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Sang-Ahm Lee

Publications and source records attributed to Sang-Ahm Lee.

13 recordsLinked to original sources
PubMed2006

Executive performance on the Wisconsin Card Sorting Test in mesial temporal lobe epilepsy.

Executive dysfunction assessed by the Wisconsin Card Sorting Test has been observed in patients with mesial temporal lobe epilepsy (TLE); however, the mechanism of executive impairment is unclear. We therefore investigated the potential contribution of the hippocampus toward executive dysfunction in 85 mesial TLE patients, and in a control group of 34 patients with neocortical TLE. Standardized regression-based methodology was used for correcting test-retest bias. We found that 56% of mesial TLE patients had impaired sorting performance, with 30% showing severe impairment. A lower full-scale intelligence quotient, older age, longer duration, and preoperative use of topiramate were significantly correlated with poorer preoperative sorting abilities. However, neither these variables nor postoperative discontinuation/reduction of topiramate were related to postoperative changes in sorting abilities. Only preoperative sorting abilities were negatively correlated with postoperative changes in executive performance. That is, patients with better preoperative executive ability showed greater postoperative deterioration in executive function, whereas those with poorer preoperative sorting ability had greater improvement in executive function after mesial temporal resection. There were no differences in card sorting ability between the mesial and neocortical TLE groups. In conclusion, our results suggest that impairment of card sorting performance in the mesial TLE group cannot be explained only by hippocampal dysfunction, but that other processes (possibly epileptic discharges propagated to the extratemporal area) must play a predominant role.

Adult↗
PubMed2006

Factors predicting seizure outcome of anterior temporal lobectomy for patients with mesial temporal sclerosis.

PURPOSE: To investigate the factors, including those associated with ictal scalp EEG results, related to surgical outcome in patients with pathologically proven mesial temporal sclerosis. METHODS: We studied 51 consecutive patients who underwent anterior temporal lobectomy and had at least 4 years of follow-up. Surgical outcome was classified as being seizure-free or not seizure-free during the first two and the subsequent two postoperative years. Clinical variables and scalp EEG parameters were subjected to statistical analysis. RESULTS: Of the 51 patients, 36 (70.6%) were seizure-free during postoperative years 3 and 4. Logistic regression analysis revealed that seizure remission for the first 2 years (p = 0.002) and contralateral propagated ictal discharges (p = 0.015) were independently related to seizure outcome at 4 years. Patients who were seizure-free at 2 years had an 86.5% chance of remaining seizure-free at 4 years. Of the patients without bitemporal asynchrony or switch of lateralization, 88.9% were seizure free at 4 years, compared with 54.5% of patients with asynchrony or switch of lateralization (p = 0.007). These two factors, however, were not predictive of seizure outcome at 2 years. CONCLUSIONS: Contralateral propagated ictal discharges, including bitemporal asynchrony and switch of lateralization, unfavorably influence long-term seizure outcome. Long-term seizure control is best when the patient has no such propagation patterns of ictal discharges and is seizure-free during the first 2 years after temporal lobectomy.

Adolescent↗
PubMed2006

Factors contributing to clinical seizure lateralization in patients with mesial temporal lobe epilepsy.

Clinical seizure semiology can provide important information on the lateralization of the epileptogenic zone. We investigated factors associated with clinical seizure lateralization in patients with pathologically proven mesial temporal sclerosis. We reviewed 243 seizures of 58 patients. Clinical lateralization was possible in 155 (63.8%) of 243 seizures. Lateralization was correct in 144 (92.9%) of 155 lateralized seizures. Logistic regression analysis showed that age at onset (p = 0.001; odds ra tio = 1.089, 95% confidence interval = 1.035-1.145) and the contralateral propagation pattern of ictal discharges (p = 0.001; odds ratio = 3.544, 95% confidence interval = 1.723-7.289) correlated with clinical seizure lateralization. The patient group with clinically lateralized seizures had a younger age at onset of habitual seizures compared to the clinically nonlateralized group (11.1 +/- 6.3 vs. 15.6 +/- 8.4 years; p < 0.001). Of seizures without bitemporal asynchrony or switch of lateralization, 70.7% were clinically lateralized compared with only 46.4% of seizures with asynchrony or lateralization switch. The present results suggest that the age of epilepsy onset and the ictal scalp EEG propagation pattern affect clinical seizure lateralization in patients with mesial temporal sclerosis.

Adult↗
PubMed2005

Correlation of interictal spike-wave with thalamic glucose metabolism in juvenile myoclonic epilepsy.

The purpose of this study is to define metabolic correlates of generalized spike-wave discharges in juvenile myoclonic epilepsy. We investigated the alterations in glucose metabolism and possible correlations between the interictal epileptiform discharges and regional metabolism in patients with juvenile myoclonic epilepsy using a combined positron emission tomography/electroencephalography method. We found that the thalamic metabolism is slightly increased interictally in the patient group compared with controls. We also observed significant positive correlations between the amount of spike-wave activity and thalamic metabolism. Our results provide evidence that the thalamus has an important role in the generation of spontaneous generalized spike-wave discharges in juvenile myoclonic epilepsy.

Adolescent↗
PubMed2005

Complex visual hallucinations after occipital cortical resection in a patient with epilepsy due to cortical dysplasia.

BACKGROUND: Charles Bonnet syndrome is a rare disorder characterized by complex and recurrent visual hallucinations in elderly patients with visual pathway pathologic defects. To date, to our knowledge, it has not been described in patients undergoing surgical resection for occipital lobe epilepsy due to cortical dysplasia. OBJECTIVE: To describe a patient who experienced complex visual hallucinations following resection of cortical dysplasia on the right occipital lobe and who was diagnosed as having Charles Bonnet syndrome. PATIENT: A 35-year-old woman underwent surgical resection for medically intractable epilepsy caused by cortical dysplasia involving the right occipital lobe. RESULTS: Two months after resection of the epileptogenic zone, complex visual hallucinations in the left visual field not associated with loss of consciousness or delusion developed in the patient. Hallucinations persisted for more than 12 months despite treatment with antiepileptic medications. During hallucination, no electrographic seizures were recorded through long-term video-electroencephalographic monitoring. CONCLUSIONS: Charles Bonnet syndrome may occur in a patient with occipital lobe epilepsy following resection of the diseased brain with a developmental malformation. Charles Bonnet syndrome associated with surgical treatment of occipital lobe epilepsy may have been overlooked.

Adult↗
PubMed2005

Perceived self-control of seizures in patients with uncontrolled partial epilepsy.

Many patients with epilepsy have warning symptoms prior to seizure onset, and some of these individuals report the ability to abort or prevent these seizures. We investigated the clinical characteristics of perceived self-control of seizures in 174 patients with uncontrolled partial epilepsy. The warning symptoms were categorized as premonitory (prodrome) and as initial symptoms of simple partial seizure onset, depending on the relationship between the warning events and the ensuing seizures. About 50% of the patients with simple partial seizure onset and about 70% of those with prodrome or premonitory symptoms reported that they could abort or prevent their seizures by various self-developed techniques. Patients who attempted to abort or prevent their seizures reported success rates as high as 80%. The proportion of patients with secondary generalized seizures was significantly lower in patients who tried to abort their seizures than in those who did not (p<0.05). The ability to prevent seizures was significantly higher in patients with brain lesions on MRI than in those without lesions (p<0.05). These results suggest that spontaneously developed methods are helpful in controlling seizures in some patients with uncontrolled partial epilepsy and that the potential success of self-control methods may be influenced by structural abnormalities on brain MRI.

Adolescent↗
PubMed2005

Factors contributing to the stigma of epilepsy.

PURPOSE: To evaluate the factors, including personality and coping styles, likely to be influential in enhancing the social stigma of epilepsy. METHODS: Data were collected from 400 adults with epilepsy recruited from 10 epilepsy centers in Korea. Clinical information about seizures was obtained by neurologists, and other information was collected from self-completed questionnaires, including those measuring stigma scales. RESULTS: Thirty-one percent of people with epilepsy felt stigmatized by their condition and in 9% of these the stigma was severe. Multivariate analysis identified experiences of actual discrimination from society, introverted personality, problem solving controllability, and emotional subscale of QOLIE-31 as being independently associated with the social stigma of epilepsy. CONCLUSIONS: Episodes of discrimination, coping strategies, and personality may be important in feeling the stigma of epilepsy. These findings may provide a basis for further studies to clarify the causative factors generating the stigma of epilepsy.

Adult↗
PubMed2005

What we confront with employment of people with epilepsy in Korea.

PURPOSE: To investigate the current status of employability in people with epilepsy (PWE) in Korea. METHODS: Data were collected from 543 adult epilepsy patients. Housewives and students were excluded. Information was obtained from self-completed questionnaires. RESULTS: The unemployment rate for Korean PWE was as high as 31%. This figure was five times higher than that of general population. The unemployed PWE had significantly lower quality of life than the employed PWE. the employability of PWE was significantly affected by certain factors: the frequency and severity of seizures; age at onset; interseizure psychosocial disabilities including self-esteem, personality, and problem-solving style; and social discrimination. Actual discriminatory practices in the employment of the PWE were prevalent in Korea. Overall, 24.5% of respondents believed that they had even been treated unfairly at work or when trying to get a job. More than half of those who disclosed their disease to employers reported that they have been refused a job because of epilepsy. About 75% of the patients surveyed said that they have never disclosed their disease in applying for a job. CONCLUSIONS: In Korea, PWE have faced many difficulties in employment. The discrimination against PWE and negative social attitudes toward epilepsy may play an important role in the employability of PWE. We need active participation in the "Out of the Shadows" world campaign.

Attitude to Health↗
PubMed2002

Coma probably induced by lorazepam-valproate interaction.

Both valproate (VPA) and lorazepam (LZP) are primarily cleared from the body by glucuronidation. Concomitant administration of VPA has been reported to reduce the elimination of LZP. However, it remains unknown whether this drug interaction is clinically significant. We report a patient with epilepsy who showed that VPA-LZP interaction could result in severe encephalopathy such as coma.

Adult↗