Tohru Seki

Monotherapy for Childhood Epilepsies with Zonisamide

Abstract: Zonisamide was tried on 44 children, 18 girls and 26 boys, from 8 months to 15 years of age at the start of the trial. In 6 children the drug has been stopped because of side effects. The drug was introduced at a dose of 2–4 mg/kg/day and increased to 12 mg/kg/day unless a satisfactory response occurred at a lower dose. A 100% control of seizures was achieved in 5 of 5 cases of idiopathic generalized epilepsies, in 7 of 8 cases of symptomatic generalized epilepsies, in one of one case of idiopathic partial epilepsies, and in 17 of 24 cases of symptomatic partial epiSepsies. The main side effect was drowsiness, especially during the introduction.

Combination Treatment of High-Dose Pyridoxal Phosphate and Low-Dose ACTH in Children with West Syndrome and Related Disorders

Abstract: Combination therapy of hih‐dose pyridoxal phosphate (PALP, 40–50 mg/kg/day) and low‐dose ACTIW1‐X‐Z (tetracosactide acetate‐Zn, Cortrosyn Z®, 0.01 mg/kg/day) was institnted in 26 children suffering from West syndrome and related disorders ‐pretreated without success with high‐dose PAL‐P alone; 18 with West syndrome (14 with symptomatic and 4 with cryptogenic types), 2 with symptomatic Lennox‐Gastaut syndrome, 5 with cerebral palsy with hypsarhythmia or diffuse slow spike‐waves and one with myoclonic seizures (secondary generalized epilepsy). Clinical, electroencephalographic and neurochemical investigations were carried out.

The Long‐Term Prognosis of Infantile Spasms—The Present Condition of Cases of Infantile Spasms Followed in School Age

A follow‐up study has been made of 25 cases with infantile spasms, all of whom were six years old or more at review.

The long-term prognosis of minor seizures in childhood epilepsy.

The long–term clinical and electroence‐phalographic follow‐up studies were carried out for more than three to 13 years on 72 cases with minor seizures in childhood epilepsy at the Department of Pediatrics of Keio University from January 1963 to January 1973. Minor seizures were classified into typical absences, infantile spasms, Lennox syndrome, myoclonic seizures and atonic seizures. The results of each group were summarized as follows, but atonic seizures were excluded because there were too few cases of this group.

Guidelines for Discontinuation of Antiepileptic Drugs for Childhood Absence Epilepsy and Rolandic Epilepsy

It is generally considered that most patients with childhood absence epilepsy (CAE) and rolandic epilepsy (RE) have outgrown epilepsy by the age of 20. However, there are a few reports about a rational approach to the treatment of these epilepsies. We studied 56 patients with CAE and 60 patients with RE who were followed up for more than five years and were over 14 years of age at the last visit to make some guidelines when to discontinue antiepileptic drugs (AEDs).

Long-Term Prognosis of Childhood Epilepsy–Follow-Up Until Adulthood in Patients Whose Age of Onset Is Under 10

In patients suffering from epilepsy, the symptoms usually start in childhood and last until adulthood. During the long period of treatment, patients usually change their clinics due to transference and various other reasons. So it is difficult to follow-up these patients in the same clinic for a long time, making it difficult for us to carry out detailed investigations of a long-term prognosis in patients with epilepsy. To overcome this problem, only adult patients who have been followed-up at our neuropediatric outpatient clinic since childhood have been selected for this investigation of the long-term prognosis in patients with epilepsy.

Prognosis of typical absence: a follow-up study of more than three years.

This report is based on 28 cases of typical absence, which were followed by the Department of Pediatrics of Keio University from January 1963 to September 1974. Typical absence is defined as follows: the attacks are characterized by a sudden and brief disturbance of consciousness lasting 5-20 seconds without aura and postparoxysmal symptoms, either with or without minor motor, automatic and autonomic components, accompanied by diffuse rhythmic 3 ~ / ~ spike & wave discharges in EEG during the attacks. The termination of the attacks is abrupt and the attacks occur frequently. The cases of typical absence during the period of observation totalled forty-three, but there were 35% (15 cases) of dropouts. The single or combined medication with ethosuximide, sodium valproate and trimethadione was used in all cases. Phenobarbital was combined with anti-absence drugs only in typical absence cases and both phenobarbital and diphenylhydantoin in cases of grand ma1 or those with a history of febrile convulsions (mixed form by Fukuyama) in addition to typical absence. However, diphenylhydantoin was given in a smaller dose as compared to maintenance dose because diphenylhydantoin may induce attacks of typical absence. Of the 28 cases, 12 (43%) were males