

Intravenous levetiracetam versus phenobarbital in children with status epilepticus or acute repetitive seizures
Yun-Jeong Lee, Mi-Sun Yum, Eun-Hee Kim, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(1):35-39.   Published online January 22, 2016
Purpose

This study compared the efficacy and tolerability of intravenous (i.v.) phenobarbital (PHB) and i.v. levetiracetam (LEV) in children with status epilepticus (SE) or acute repetitive seizure (ARS).

Methods

The medical records of children (age range, 1 month to 15 years) treated with i.v. PHB or LEV for SE or ARS at our single tertiary center were retrospectively reviewed. Seizure termination was defined...

Serum interleukin-1beta and tumor necrosis factor-alpha in febrile seizures: is there a link?
Abolfazl Mahyar, Parviz Ayazi, Reza Orangpour, Mohammad Mahdi Daneshi-Kohan, Mohammad Reza Sarokhani, Amir Javadi, Morteza Habibi, Mousa Talebi-Bakhshayesh
Clin Exp Pediatr. 2014;57(10):440-444.   Published online October 31, 2014
Purpose

Febrile seizures are induced by fever and are the most common type of seizures in children. Although numerous studies have been performed on febrile seizures, their pathophysiology remains unclear. Recent studies have shown that cytokines may play a role in the pathogenesis of febrile seizures. The present study was conducted to identify potential links between serum interleukin-1beta (IL-1β), tumor necrosis...

Review Article
Febrile seizures
Sajun Chung
Clin Exp Pediatr. 2014;57(9):384-395.   Published online September 30, 2014

Febrile seizure (FS) is the most common seizure disorder of childhood, and occurs in an age-related manner. FS are classified into simple and complex. FS has a multifactorial inheritance, suggesting that both genetic and environmental factors are causative. Various animal models have elucidated the pathophysiological mechanisms of FS. Risk factors for a first FS are a family history of the...

Benign convulsion with mild gastroenteritis
Ben Kang, Young Se Kwon
Clin Exp Pediatr. 2014;57(7):304-309.   Published online July 23, 2014

Benign convulsion with mild gastroenteritis (CwG) is a type of afebrile seizure that occurs in children. CwG is defined as a convulsion in a previously healthy child with no known central nervous system infection or encephalopathy, accompanying mild diarrhea without fever, electrolyte imbalance, or moderate to severe dehydration. Convulsions in CwG are characterized by multiple brief episodes of generalized or...

Original Article
Early postictal electroencephalography and correlation with clinical findings in children with febrile seizures
Kyung A Jeong, Myung Hee Han, Eun Hye Lee, Sajun Chung
Clin Exp Pediatr. 2013;56(12):534-539.   Published online December 20, 2013
Purpose

Electroencephalography (EEG) is frequently ordered for patients with febrile seizures despite its unclear diagnostic value. We evaluated the prevalence of abnormal EEGs, the association between clinical findings and abnormal EEGs, and the predictive value of EEG for the recurrence of febrile seizures.

Methods

Data were collected on 230 children who were treated for febrile seizures at Kyung Hee University Medical Center from...

Review Article
The role of cytokines in seizures: interleukin (IL)-1β, IL-1Ra, IL-8, and IL-10
Youngah Youn, In Kyung Sung, In Goo Lee
Clin Exp Pediatr. 2013;56(7):271-274.   Published online July 19, 2013

Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial...

Original Article
Selenium and leptin levels in febrile seizure: a case-control study in children
Abolfazl Khoshdel, Neda Parvin, Maedeh Abbasi
Clin Exp Pediatr. 2013;56(2):80-85.   Published online February 25, 2013
Purpose

Febrile seizures (FS) are seizures that occur between the age of 6 and 60 months, but its pathophysiology still is not fully understood. There is limited information about the correlation between levels of selenium and leptin with FS. This study aimed to determine the relationship between serum levels of selenium and leptin in children with FS.

Methods

This case-control study was conducted...

Review Article
Cognitive function of idiopathic childhood epilepsy
Su Jeong You
Clin Exp Pediatr. 2012;55(5):159-163.   Published online May 21, 2012

Most children with epilepsy are of normal intelligence. However, a significant subset will have temporary or permanent cognitive impairment. Factors that affect cognitive function are myriad and include the underlying neuropathology of the epilepsy, seizures, epileptiform discharges, psychosocial problems, age at seizure onset, duration of epilepsy, and side effects associated with antiepileptic drugs. This review article discusses cognitive function in...

Case Report
A case of Hashimoto's encephalopathy presenting with seizures and psychosis
Min-Joo Lee, Hae-Sang Lee, Jin-Soon Hwang, Da-Eun Jung
Clin Exp Pediatr. 2012;55(3):111-113.   Published online March 16, 2012

Hashimoto's encephalopathy (HE) is a rare, poorly understood, autoimmune disease characterized by symptoms of acute or subacute encephalopathy associated with increased anti-thyroid antibody levels. Here, we report a case of a 14-year-old girl with HE and briefly review the literature. The patient presented with acute mental changes and seizures, but no evidence of infectious encephalitis. In the acute stage, the...

Transient splenial lesion of the corpus callosum in a case of benign convulsion associated with rotaviral gastroenteritis
Yoon Young Jang, Kye Hyang Lee
Clin Exp Pediatr. 2010;53(9):859-862.   Published online September 13, 2010

Transient magnetic resonance (MR) signal changes in the splenium of the corpus callosum (SCC) arise from many different conditions, including encephalopathy or encephalitis caused by infection, seizures, metabolic derangements, and asphyxia. Few case reports exist on reversible SCC lesions associated with rotavirus infection. A benign convulsion with mild gastroenteritis (CwG) is frequently associated with rotaviral infections. This entity is characterized...

Review Article
Diagnosis of neonatal seizures
Hee Jung Chung, Yun Jung Hur
Clin Exp Pediatr. 2009;52(9):964-970.   Published online September 15, 2009
Neonatal seizures are generally not only brief and subtle but also not easily recognized and are usually untreated. In sick neonates, seizures are frequently not manifested clinically but are detected only by electroencephalography (subclinical EEG seizures). This phenomenon of electroclinical dissociation is fairly common in neonates. On the other hand, neonates frequently show clinical behaviors such as stiffening, apnea, or...
Neonatal seizures in Korea, 1983-2009
Eun Sook Suh
Clin Exp Pediatr. 2009;52(9):957-963.   Published online September 15, 2009
Neonatal seizures are the most common and distinctive clinical sign of prenatal and/or neonatal brain disorders. Newborn infants with seizures are at risk of mortality and survivors at risk for neurologic impairment, developmental delay, and subsequent epilepsy. Fifteen reports on neonatal seizures in Korea from 1983 to 2009 were analyzed. A total of 731 neonatal seizure cases were reported. Day...
Original Article
Inherited metabolic diseases in the urine organic acid analysis of complex febrile seizure patients
Hee Jeong Cheong, Hye Rim Kim, Seong Soo Lee, Eun Joo Bae, Won Il Park, Hong Jin Lee, Hui Chul Choi
Clin Exp Pediatr. 2009;52(2):199-204.   Published online February 15, 2009
Purpose : Seizure associated with fever may indicate the presence of underlying inherited metabolic diseases. The present study was performed to investigate the presence of underlying metabolic diseases in patients with complex febrile seizures, using analyses of urine organic acids. Method : We retrospectively analyzed and compared the results of urine organic acid analysis with routine laboratory findings in 278...
Case Report
Reflex seizures induced by micturition : A pediatric case and ictal EEG finding
Young Il Rho
Clin Exp Pediatr. 2008;51(12):1346-1349.   Published online December 15, 2008
Reflex seizures induced by micturition are rare, and there have been few reports on ictal electroencephalogram (EEG) findings. Here, we report a 7-year-old boy with secondarily generalized partial seizures induced by micturition. The seizures occurred every time he urinated. A few seconds after micturition begun, he toppled down with hand automatism followed by a secondarily generalized tonic posture and loss...