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Clinical Study of Epilepsy in Children.

Journal of the Korean Pediatric Society 1982;25(12):1234-1242.
Published online December 31, 1982.
Clinical Study of Epilepsy in Children.
C J Coe, D K Han, K Y Lee, B S Kim
Dept, of Pediatrics School of Medicine Yonsei University
소아간질의 임상적 고찰
고창준, 한동관, 이기영, 김병수
연세대학교 의과대학 소아과학교실
Abstract
From November 1980 to June 1982, for 19 months, 636 cases of child epileptic patients were clinically investigated at Pediatric department of Yonsei Medical school, and obtained follo- wing results. 1. The epileptic patients was 4.4% of all the pediatric patients, visited or hospitalized during the same period of time. 2. Epilepsy was commoner in male child compare to female representing male to female ratio, 1.3:1. 3. The most common epilepsy was generalized tonic and clonic, tonic, clonic seizure repre- senting 60.22% of all. 4. Infantile spasm was 2.36% of all patients, and most of them had their onset before age of 1. 93% of these patients had delayed developmental mile stone for their ages. 5. Myoclonic seizure was 5.5% of all patients, 74% of them had their onset before, age of 4. Myoclonic seizure was common in. male child and 40% of them accompanied various degree of mental deficiency. 6. 2.51% of patients were pstit mal, which was three times more common in female, child and they usually had their onset after age of 5. No one had any evidence of preceeding brain damage, identified by computerized tomography of brain. 7. The elementary symptomatology of focal seizure was 14. 63% of all patients. 8. Patients of complex symptomatology had various clinical features and they are 8.18%- of all patients. 9. Computerized tomography of brain was performed in 271 cases out patieats, and 39.85% manifested abnormal findings. Abnormal finding was of 636 epileptic most commonly dstscted in infantile spasm and myoclonic seizure, 50%, 64.3% respectively. In petit mal, no- one manifested abnormal finding. In generalized tonic and clonic seizure, 30.9%, in elemen- tary symptomatology of focal epilepsy, 46.1%, and in complex symptomatology 40.9% had pathological lesions in computerized tomography. 10. 2.2% of 271 patients who were investigated by computerized tomography had granulo- matous lesion in various site of brain, these lesion was known to disappeared or decreased ia size without specific treatment by follow up study. The etiology of the lesion was not iden- tified but it was postulated that it might be one of inflammatory process. This granulomatous lesion in epilepsy should differenciated from brain, tumor such as glioma or other space occupying lesion. As it might be disappeared spontaneously without treatment, it would be wise to observe some period of time with periodic investigation rather than unnecessary urgent neurosurgical intervention.
Key Words: Infantile spasm, myoclonic seizure, generalized seizure, elementary symptomatology. Complex symptomatology, automatism


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