てんかんジャーナル

Epilepsy is increasingly recognized as an important association with tic disorders and Tourette syndrome in children. Previous studies reported the overall prevalence of Tourette syndrome was around 1% in children. Epidemiological studies showed evidences of increased neuropsychiatric comorbidities of Tourette syndrome including attention-deficit hyperactivity disorder, obsessive-compulsive disorder and autistic spectrum disorder. The recent studies have demonstrated that increased risk of epilepsy in children with Tourette syndrome, and also increased risk of Tourette syndrome in epilepsy children. The genetic and clinical information refer to a common neurobiological basis for epilepsy and Tourette syndrome.

Objective: Many patients with Idiopathic Generalized Epilepsy (IGE) exhibit cognitive deficits. Interictal Epileptiform Discharges (IEDs) may contribute to cognitive impairment in epilepsy; however, the relationship between IEDs and cognitive impairment is unclear.
Methods: In this study, we analysed executive function in three groups: IGE patients with IEDs, IGE patients without IEDs and healthy controls. Executive function was assessed using the Stroop Test, the Verbal Fluency Test, the Digit Span Test and Wisconsin Card-Sorting Test.
Results: The IGE patients with IEDs performed worse on executive function tests compared with patients without IEDs. Furthermore, the IGE patients without IEDs performed worse compared with healthy controls. There were significant differences between the three groups in performance on the Stroop Test, the Digit Span Test (forward and backward), Verbal Fluency Test (animals, fruits) and the subscales of WCST (Categories Completed, Correct Response, Total Errors and Preservative Errors).
Conclusion: These results suggest that executive function in patients with IGE is impaired and is further impaired by IEDs. Future studies should determine whether well-controlled patients with IGE could benefit from antiepileptic treatment.

Objective: To evaluate the incidence, etiologies, clinical features and EEG findings of seizures among the neonates admitted to one medical center.
Method: We retrospectively reviewed the medical records of neonates who were diagnosed to have neonatal seizure at the Neonatal Intensive Care Unit (NICU) of one medical center in Taiwan from January to December 2015. The clinical pictures, laboratory data, image and EEG findings were reviewed in all cases.
Results: Neonatal seizures were diagnosed in 22 among 122 neonatal admissions in NICU in 2015. The most common type of seizures observed were subtle (77.2%), followed by tonic (13.7%) and clonic (9.1%) seizures. Acidosis was noted in cases with perinatal asphyxia and shock. The other laboratory data was non-contributory. Seventeen (77.3%) cases had abnormal EEG (focal spikes in majority) and 12 (54.5%) cases had abnormal image findings. Perinatal asphyxia (59.1%) was the most common cause of neonatal seizures, followed by CNS infection (18.2%), malformation syndrome (9.1%) and intracranial hemorrhage (9.1%).
Conclusion: Neonatal seizures were found in about 18% of our NICU admissions in one year and the most common was subtle type. Perinatal asphyxia was the most common etiology of neonatal seizures, followed by CNS infection. EEG plays a major role in the diagnosis and follow-up of neonatal seizures.