Chikaya Ohtsuka

The Effects of Clonazepam on Rolandic Discharge of Benign Epilepsy of Children with Centro‐Temporal EEG Foci

1) CZP had marked effects on RD. RD disappeared in 8 (73%) of 11 patients treated with CZP alone and 6 (43%) of 14 treated with CZP in combination with other drugs. Even when RD persisted, its amplitude and frequency decreased in some patients.

Brain function estimated from the ratio of glutamine to homocarnosine levels in cerebrospinal fluid.

The ratio of glutamine to homocarnosine (G/H ratio) in CSF of children with meningeal pathology or convulsions was measured and the following results were obtained. 1. The mean G/H ratio of normal subjects was 83.0 +/- 41.4. 2. The mean G/H ratios of the patients with bacterial meningitis and meningeal leukemia were 115.9 +/- 81.9 and 115.2 +/- 49.2, respectively. Significant differences were found between those in normal subjects and these diseases. 3. The mean G/H ratio of the patients with viral meningitis was 80.0 +/- 35.1 and no significant difference was found between normal subjects and these patients. 4. The mean G/H ratios in the patients with controlled versus uncontrolled epilepsy were 130.9 +/- 67.1 and 74.8 +/- 49.4, respectively. A significant difference was found between normal subjects and the patients with controlled epilepsy. 5. The mean G/H ratio in the patients with febrile convulsions was 46.5 +/- 6.3. A significant difference was found between normal subjects and these patients. These data suggest that a high G/H ratio in CSF may indicate the excited state of the brain.

Complication of the central nervous system in Kawasaki disease

Kawasaki disease is an acute febrile disease which has been described by T. Kawasaki as a syndrome of mucocutaneous lymph node in which systemic arteritis, especially in the coronary arteries, has been histologically demonstrated. Abnormalities of the cerebral arteries were also noted as a complications of this disease in the CNS. The present authors first thought that convulsions including the so-called febrile convulsions may frequently occur, because the age of the patients, under 5 years of age, is near that of patients with febrile convulsions and disorders of cerebral circulation may be caused due to arteritis. However, convulsions as a symptom of this disease seems to be relatively rare. This study was carried out and the pathogenesis of febrile convulsions was surmised to determine the frequency and characteristics of the complications of this disease in the CNS, particularly convulsions. One hundred fifty-five cases of Kawasaki disease observed at our hospital from March 1973 to July 1982 were checked for this purpose. Results

Homocarnosine levels in cerebrospinal fluid of patients with infantile spasms under ACTH therapy

The alteration of homocarnosine (dipeptide of GABA and histidine) levels in cerebrospinal fluid (CSF) was studied on 8 cases with infantile spasms under ACTH therapy. CSF was obtained by lumbar puncture before and during ACTH therapy. Homocarnosine was determined by the amino acid autoanalyzer. The attacks of infantile spasms were well controlled in all 8 cases by ACTH therapy. Homocarnosine levels in cerebrospinal fluid of each case decreased from 1.09 to 0.55, 0.92 to 0.41, 1.23 to 0.90, 0.79 to 0.49, 1.06 to 0.75, 1.06 to 0.89, 0.84 to 0.33 and 2.17 to 0.97 mumol/dl, respectively. The decrease of homocarnosine in CSF were 49.5%, 55.4%, 26.8%, 38.0%, 29.2%, 16.0%, 60.7% and 55.3%, respectively. This finding suggests that the decrease of homocarnosine in CSF may be related to the disappearance of attacks of infantile spasms.

Clinical investigation of daily anticonvulsant administration for children with febrile convulsions

onset of febrile seizures had EEG abnormalities before 3 years of age. Discussion. The observation of epileptiform EEG abnormalities before epilepsy onset was associated with no family history of febrile seizures within second-degree relatives, higher age at epilepsy onset, longer period between febrile seizures and epilepsy onset, and neurological abnormalities before the onset of febrile seizures. The centroparietal area was the most frequent focus in patients with, while the frontal area was most frequent in those without, EEG abnormalities before epilepsy onset. The degree of maturity and the location of the irritable brain lesion were closely related to the development of epileptiform EEG abnormalities.

A case of intractable epilepsy with left pachygyria. The effect of TRH-T treatment with a nasal nebulizer

of the right frontal, temporal, and parietal lobes. He develdifference between our patient and reported patients with oped a GTC 1 month after this MRI procedure. typical hemimegalencephaly. Conclusion: Neuronal migration disorders can be recognized distinctly on MRI. MRI revealed that the ectopic gray matter exhibits a wide spectrum, from the double cortex syndrome (case 3) to a nodular heterotopia (case 1). The accumulation of patient records will help to clarify the clinical status more precisely.

Special task report: A proposed revision of the guideline for managing patients with febrile convulsions

Benign epilepsy of children with complex partial seizures following febrile convulsions Kazuyoshi Watanabe, Izumi Takahashi, Tamiko Negoro, Kosaburo Aso and Kiyokuni Miura (Department of Pediatrics, Nagoya University School of Medicine, Nagoya, Japan) This study was presented for discussion to the meeting by invitation of the meeting organizer, although the study is already published as an original article in Seizure 1993;2:57-61.

Clinical studies on febrile convulsions appearing after 5 years of age

A clinical survey of febrile convulsions Toshihide Ishibashiavb and Yoshifumi Yamashitaa (aDepartment of Pediatrics, Kamigotoh Hospital, Nagasaki, Japan; bDepartment of Pediatrics, Shimabara Maternity Hospital, Nagasaki, Japan) In general, febrile convulsions have a good prognosis, but some cases of complex febrile convulsions and epilepsy developing from febrile convulsions require long-term treatment with anticonvulsants. Patients with febrile convulsions were investigated as to the correlations between the outcome and the cause of the seizures, the cause of the fever, and risk factors. Subjects and Methods. This study included 117 inpatients with febrile convulsions at Kamigotoh Hospital during the 15year period between January 1979 and December 1993. Information on age at initial onset, sex, cause of fever, duration, frequency of repetitive convulsions, and electroencephalographic findings was collected from charts and letters. Results. The male-to-female ratio of the febrile convulsion patients was 1.86. A viral disease was the cause of the fever in 63.9%, and a bacterial infection was involved in the etiology of the febrile convulsions in 19.6%. The outcome was simple febrile convulsions in 47%, no medication for complex febrile convulsions in 29.1%, medication for complex febrile convulsions in 14.6%, and epilepsy in 9.4% of the 117 patients 3-18 years after the initial onset. There were significant differences in terms of neurological symptoms at the time of onset, partial seizures, neurological symptoms after seizures, frequent seizures, abnormal EEG, and low grade fever ( < 37.9”C) in febrile convulsions with and without epilepsy. Conclusions. Viral diseases were the most frequent causes of fever in febrile convulsions. Bacterial infections were involved in the etiology in many patients, but this was difficult to demonstrate in most cases. Neurological symptoms at the time of onset, partial seizures, neurological symptoms after seizures, frequent seizures, and abnormal EEG findings are considered to be risk factors for transition to epilepsy even when such symptoms occur in isolation. Prophylactic administration of anticonvulsants is commonly performed in the treatment of complex febrile convulsions, but it is generally believed that treatment cannot prevent the onset of epilepsy. Such problems as hepatopathy and intellectual disturbance have also recently become issues. Intermittent administration of anticonvulsants during fever is therefore recommended.