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Review Article
Neonatal seizures: stepping outside the comfort zone
Menna Hashish, Mohamed Reda Bassiouny
Seizures are the most common neurological disorders in newborns. Managing neonatal seizures is challenging, especially for neurologists who are not neonatal specialists. Acute brain injury during ischemic insult is a key component of seizure occurrence, while genetic and metabolic disorders play less prevalent but more severe roles. The diagnosis of neonatal seizure is ambiguous, as the subjective differentiation between seizure...
Neurology
Big data analysis and artificial intelligence in epilepsy – common data model analysis and machine learning-based seizure detection and forecasting
Yoon Gi Chung, Yonghoon Jeon, Sooyoung Yoo, Hunmin Kim, Hee Hwang
Clin Exp Pediatr. 2022;65(6):272-282.   Published online November 26, 2021
· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care.
· Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection.
· Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting.
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...
Advanced neuroimaging techniques for evaluating pediatric epilepsy
Yun Jeong Lee
Clin Exp Pediatr. 2020;63(3):88-95.   Published online February 6, 2020
Accurate localization of the seizure onset zone is important for better seizure outcomes and preventing deficits following epilepsy surgery. Recent advances in neuroimaging techniques have increased our understanding of the underlying etiology and improved our ability to noninvasively identify the seizure onset zone. Using epilepsy-specific magnetic resonance imaging (MRI) protocols, structural MRI allows better detection of the seizure onset zone,...
Factors associated with seizure and cognitive outcomes after epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumors in children
Ara Ko, Joon Soo Lee
Clin Exp Pediatr. 2020;63(5):171-177.   Published online November 13, 2019
Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are responsible for drug-resistant chronic focal epilepsy, and are the second-most common reason for epilepsy surgery in children. LEATs are extremely responsive to surgical treatment, and therefore epilepsy surgery should be considered as a treatment option for LEATs. However, the optimal time for surgery remains controversial, and surgeries are often delayed. In this review, we...
Autoimmune encephalitis and epilepsy: evolving definition and clinical spectrum
Joo Hee Seo, Yun-Jin Lee, Ki Hyeong Lee, Elakkat Gireesh, Holly Skinner, Michael Westerveld
Clin Exp Pediatr. 2020;63(8):291-300.   Published online August 16, 2019
Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of pathologic processes associated with the neuron-specific autoantibodies targeting intracellular and plasma membrane antigens. However, current criteria for autoimmune encephalitis...
Epilepsy syndromes during the first year of life and the usefulness of an epilepsy gene panel
Eun Hye Lee
Clin Exp Pediatr. 2018;61(4):101-107.   Published online April 23, 2018

Recent advances in genetics have determined that a number of epilepsy syndromes that occur in the first year of life are associated with genetic etiologies. These syndromes range from benign familial epilepsy syndromes to early-onset epileptic encephalopathies that lead to poor prognoses and severe psychomotor retardation. An early genetic diagnosis can save time and overall cost by reducing the amount...

Malformations of cortical development: genetic mechanisms and diagnostic approach
Jeehun Lee
Clin Exp Pediatr. 2017;60(1):1-9.   Published online January 31, 2017

Malformations of cortical development are rare congenital anomalies of the cerebral cortex, wherein patients present with intractable epilepsy and various degrees of developmental delay. Cases show a spectrum of anomalous cortical formations with diverse anatomic and morphological abnormalities, a variety of genetic causes, and different clinical presentations. Brain magnetic resonance imaging has been of great help in determining the exact...

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...

A rare case of dysembryoplastic neuroepithelial tumor combined with encephalocraniocutaneous lipomatosis and intractable seizures
Jee-Yeon Han, Mi-Sun Yum, Eun-Hee Kim, Seokho Hong, Tae-Sung Ko
Clin Exp Pediatr. 2016;59(Suppl 1):S139-S144.   Published online November 30, 2016

Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome that affects ectomesodermal tissues (skin, eyes, adipose tissue, and brain). The neurologic manifestations associated with ECCL are various including seizures. However, ECCL patients very rarely develop brain tumors that originate from the neuroepithelium. This is the first described case of ECCL in combination with dysembryoplastic neuroepithelial tumor (DNET) that presented with intractable...

Original Article
Neurology
Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia
Sun Young Seo, Gyu Hong Shim, Myoung Jae Chey, Su Jeong You
Clin Exp Pediatr. 2016;59(11):440-445.   Published online November 18, 2016
Purpose

This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia.

Methods

All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2...

Venous angioma may be associated with epilepsy in children
Bo Ryung Kim, Yun Jin Lee, Sang Ook Nam, Kyung Hee Park
Clin Exp Pediatr. 2016;59(8):341-345.   Published online August 24, 2016
Purpose

Venous angioma (VA) is the most common congenital abnormality of the intracranial vasculature. This study aimed to investigate the relationship between VA and epilepsy and to identify the characteristics of children with VA and epilepsy.

Methods

The records of all patients aged less than 18 years who underwent brain magnetic resonance imaging (MRI) at Pusan National University Hospital were retrospectively reviewed. Patients...

Review Article
Neurology
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...

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...

Magnetoencephalography in pediatric epilepsy
Hunmin Kim, Chun Kee Chung, Hee Hwang
Clin Exp Pediatr. 2013;56(10):431-438.   Published online October 31, 2013

Magnetoencephalography (MEG) records the magnetic field generated by electrical activity of cortical neurons. The signal is not distorted or attenuated, and it is contactless recording that can be performed comfortably even for longer than an hour. It has excellent and decent temporal resolution, especially when it is combined with the patient's own brain magnetic resonance imaging (magnetic source imaging). Data...

Lower fat and better quality diet therapy for children with pharmacoresistant epilepsy
Jung-Rim Yoon, Heung Dong Kim, Hoon-Chul Kang
Clin Exp Pediatr. 2013;56(8):327-331.   Published online August 27, 2013

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary...

Temporal lobe epilepsy surgery in children versus adults: from etiologies to outcomes
Yun-Jin Lee, Joon Soo Lee
Clin Exp Pediatr. 2013;56(7):275-281.   Published online July 19, 2013

Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in...

Original Article
Cognitive and other neuropsychological profiles in children with newly diagnosed benign rolandic epilepsy
Soonhak Kwon, Hye-Eun Seo, Su Kyeong Hwang
Clin Exp Pediatr. 2012;55(10):383-387.   Published online October 29, 2012
Purpose

Although benign rolandic epilepsy (BRE) is a benign condition, it may be associated with a spectrum of behavioral, psychiatric, and cognitive disorders. This study aimed to assess the cognitive and other neuropsychological profiles of children with BRE.

Methods

In total, 23 children with BRE were consecutively recruited. All children underwent sleep electroencephalography (EEG) and were assessed on a battery of comprehensive neuropsychological...

Review Article
The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders
Munhyang Lee
Clin Exp Pediatr. 2012;55(9):316-321.   Published online September 14, 2012

The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its anti-epileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency...

Original Article
Epilepsy in Korean patients with Angelman syndrome
Sung-Hee Park, Jung-Rim Yoon, Heung Dong Kim, Joon Soo Lee, Young-Mock Lee, Hoon-Chul Kang
Clin Exp Pediatr. 2012;55(5):171-176.   Published online May 21, 2012
Purpose

The aim of this study was to investigate the natural history of epilepsy and response to anti-epileptic drug treatment in patients with Angelman syndrome (AS) in Korea.

Methods

We retrospectively reviewed the clinical records of 14 patients diagnosed with epilepsy out of a total of 17 patients with a genetic diagnosis of AS. These patients were seen at the Department of Pediatric...

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
Signal change in hippocampus and current source of spikes in Panayiotopoulos syndrome
Jung Sook Yeom, Youngsoo Kim, Ji Sook Park, Ji Hyun Seo, Eun Sil Park, Jae Young Lim, Chan-Hoo Park, Hyang Ok Woo, Hee-Shang Youn, Oh-Young Kwon
Clin Exp Pediatr. 2012;55(2):63-67.   Published online February 14, 2012

A 4-year-old girl with Panayiotopoulos syndrome presented with a history of 4 prolonged autonomic seizures. The clinical features of her seizures included, in order of occurrence, blank staring, pallor, vomiting, hemi-clonic movement on the right side, and unresponsiveness. A brain magnetic resonance imaging (MRI) showed a slightly high T2 signal in the left hippocampus. Interictal electoencephalogram revealed spikes in the...

Original Article
Characteristics of late-onset epilepsy and EEG findings in children with autism spectrum disorders
Haneul Lee, Hoon Chul Kang, Seung Woo Kim, Young Key Kim, Hee Jung Chung
Clin Exp Pediatr. 2011;54(1):22-28.   Published online January 31, 2011
Purpose

To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems.

Methods

Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy...

Review Article
Multimodal neuroimaging in presurgical evaluation of childhood epilepsy
Da Eun Jung, Joon-Soo Lee
Clin Exp Pediatr. 2010;53(8):779-785.   Published online August 31, 2010

In pre-surgical evaluation of pediatric epilepsy, the combined use of multiple imaging modalities for precise localization of the epileptogenic focus is a worthwhile endeavor. Advanced neuroimaging by high field Magnetic resonance imaging (MRI), diffusion tensor images, and MR spectroscopy have the potential to identify subtle lesions. 18F-FDG positron emission tomography and single photon emission tomography provide visualization of metabolic alterations...

Original Article
Efficacy of levetiracetam in refractory childhood epilepsy
Keon Su Lee, Joon Won Kang
Clin Exp Pediatr. 2010;53(4):571-578.   Published online April 15, 2010
Purpose : To evaluate the efficacy and safety of levetiracetam adjunctive therapy for reducing the rate of seizure frequency in children with intractable pediatric epilepsy. Methods : We reviewed the medical records of 86 patients with intractable pediatric epilepsy who visited our hospital between March 1989 and February 2009. Levetiracetam was included in the previous anticonvulsant regimen for at least 6...
Clinical efficacy and safety of lamotrigine monotherapy in newly diagnosed pediatric patients with epilepsy
Ji Hye Han, Jung Eun Oh, Sun Jun Kim
Clin Exp Pediatr. 2010;53(4):565-570.   Published online April 15, 2010
Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining...
Change of interictal epileptiform discharges after antiepiletic drug treatment in childhood epilepsy
Mun Ju Kim, Sang Ook Nam
Clin Exp Pediatr. 2010;53(4):560-564.   Published online April 15, 2010
Purpose : Electroencephalography (EEG) findings can play a critical role in a variety of decisions, including initiation and withdrawal of antiepileptic drugs (AEDs) therapy. Interictal epileptiform discharges (IEDs) are predictor of recurrent seizures. We investigated IEDs in EEG after AED therapy and related factors in epileptic children. Methods : The subjects were 257 children [151 males and 106 females; age,...
Case Report
A case of hippocampal sclerosis diagnosed as cortical dysplasia due to preoperative brain MRI finding
Jun Seok Lee, Kyo Ryung Kim, Jeong Tae Kim, Min Jung Choi, Young Mock Lee, Heung Dong Kim, Joon Soo Lee, Dong Seok Kim, Tae Seong Kim
Clin Exp Pediatr. 2010;53(1):106-110.   Published online January 15, 2010
Hippocampal sclerosis (HS) is one of the most common features of intractable temporal lobe epilepsy. Generally it can be identified through brain magnetic resonance imaging (MRI) with high degree of sensitivity and specificity. Typical brain MRI findings of HS are hippocampal atrophy with hyperintense signal confined to the lesion. On the other hand cortical dysplasia exhibits blurring of the gray-white...
Original Article
Mediating effect of perceived stigma against epilepsy on quality of life among parents with epileptic child
Nho Eun Kim, Sung Min Cho, Dong Wook Kim
Clin Exp Pediatr. 2009;52(9):1005-1014.   Published online September 15, 2009

Purpose:Epilepsy of child may cause high level of psychosocial difficulties for parents including stigmatization and stress and therefore worsen their quality of life (QOL). The purpose of this study was to evaluate the mediating effect of perceived stigma against epilepsy on QOL among parents with epileptic child. Methods:Two hundred and sixty parents of epileptic child recruited from five separated university...
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