Biomedical subjects

Shih-Hui Lim

Publications and source records attributed to Shih-Hui Lim.

6 recordsLinked to original sources

PubMed2007

Valproate-induced Parkinsonism in epilepsy patients.

We systematically examined 226 epilepsy patients in a tertiary-referral center and found 6 (5.04%) to have valproate-induced Parkinsonism. There was a significantly higher prevalence of patients with Parkinsonism in the group of patients treated with valproate compared to those who were on other antiepileptic drugs (6 [5.04%] of 119 vs. 0 [0%] of 107; chi2 = 5.54; P = 0.025). These six patients had been on valproate for more than 3 years (mean, 75.67 +/- 25.32 months) at an average dose of 750 +/- 273.86 mg/day. The valproate doses were decreased or discontinued with supplementation from another antiepileptic medication. The mean UPDRS motor score significantly improved from 10.67 +/- 5.1 to 4.75 +/- 2.75 (P < 0.05). There was no relapse of seizures. Clinicians working in tertiary-referral centers should have a high index of suspicion for valproate-induced Parkinsonism. Early recognition and switching into another antiepileptic medication may help reduce unnecessary suffering in these patients.

Adult↗

PubMed2006

Persistent hand spasm: movement disorder or seizure?

Dystonia is a movement disorder characterized by involuntary, sustained or repetitive, patterned muscle contractions or spasms, frequently causing squeezing and twisting movements or abnormal postures. Dystonic posturing could be one of the accompanying features of epilepsy. We report an elderly lady with intractable focal seizure who presented with more than a year of persistent hand spasms. The clinical importance of differentiating epilepsy from movement disorders is discussed.

Aged↗

PubMed2006

Acute symptomatic seizures and hippocampus damage: DWI and MRS findings.

The authors describe diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) changes in the hippocampus within 48 hours of acute symptomatic seizures or status epilepticus in 12 patients. DWI showed increased signal and a decreased apparent diffusion coefficient (ADC) in all patients, with corresponding lactate detected on MRS in six patients and EEG seizure activity in nine patients. On follow-up, the atrophic hippocampus had an increased ADC in six patients. DWI and MRS may predict development of hippocampal sclerosis.

Adolescent↗

PubMed2005

Knowledge, attitudes, and perceptions of epilepsy in Asia: toward a uniform study protocol.

PURPOSE: Knowledge, attitudes, and perceptions of epilepsy (KAPE) among the public play a major role in determining the extent to which people with epilepsy can be integrated into their society. KAPE SURVEYS IN ASIA: Surveys conducted among Chinese in China, Taiwan, Malaysia, Singapore, and Hong Kong demonstrated similarities as well as differences in certain aspects of KAPE. These suggest that KAPE might not be uniform among other racial groups in the same or different regions of Asia. For KAPE to have usefulness to a country or community, it has to be location specific. TOWARD A UNIFORM STUDY PROTOCOL: There are several advantages of using a uniform study protocol. Collection of KAPE data could be faster for any country or community that chooses to use any existing study protocol. Intraregional, interregional, intercontinental, interethnic, intercommunity, and longitudinal comparison within any subgroup could be carried out. Sharing of common information would enhance the regional effort in improving the quality of life of people affected by epilepsy. However, survey methods need not be uniform. Regional adaptation and flexibility of a unified protocol should be encouraged. After the study, concerted local and regional efforts in epilepsy education must be carried out systematically for the general public as well as for strategic groups. CONCLUSIONS: Determination of the KAPE in different parts of Asia would help to define the magnitude of and be the first step toward alleviating social discrimination against people with epilepsy in Asia.

Asia↗

PubMed2005

Functional magnetic resonance imaging in adult craniopagus for presurgical evaluation.

Cranially conjoined twins are rare and pose unique challenges in the preoperative evaluation of cerebral language function. The authors report on their experience in the functional magnetic resonance (fMR) imaging evaluation of adult craniopagus (temporoparietooccipital fusion) to evaluate hemispheric language dominance and the eloquent language areas in the preoperative planning stages. Conventional clinical imaging hardware originally designed for individuals was adapted and tailored for use in the twins. They were assigned a selection of language tasks while undergoing fMR imaging. Significant blood oxygen level-dependent activations were detected in the main language regions in each twin, that is, the inferior frontal gyrus (around the Broca area), the middle and superior temporal lobes (around the Wernicke area) together with the inferior parietal lobe, and the middle and superior frontal gyri. Overall, the right-handed twin was strongly left lateralized for language, whereas the left-handed twin showed more bilateral activation during language tasks. Noninvasive language mapping with the aid of fMR imaging has been demonstrated for the first time in total craniopagus.

Adult↗

PubMed2003

Efficacy of eletriptan in migraineurs with persistent poor response to nonsteroidal anti-inflammatory drugs.

BACKGROUND/OBJECTIVE: Nonsteroidal anti-inflammatory drugs continue to be one of the most widely used therapies for migraine, but their efficacy in treating moderate to severe migraine headache has not been well documented. In contrast, the efficacy of triptans in this group of patients is well documented, although no systematic research is available that evaluates the effectiveness of switching to a triptan in patients who respond poorly to nonsteroidal anti-inflammatory drugs. METHODS: One hundred thirteen patients who met International Headache Society criteria for migraine and who did not experience satisfactory response to nonsteroidal anti-inflammatory drugs, received open-label treatment with a 40-mg dose of eletriptan for one migraine attack. Efficacy assessments were made at 1, 2, 4, and 24 hours postdose and consisted of headache and pain-free response rates, absence of associated symptoms, and functional response. Global ratings of treatment effectiveness and preference were obtained at 24 hours. RESULTS: The pain-free response rate at 2 hours postdose was 25% and at 4 hours postdose, 55%; the headache response rate at 2 hours was 66% and at 4 hours, 87%. At 2 hours postdose, relief of baseline associated symptoms was achieved by 41% of patients with nausea compared to 82% of patients at 4 hours; for patients with phonophobia, 67% were relieved at 2 hours and 93% at 4 hours, and for patients with photophobia, 70% were relieved at 2 hours and 91% at 4 hours. Functional response was achieved by 70% of patients by 2 hours postdose. The high level of acute response was maintained over 24 hours, with only 24% of patients experiencing a headache recurrence and only 10% using rescue medication. At 24 hours postdose, 74% of patients rated eletriptan as preferable to any previous treatment for migraine. The most frequent reasons cited for this treatment preference were faster headache improvement (83%) and functional response (78%). Overall, eletriptan was well tolerated; most adverse events were transient and mild to moderate in severity. No serious adverse events were reported. CONCLUSION: Results of this open-label trial found the 40-mg dose of eletriptan to have a high degree of efficacy and tolerability among patients who responded poorly to nonsteroidal anti-inflammatory drugs.

Acute Disease↗