Showing papers by "Sung Eun Kim published in 2017"
TL;DR: There is an association between epileptiform discharges and SCM, and the involvement of the unilateral cortex and ipsilateral thalamus in SCM and its hyperperfusion state could be helpful in differentiating the consequences of epileptic seizures from other pathologies.
Abstract: Purpose The aim of this study was to investigate the predictive factors and identify the characteristics of the seizure-induced signal changes on MRI (SCM) in patients with first seizures. Methods We conducted a retrospective study of patients with first seizures from March 2010 to August 2014. The inclusion criteria for this study were patients with 1) first seizures, and 2) MRI and EEG performed within 24h of the first seizures. The definition of SCM was hyper-intensities in the brain not applying to cerebral arterial territories. Multivariate logistic regression was performed with or without SCM as a dependent variable. Results Of 431 patients with seizures visiting the ER, 69 patients met the inclusion criteria. Of 69 patients, 11 patients (15.9%) had SCM. Epileptiform discharge on EEG (OR 29.7, 95% CI 1.79–493.37, p=0.018) was an independently significant variable predicting the presence of SCM in patients with first seizures. In addition, the topography of SCM was as follows; i) ipsilateral hippocampus, thalamus and cerebral cortex (5/11), ii) unilateral cortex (4/11), iii) ipsilateral thalamus and cerebral cortex (1/11), iv) bilateral hippocampus (1/11). Moreover, 6 out of 7 patients who underwent both perfusion CT and MRI exhibited unilateral cortical hyperperfusion with ipsilateral thalamic involvement reflecting unrestricted vascular territories. Conclusion There is an association between epileptiform discharges and SCM. Additionally, the involvement of the unilateral cortex and ipsilateral thalamus in SCM and its hyperperfusion state could be helpful in differentiating the consequences of epileptic seizures from other pathologies.
30 citations
TL;DR: It is demonstrated that neuroimaging, genetics, and surgery are emerging topics in the field of epilepsy over the past decades, as well as the majority of top-cited articles on epilepsy and status epilepticus originated from institutions in the United States of America.
16 citations
TL;DR: This study aimed to evaluate the role of the thalamus in TLE patients with HS and hypothesized that temporal lobe epilepsy patients with and without hippocampal sclerosis showed differences in their limbic networks.
Abstract: Objective
We hypothesized that temporal lobe epilepsy (TLE) patients with and without hippocampal sclerosis (HS) showed differences in their limbic networks. This study aimed to evaluate the role of the thalamus in TLE patients with HS.
Materials and methods
Twenty-nine TLE patients with HS and 30 controls were enrolled in this study. In addition, we included eight TLE patients without HS as a disease control group. Using whole-brain T1-weighted MRIs, we analyzed the volumes of the limbic structures, including the hippocampus, thalamus, and total cortex, with FreeSurfer 5.1. We also investigated the effective connectivity among these structures using SPSS Amos 21 based on these volumetric measures. Moreover, we quantified correlations between epilepsy duration and the volumes of these structures.
Results
There was a statistically significant effective connectivity from the hippocampus to the thalamus in TLE patients with HS. Moreover, the volumes of the left and right thalamus were negatively correlated with epilepsy duration (r=−.42, P=.0315 and r=−.52, P=.0062, respectively). However, neither TLE patients without HS nor normal controls had a significant effective connectivity from the hippocampus to the thalamus.
Conclusions
The limbic networks of TLE patients with and without HS could be different, and the thalamus might play a critical role in TLE patients with HS.
13 citations
TL;DR: The aim of this study was to investigate whether volumes of the corpus callosum could predict a response to antiepileptic drugs in patients with newly diagnosed focal epilepsy.
Abstract: Objective
The aim of this study was to investigate whether volumes of the corpus callosum could predict a response to antiepileptic drugs in patients with newly diagnosed focal epilepsy.
Methods
Fifty-three patients with newly diagnosed focal epilepsy of unknown etiology and healthy subjects were enrolled in this study. First, we analyzed the differences in the volumes of the corpus callosum between patients with epilepsy and healthy subjects. Second, we divided patients with epilepsy into antiepileptic drug responders and drug nonresponders groups, according to their seizure controls, and evaluated the differences in the volumes of the corpus callosum between the groups. Third, we conducted correlation analyses between the volumes of the corpus callosum and mean diffusion measures in healthy subjects.
Results
The volumes of the corpus callosum in patients with epilepsy were significantly lower than those in normal controls (p = .0001). Among epilepsy patients, the volumes of the corpus callosum were significantly lower in antiepileptic drug responders compared with nonresponders (p = .0481), which was the only independent variable for predicting antiepileptic drug response (OR = 10.07, p = .0434). In addition, we found that the volumes of the corpus callosum were significantly correlated with the mean diffusion measures (fractional anisotropy, r = .408, p = .0027; mean diffusivity, r = −0.403, p = .0028) in normal controls.
Conclusions
We demonstrated that the volumes of the corpus callosum were different according to antiepileptic drug responses in patients with newly diagnosed focal epilepsy, which might suggest that the volumes of the corpus callosum could be a new biomarker for predicting responses to antiepileptic drugs.
10 citations
TL;DR: This evaluation sought to evaluate whether cerebral autoregulation is an alternative cause for orthostatic dizziness in PD patients, using transcranial Doppler monitoring during head‐up tilting.
Abstract: Objectives Orthostatic hypotension (OH) is controversially regarded as the cause of orthostatic dizziness in Parkinson's disease (PD) We sought to evaluate whether cerebral autoregulation is an alternative cause for orthostatic dizziness in PD patients, using transcranial Doppler monitoring during head-up tilting Methods Forty-five PD patients with dizziness, 13 PD patients without dizziness, and 10 age-matched healthy controls were enrolled Participants were divided into the following four groups: patients with dizziness and OH (group 1, n = 22), patients with dizziness but no OH (n = 23, group 2), patients without dizziness (n = 11, group 3), and age-matched healthy controls (n = 10, group 4) All participants underwent transcranial Doppler and blood pressure monitoring for 10 minutes during the head-up tilt test Changes in the cerebral blood flow velocity (CBFV) in the middle cerebral artery and the mean blood pressure (mBP) within 3 minutes after head-up tilting were compared between groups Results Group 1 showed a significantly higher change in mBP (-163 ± 108 mmHg) than groups 2 (-26 ± 49), 3 (-22 ± 36), or 4 (18 ± 60) (p Conclusions Our results suggest that cerebral hypoperfusion contributes to dizziness in PD patients despite a lack of OH Transcranial Doppler monitoring during head-up tilting may be a useful tool for evaluating dizziness in PD patients with or without OH © 2016 Wiley Periodicals, Inc J Clin Ultrasound 45:337-342, 2017
10 citations
TL;DR: Procedural outcomes such as successful recanalization and S-ICH after EVT in octogenarians are comparable to those seen in patients <80years, and EVT is technically feasible to treat hyperacute stroke inOctogenarians.
9 citations
TL;DR: This study evaluated alterations in cortical morphology in patients with transient global amnesia (TGA) to find out if these changes are related to hippocampal haemorrhage or simply down-regulation in the hippocampus.
Abstract: Objective This study evaluated alterations in cortical morphology in patients with transient global amnesia (TGA). Materials and methods Diagnoses of TGA occurred at our hospital. Evaluation involved a structured interview to obtain clinical information and a brain magnetic resonance imaging scan. We analyzed whole-brain T1-weighted MRI data using FreeSurfer 5.1. Measures of cortical morphology, such as thickness, surface area, volume, and curvature were compared between patients with TGA and healthy controls. We also quantified the correlations between clinical variables and each measure of abnormal cortical morphology. Results Seventy patients met the inclusion criteria. Compared to healthy controls, patients with TGA had significant alterations in cortical thickness in several regions of bilateral hemisphere. Moreover, several regions of cortical volumes in left hemisphere were significantly different between patients with TGA and healthy controls. In addition, there were significant correlations between the durations of episodes and cortical thickness, especially in the parietal cortex. However, there were no differences between groups in other measures of cortical morphology, including surface area and curvatures. Conclusions We observed significant alterations in cortical morphology in patients with TGA; these alterations are implicated in the pathogenesis of TGA.
9 citations
TL;DR: The mortality rate during hospitalization as a marker of prognosis in patients with bacterial meningitis and high levels of procalcitonin in the blood found to be an independently significant predictor for death were found.
8 citations
TL;DR: Primary suction thrombectomy produced higher recanalization and good clinical outcome rates than did stent retriever thromBectomy, and larger-scale studies are necessary that consider factors such as occlusion site, stroke severity, and concomitant use of endovascular devices.
7 citations
TL;DR: Whether juvenile myoclonic epilepsy is a disorder of thalamus or cortex or cortex is evaluated using whole-brain T1-weighted MRIs and the effective connectivity among these structures is investigated using SPSS Amos 21 based on volumetric measures.
4 citations
TL;DR: A 29-year-old female who had been treated in another hospital and who had a history of two stroke attacks was admitted with newly developed dysarthria and diagnosed with systemic lupus erythematosus based on oral ulcers, proteinuria of 3+, positive ANA, and positive anti-dsDNA in accordance with the 2015 revised criteria of the American College of Rheumatology/Systemic Lupus International Collaborating Clinics.
Abstract: Dear Editor, A 29-year-old female who had been treated in another hospital and who had a history of two stroke attacks was admitted with newly developed dysarthria. The two previous stroke attacks were lacunar syndromes caused by a right anterior thalamic infarction and a left lateral medullary infarction at 11 and 8 months prior to admission to our hospital, respectively. She denied having any conventional risk factors. On examination she was found to have moderately decreased sensation in the left side without any sequelae from the previous attacks. She was taking clopidogrel, warfarin, and rosuvastatin. Her initial international normalized ratio value for the prothrombin time was 2.38. Diffusion-weighted images obtained on her admission day showed an acute infarction in the right internal capsule (Fig. 1A). Her 3D and source images of time-of-flight magnetic resonance angiography (MRA) revealed abnormal dilatation and narrowing in a branch of the right distal internal carotid artery (Fig. 1B and C). We performed a lumbar puncture on the fifth day after admission. The findings for the cerebrospinal fluid, including the cell count, were normal. Conventional angiography revealed a characteristic beading pattern, consistent with vasculitis in the right anterior choroidal artery (Fig. 1D). The results of the laboratory tests for vasculitis can be summarized as positivity for antinuclear antibody (ANA) at a dilution of 1:640 with a homogeneous and speckled pattern, and for anti-double-stranded DNA (anti-dsDNA) at a dilution of 1:80. She was diagnosed with systemic lupus erythematosus (SLE) based on oral ulcers, proteinuria of 3+, positive ANA, and positive anti-dsDNA in accordance with the 2015 revised criteria of the American College of Rheumatology/Systemic Lupus International Collaborating Clinics. The immunosuppressant of hydroxychloroquine was added to her steroid therapy for treating the central nervous system (CNS) lupus for several weeks after admission. The abnormal findings for the right anterior choroidal artery had disappeared at follow-up MRA performed 1 year after starting steroid and immunosuppressive therapy (Fig. 1E). The follow-up fluid-attenuated inversion recovery image showed only a subtle old lesion in the right internal capsule (Fig. 1F). Ischemic stroke caused by lupus vasculitis is rare. Although magnetic resonance (MR) imaging is sensitive for CNS vasculitis,1 the findings of MRA evaluating vasculitis caused by SLE may be mostly normal since mainly small vessels are affected by lupus.2 Our case of lupus vasculitis shows two rare features: 1) vasculitis with a beading pattern appearing as narrowing and ectasia in the anterior choroidal artery and 2) abnormal findings for the anterior choroidal artery were detected in 3D-reconstructed MRA images as well as in conventional angiography. The main pathology of arteritis caused by collagen disease is fibrinoid degeneration in the arterial walls.3 While endothelial proliferations with destroyed muscular and elastic tissue are associated with arterial narrowing, weakening of the walls with smaller extents of endothelial hyperplasia may produce ectasias.3 This beading pattern of arteritis is easiest to detect usHyung Chan Kim Soo Young Bae Joon Won Lee Si Eun Kim Byung In Lee Sung Eun Kim Kyong Jin Shin JinSe Park Kang Min Park Sam Yeol Ha
TL;DR: Received November 9, 2016 Revised February 20, 2017 Accepted February20, 2017 Address for correspondence: Kyong Jin Shin, MD, PhD Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, 875 Haeun-daero, Busan 48108, Korea.
Abstract: Received November 9, 2016 Revised February 20, 2017 Accepted February 20, 2017 Address for correspondence: Kyong Jin Shin, MD, PhD Department of Neurology, Haeundae-Paik Hospital, Inje University, College of Medicine, 875 Haeun-daero, Heaundae-gu, Busan 48108, Korea Tel: +82-51-797-2080 Fax: +82-51-797-1159 E-mail: neurof1130@paik.ac.kr 신경매독은 매독균(Treponema pallidum)의 중추신경계 감염으 로 발생하며, 모든 시기의 매독에서 신경매독으로의 진행이 가능 하다. 초기의 가장 흔한 형태의 신경매독은 뇌수막염이고, 후기에 서는 뇌, 척수의 실질을 침범하는 진행마비(general paresis)이다. 수막혈관신경매독은 뇌매독의 모든 시기에 발현이 가능하고 두통, 혼동, 구역 및 구토 등 단순한 증상에서부터, 시력저하, 안면마비, 청력저하, 편마비, 언어장애, 감각이상, 보행장애 등의 다양한 임상 양상으로 나타날 수 있다. 저자들은 아급성경과의 발음장애와 언
TL;DR: Serial MRI and funduscopic examination are needed in diagnosing OPN to differentiate to the temporal change of ON.
Abstract: Optic perineuritis (OPN) is a rare form of orbital inflammatory disease of optic nerve sheath. The clinical presentation of OPN are known as distinct from demyelinating optic neuritis (ON). Recently, we have experienced a patient with bilateral idiopathic ON who had initial magnetic resonance imaging (MRI) feature of OPN. Serial MRI and funduscopic examination exhibited the bilateral ON findings. Serial MRI and funduscopic examination are needed in diagnosing OPN to differentiate to the temporal change of ON. J Korean Neurol Assoc 35(1):43-45, 2017