著者

Yukako Nakagami Genichi Sugihara Kengo Uemura Naoto Jingami Keita Ueda Ryosuke Takahashi Toshiya Murai

出版者

日本てんかん学会

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.7, no.1, pp.23-29, 2014 (Released:2014-02-15)

参考文献数

14

被引用文献数

1

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Cerebral microbleeds (CMBs) usually produce no symptoms. We encountered a patient who developed cognitive decline and psychotic symptoms associated with nonconvulsive status epilepticus (NCSE), with presumptive epileptogenic focus possibly caused by a CMB. A 70-year-old man developed progressive cognitive disturbances including disorientation and hallucinations two months after a mild head injury. He was admitted to our hospital three months after the trauma, because of progression of symptoms. The first positron emission tomography (PET) with [18F]fluoro-2-deoxy-d-glucose (FDG) demonstrated intense FDG uptake in the left occipitoparietal region, in which a CMB was detected by T2∗-weighted magnetic resonance imaging (MRI). Electroencephalography showed continuous slow waves in the left occipital and parietal areas. After anticonvulsive therapy, his symptoms completely disappeared, accompanied by change in FDG uptake. Our case suggests that CMBs may be an epileptogenic focus of NCSE, and that FDG-PET is useful for the diagnosis of NCSE and assessment of therapeutic efficacy.

著者

Hiroshi Oketani Takato Morioka Satoshi Inoha Kenji Miki Takafumi Shimogawa Nobutaka Mukae Ayumi Sakata Hiroshi Shigeto Koji Yoshimoto

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.15, no.1, pp.59-66, 2023 (Released:2023-09-26)

参考文献数

17

被引用文献数

3

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Introduction: Arterial spin labeling (ASL) magnetic resonance (MR) perfusion imaging is useful for diagnosing non-convulsive status epilepticus (NCSE) as it visualizes ictal hyperperfusion in epileptically activated areas.Case report: A 94-year-old woman presented with inability to communicate. An electroencephalogram revealed generalized periodic discharges with triphasic morphology. However, as her liver and kidney function were normal, it was difficult to distinguish metabolic encephalopathy from NCSE. ASL showed not only diffuse hypoperfusion in the cerebral parenchyma, instead of ictal hyperperfusion, but also marked appearance of arterial transit artifact in the major arteries, probably due to stagnant flow. The patient was therefore diagnosed with hyperammonemic encephalopathy (ammonia level 128 mg/dL) induced by constipation. Along with normalization of the ammonia level, the mental status and ASL findings improved.Conclusion: In this case, ASL helped visualize the decreased blood flow and velocity secondary to hypometabolism. The addition of ASL to conventional MR images may be useful in differentiating metabolic encephalopathy from NCSE, particularly in neuroemergency situations.

著者

Naoto Kuroda Ayako Shibata Takafumi Kubota

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.13, no.1, pp.31-35, 2021 (Released:2021-02-26)

参考文献数

17

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The purpose of this review is to describe the impact of COVID-19 on women with epilepsy and how the issues are managed. From a review of relevant literature, we discuss special considerations for women with epilepsy during the COVID-19 crisis, which include menstruation, pregnancy, and living environment. We also propose comprehensive management including menstruation/pregnancy, medications, and mental stress. Through this review, the serious impact of COVID-19 on women with epilepsy is revealed. Epileptologists must understand these burdens in order to provide comprehensive support for women with epilepsy.

著者

Shinako Inaida Kousuke Kanemoto Shiro Tanaka Yoko Gouji Tomohiro Oshima Riki Matsumoto Akio Ikeda Koji Kawakami

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.10, no.1, pp.73-86, 2018 (Released:2018-09-08)

参考文献数

35

被引用文献数

3

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Purpose: Psychogenic non-epileptic seizures (PNES) are psychogenic disorders that often resemble epileptic seizures. Herein, we describe the recent clinical trends of PNES by using the data from a large, claims-based Japanese database obtained from the Japan Medical Data Center.Methods: A 10-year epidemiological study of patients of all ages with newly diagnosed PNES was conducted. Data were extracted using the International Classification of Diseases 10th Revision (ICD-10) diagnostic codes. Prevalence in new epilepsy patients and period of the diagnostic delay of PNES after epilepsy diagnosis were retrieved from the data. The study endpoint was change in frequency of hospital visits. Data of 413 patients with PNES were retrieved using the criterion of “PNES diagnosis after epilepsy diagnosis.”Results: The highest PNES prevalence in new epilepsy patients was observed in the 40-49 year age group (4.3%) for males, and in the 30-39 age group (4.9%) for females. The ratio of the prevalence in males to that in females was 1:2 for 0-9, 10-19, and >60 age groups, and 1:1 for the other age groups. A significant and positive correlation was found between the frequency of hospital visits and duration of the diagnostic delay of PNES. After PNES diagnosis, the average number of monthly hospital visits decreased over time.Discussion: The differences in the duration of diagnostic delay of PNES among cases and also a decrease in the frequency of hospital visits after PNES diagnosis highlight the importance of early differentiation between epilepsy and PNES.

著者

Hirotaka Kosaka Tetsuhito Murata Tetsuya Takahashi Masao Omori Hidehiko Okazawa Yuji Wada

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.2, no.1, pp.28-33, 2009 (Released:2009-10-23)

参考文献数

13

被引用文献数

2 2

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We report a case of a 51-year-old man presenting anxiety and autonomic symptoms of panic-like attacks and simultaneous auditory hallucination. No abnormalities were evident in a physical examination but his cognitive function was impaired. Thus panic disorder or non-specific dementia with psychosis was initially suspected. Brain MRI was almost normal, except for an old right basal ganglia infarction and mild frontal atrophy. Neuroimaging studies showed reduced glucose metabolism over bilateral frontal, right temporal and right parietal regions. When a panic-like attack occurred, EEG documented ictal discharges in the right frontal and temporal areas. After successful treatment with carbamazepine, cognitive dysfunction and abnormal findings on brain imaging were improved. This case suggests that epilepsy should be suspected in a patients presenting with anxiety symptoms of panic-like attacks and hallucinations.

著者

Mihoko Kawai Kousuke Kanemoto Yukai Tadokoro Hiroko Goji

出版者

JAPAN EPILEPSY SOCIETY

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.10, no.1, pp.68-72, 2018 (Released:2018-09-08)

参考文献数

11

被引用文献数

1 1

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We examined the effects of switching from carbamazepine to lacosamide on plasma concentrations of risperidone and its active metabolite 9-hydroxyrisperidone in two patients with partial epilepsy manifesting epileptic psychosis. Within 1 week of switch, increases of 52.5-347% in plasma levels of risperidone and 9-hydroxyrisperidone were observed, along with improvements in psychiatric symptoms as shown by Positive and Negative Syndrome Scale scores (PANSS). Neither of the patients showed extrapyramidal symptoms or seizures during 3 months after switching. The present results support the notion that carbamazepine (CBZ) administration induces hepatic microsomal enzyme systems that regulate inactivation of antipsychotic drugs. When CBZ and psychotropic agents are used in combination, a switch from CBZ to lacosamide may be effective in patients with treatment-resistance epileptic psychosis.

著者

Ono Tomonori S. Galanopoulou Aristea L. Moshé Solomon

出版者

一般社団法人 日本てんかん学会

雑誌

Epilepsy & Seizure

巻号頁・発行日

vol.6, no.1, pp.19-29, 2013

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Infantile spasms (IS) are an age-specific epileptic syndrome with overall poor outcome and are recognized as one of the 'catastrophic epilepsies'. Current conventional therapies including adrenocorticotropic hormone and vigabatrin often fail to control the spasms and improve the long-term outcome, especially in cases with structural/metabolic etiologies. To improve this situation, new treatments with a disease modifying potential must be identified. Recent translational studies have led to the development of several animal models of IS that reflect their multiple etiologies. Among these, the multiple hit model has been used to screen new promising therapies that, in the future, may be explored in clinical trials.

著者

Takamichi Yamamoto Seung Bong Hong Masahiro Shimizu Katsuaki Sato Yotaro Numachi

出版者

日本てんかん学会

雑誌

Epilepsy & Seizure (ISSN:18825567)

巻号頁・発行日

vol.7, no.1, pp.55-65, 2014-08-15 (Released:2014-08-15)

参考文献数

12

被引用文献数

5

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Purpose: To evaluate the efficacy and safety of lamotrigine monotherapy in patients with newly diagnosed partial seizures including secondarily generalized seizures or generalized tonic-clonic seizures, and those with recurrent seizures in Japan and South Korea.Methods: The study was a multi-center, open-label, evaluation of lamotrigine monotherapy in patients with newly diagnosed epilepsy or epilepsy with recurrent seizures. The primary endpoint was the seizure-free rate in the maintenance phase.Results: A total of 67 patients were enrolled; 52 patients completed 6 weeks of treatment (the escalation phase) and 42 patients completed 30 weeks of treatment (the escalation phase and the maintenance phase). The seizure-free rate in the maintenance phase for all seizure types was 43.1%. Adverse events (AEs) were reported in 82% (53/65) of patients. The most common AEs were headache (14/65, 22%), nasopharyngitis (12/65, 18%) and rash (7/65, 11%).Conclusion: The seizure-free rate with lamotrigine monotherapy in the maintenance phase was 43.1% for all seizure types. Lamotrigine monotherapy appears to be effective in patients with newly diagnosed epilepsy and those with recurrent seizures in Japan and South Korea. The safety profile of lamotrigine in this monotherapy study was similar to that observed in patients with adult bipolar disorder treated with lamotrigine monotherapy.