ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02260.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYOntogenetic studies of epileptogenic process were carried out in albino rats ranging in age from birth to 45 days. Experimental epilepsy was produced by two different procedures and the results were compared with each other.Tungstic acid gel was applied to the motor area of the left side of the cortex, and the following results were obtained.The latency of the seizure appearance was long during 10 days after birth, became progressively short thereafter and reached the minimum in about 20 days of age, and gradually returned to the adult level again by 45 days of age.No obvious seizure was exhibited until five days of age. Seizure patterns developed from tonic or twitch‐like jerky convulsion (10 days old) to rhythmic or clonic type of seizure (13 days old), and the seizure patterns similar to those in the adult rat were observed in about 20 days of age.Cortical seizure activity was initially observed in about 10–day‐old rats; single high amplitude slow wave appeared and small spikes became superimposed on it in the course of maturation. Atypical spike and wave complexes were observed after 20 days of age.Electrical stimulation was applied to the left cortical motor area by constant current stimulator, and the following seizure patterns were observed: No obvious seizure could be elicited in newborn rat, whereas from three days of age, tonic seizure of the whole body, and from seven days old twitch‐like convulsion of extremities were observed. In ages from 10 to 20 days, seizure induced by electrical stimulation was mainly tonic in pattern; extension of forelimbs and flexion of hindlimbs in most cases were observed before 13 days old, but both fore‐ and hind‐limbs were extended thereafter. Tonic‐clonic seizure patterns were exhibited after 20 days of age.From these results, it was considered that tonic convulsions and high voltage slow cortical seizure activities were produced from the activities of the local cortical neuro‐nal connections, and rhythmic and/or clonic seizure patterns and spike and wave seizure activities were elicited from the more complex,i.e. cortico‐subcortical neuronal circuits.Possible contributing factors for the determination of seizure susceptibility in immature rats we

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02261.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYChildhood epilepsy with nocturnal seizure and rolandic (centro‐temporal) discharge on EEG, had recently been noted by some French and other European authors. These types of epilepsy usually appeared in middle childhood and showed a favorable effect to anticonvulsant therapy. The pre sent investigation deals with analysis of seizures and of some characteristics of rolandic discharge, particularly with respect to the cerebral maturational process involved in the appearance of seizure discharge.The patients were selected out by the symptoms of epilepsy and features of EEG's, consisting of 20 children in total. Fifteen patients showed somatomotor attacks and five showed somatosensory as well as somatomotor attacks. As for the duration of seizure, those who had seizures before three and 10 years of age, had attacks for relatively short periods, whereas those who had attacks from four to nine years of age, usually had longer duration. The amplitude of “RD” remained lower than 50 μv up to three years of age, whereas it reached as high as 200 μv up to nine years, particularly during sleep, which became lower after the age of 10. It was concluded that there is an age dependency between the ages of four a

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02262.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYThe clinical and electroencephalographical observations were performed on the two series of subjects and some relations between the EEG paroxysins of centrencephalic nature and clinical features were obtained.1One series comprised 154 children with the age‐range of six to 10 years complaining of some learning disability. The abnormal EEG paroxysms of centrencephalic nature were found in 31% of them. Behavior deviation and vegetative symptoms were the main clinical symptoms, appearing in 83% and 40% of these children respectively. It was supposed that children with both behavior deviation and vegetative symptoms and also those with vegetative symptoms alone had a close relation with the centrencephalic EEG paroxysms, and that learning disability might result from these two main symptoms.2The other series was composed of 50 patients in whom the age varied from 11 to 24 years, mainly 15–16, and 6–14/sec positive spikes were found. The behavior problems of these patients had the qualities which brought more practical sociopathic behaviors, and this was an exact difference from the behavior problems in the former series of children. In addition, vegetative disturbances and affective disorders were observed, and they are considered to relate to the behavior problems. The vegetative disturbances might play a role as an activating factor and the affective disorders as an underlying factor in the developing process of the behavior problems.Finally, it is concluded that although the fundamental clinical varieties of behavioral, affective and vegetative dysregulations were observed in the patients who had the centrencephalic EEG paroxysms, these three varieties were dependent on one another during the development of the individual pat

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02263.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYThe long‐term clinical and electroencepha‐lographic follow‐up studies were carried out for more than three years, up to 14 years in the longest, on 116 cases with Lennox syndrome. And the results of systematic study on changing patterns and outcome have been reported.The follow‐up examination was performed also on West syndrome which is closely related with Lennox syndrome; especially the relationship between both syndromes regarding prognosis has been clarified.1According to the long‐term follow‐up on 116 cases with Lennox syndrome, there were 98 cases (84.5%) having mental defect. The remaining of seizure was observed in 71 cases (61.2%) and persisted as Lennox syndrome except for one case.2Generally speaking, the cases with age of onset before two years old showed unfavorable outcome.3There were 42 cases (36.2%), which were converted from West syndrome and showed markedly unfavorable prognosis in regard to intelligence as well as the remaining of seizure. (31 cases, 77.5%)4On the other hand, in 23 idiopathic cases, which showed no developmental retardation before onset of seizure, had favorable outcome, and the remaining of seizure was observed in eight cases (34.8%). However, even in such cases, it was noticed that those displaying mental defect at the follow‐up attained 14 cases (60.9%). That is to say, it was clarified that persistence of even minor seizures induced mental deterioration.5The cases with favorable prognosis showed usually a typical slow spike‐and‐wave pattern electroencephalographically, whereas those with poor prognosis showed mostly an asymmetric or disorganized slow spike‐and‐wave pattern.6In many cases displaying signs of brain atrophy with pneumoencephalogram and accompanying overt neurological signs at the initial examination, prognosis is obviously poor.7From the follow‐up examination on 94 cases with West syndrome for three to 15 years, there were 51 cases (54.3%) which was transformed into Lennox syndrome. Among them, those cases with the remaining of seizure at the time of follow‐up were 44 (46.8%) out of 94 cases, of which 37 cases (83.8%) had remaining seizure as Lennox syndrome.8From the above results, it is emphasized that Lennox and West syndromes show close relationship with each other and that a study should be done on the interrelatio

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02264.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYOn 62 cases with Lennox‐Gastaut's syndrome aged four to 31, the clinical‐electro‐encephalographic findings were summarized as follows;1(1) Age of onset was over 10 years in 10 cases (16.1%).2Mental deficiencies were more severe in those with onset earlier than age three.3Behavioral problems were observed in 34 cases (54.8%); 21 with hyperactive and 13 with hypoactive ones ‐ 18 hyperactive cases (85.7%) with the onset taking place before age six, and 12 hypoactive cases (92.3%), all whose age is now over 10.4The number of clinical seizures showed a tendency in which monoictal manifestation decreased from 25 to three whereas polyictal one increased from 13 to 59 cases during the course of a decade.5Interictal EEG findings were pseudo‐rhythm of slow spike‐wave with or without focal spikes, and so‐called runs of rapid spikes during sleep recording. Focal spikes were observed in 25 cases (40.3%); mainly in the frontal area among those under 10 years old, and in the anterior temporal area among those over 20. The rapid spikes were demonstrated in 19 cases (30.6%) in the over‐15 age group and appeared to be correlated with epileptic drop seizures and atypical c

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02265.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYA follow‐up study has been made of 25 cases with infantile spasms, all of whom were six years old or more at review.Only four (16%) out of 25 cases made a full recovery and attended normal school. Spasms ceased in 96% of all cases, but fits other than spasms (grand mal, tonic seizure, atonic seizure, myoclonic seizure, atypical absence and psychomotor seizure) occurred subsequently in 11 cases (44%). The EEG became normal in two cases (8%), but still showed modified hypsarhythmia in three cases (12%), “epileptic non‐hypsarhythmic” discharges in 17 cases (68%) and non‐specific abnormalities in three cases (12%).The important factors associated with good prognosis were normal development before the onset of spasms, late onset (seven months old or over) and short duration of spasms, the absence of other types of fit following spasms and lack of neurological abnormality.A bad prognosis was associated with abnormal development prior to the onset of spasms, early onset and long duration of spasms, the presence of other types of fit following spasms and evidence of any neurological abnormality.This follow‐up may confirm that the therapy with ACTH‐A has no significant effect on final

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02266.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYThe long‐term prognosis of 185 children with epilepsy, who continued to attend the Clinic for Epileptic Children, the Department of Pediatrics, the University of Tokyo, beyond the age of 18 years, was reported. The length of follow‐up varied from three to 20 years, but most of them were followed longer than 10 years.The presumed etiology in these children was divided into a cryptogenic group (124, 67.0%) and a symptomatic group (61). The types of seizures were classified into grand mal (86 cases), focal seizure (27), petit mal absence (4), psychomotor seizure (S), infantile spasms (7), and so on. It may be noted that the highest frequency of grand rnal was demonstrated, while the incidences of infantile spasms, myoclonic seizure, and akinetic seizure were low in the series. Only 28 children (15.1%) had complications of physical and/or mental handicaps.The follow‐up study revealed that 140 patients (75.7%) had been seizure‐free in the last 12 months. One hundred and fifteen of them had no seizures for five years or longer. On the other hand, electroencepha‐lographic abnormalities generally continued for a long time after disappearance of seizures, Eighty‐one of well‐controlled patients were gradually decreasing the doses of anti‐convulsants. As for seizure types, it is noted that focal seizure, psychomotor seizure, and infantile spasms were relatively difficult to be controlled.Except for 27 patients, most of them attended normal schools, including junior colleges or universities, and engaged in various occupations. Fifteen female patients had already married, and out of 13 babies who were born from these patients, there were one with ventricular septal defect, one with mental deficiency, and one with anencephaly, while the rest were entirely normal.Additional problems on withdrawal of anticonvulsants after a long‐term seizure‐free period, and what a medical system should be for treatment of epilepsy in children up to their adult

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02267.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYPolygraphic recordings were performed 22 times during a period of about two years on a 25–year‐old man with the Lennox‐Gastaut syndrome of the adult type. He had several generalized convulsions initially when he was eight years old, and had the Lennox‐Gastaut syndrome since the age of 17 years.The paroxysmal fast rhythm shown 214 times in the recordings, which appeared only in the light stage of sleep, was analyzed. The pattern of the paroxysms, and the relationship between the pattern and the clinical seizures was studied.The paroxysms were composed of a series of spikes and slow spike and wave. They appeared diffuse and bilaterally synchronous. And so, we classified these paroxysms into four types, A through D, from the differences of basic activity before appearance of the paroxysms, amplitude, frequency and fluctuation of amplitude and frequency. Consequently D type was thought to be different from the other types on the ground of elec‐trophysiological viewpoint. But types A through C were clinicoencephalographically the same type of the pattern in spite of the differences in frequency, fluctuation of that and duration of the discharge.All of the clinical seizures which appeared with these paroxysmal fast rhythms was local tonic spasm in the lip. But D type never failed to associate with local tonic spasms and usually developed generalized tonic seizure.Except for D type, it was shown obviously that the same local tonic spasm appeared when the duration of the paroxysm was longer than 4.9 sec.We proposed the paroxysmal fast rhythm of a name “tonic seizure discharge” on the basis of the findings on

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02268.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

SUMMARYThe cases of the Lennox syndrome which began at the age between 14 and 16, namely in puberty, were reported. The first case, a 22–year‐old woman, was attacked with grand mal seizure at the age of 15, and one year later “Juchzer” (ref. Doose) appeared. This continued for two years, and then astatic seizures appeared. The second case, a 20–year‐old woman, was attacked with grand mal seizure at the age of 14, and soon after astatic seizure appeared. Thus both are closely related with grand mal seizures. The first case is idiopathic, and the intelligence developed normally till the onset of the Lennox syndrome, but after that it became disturbed. The second case is residual state of arsenic toxicosis, and so the intelligence was already disturbed before the onset. On EEG both of them at first showed diffuse slow waves of high voltage, and in several years after the appearance of the Lennox syndrome, slow spike‐waves were found. On therapy, scarcely no beneficial effects were noted by conventional antiepileptics, and by nitrazepam only the temporal beneficial effect was obtained. The symptoms of our cases are generally similar to the Lennox syndrome in infancy. Though we observed only two cases, we presented our cases as the Lennox syndrome wi

ISSN:1323-1316    

DOI:10.1111/j.1440-1819.1976.tb02269.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY