The Standardization and Validation Study of Korean Behavioral Dyscontrol Scale (BDS-K) in Elderly / 신경정신의학

The aims of this study are to demonstrate the reliability and the validity of the Korean version of Behavioral Dyscontrol Scale (BDS-K) and to present the normative values of BDS-K among the Korean elderly. The BDS-K was administered in a standardized manner to 1,389 healthy volunteers aged over 65 years recruited from the community. The elderly with serious neurological, medical or psychiatric disorders were excluded using screening tests. BDS-K showed good internal consistency (Cronbach's alpha=0.812), test-retest reliability (r=0.88) and inter-rater reliability (r=0.99). Age and educational level were found to affect BDS-K score. Based on this result, normative values of BDS-K were calculated by age and educational level. The validity of the BDS-K were demonstrated in comparison with MMSE-KC (r=0.72). BDS-K is reliable and valid instrument for measuring executive function of the elderly. The normative values suggested by this study can be widely used as reference values to objectively interpret BDS-K scores of the Korean elderly.

Surgical Outcome of Idiopathic Normal Pressure Hydrocephalus according to the Shunt Devices

OBJECTIVE: To determine the effect of shunt devices on the surgical outcome in the idiopathic normal pressure hydrocephalus(NPH), the authors present a retrospective analysis of 39 elderly patients who underwent shunt operations between November 1994 and May 2000, retrospectively. METHODS: The patients enrolled in this study did not have the history of intracranial hemorrhage, head injury, infection, cerebral infarction and brain tumor. The mean age was 69.9(range:52-89) years. Thirteen patients who received operations with simple pressure-control shunt valves(Group I), 22 patients with siphon-control shunt valves(Group II), and four patients with flow-regulating shunt valves (Group III). Final outcome with the clinical improvement and shunt associated complications were evaluated at the last follow-up and the mean follow-up period was 14.7 months. RESULTS: Signs or symptoms of shunt dysfunction were found in eight of 39 patients(20.5%) in the subsequent course. In group I, five out of 13 patients had suffered from symptomatic subdural hematomas and one from overdrainage symptoms(46.2%);in group II, two out of 22 from underdrainage(9%);in group III, one out of four from symptomatic subdural hematomas(25%). Five patients required operative shunt revisions and five underwent burr-hole trephinations for subdural hematomas. Clinical improvements were observed in 10(79.6%), 19(86.4%), and 3(75%) patients in group I, II, and III respectively. Surgical outcomes were better for patients with siphon-control shunt valves than there with the other shunt valves in terms of shunt associated complications and functional improvements(p=0.05). CONCLUSION: The shunt operation with siphon-control shunt valves might be good for the elderly patients with idiopathic NPH.

The Clinical Application of Visual Evoked Potentials in Diagnosis of Multiple Sclerosis

Visual evoked potentials(VEPs) were recorded in 30 patients with multiple sclerosis who had been diagnosed and classified as definite(10), probable(15) and possible(5) MS by clinical criteria. This study was performed to detect clinically unsuspected lesions in optic nerves, to confirm the diagnosis, and then to reclassify the patient group. The incidence of abnormal VEPs in groups classified by clinical criteria as definite, probable and possible MS was 90%(9/10), 60%(9/15) and 20%(1/5) respectively. The overall incidence was 63.3%(19/30). Of the 16 patients who had not been suspected the lesions in optic nerves, six(37%) had abnormalities in VEPs. In consideration of the clinical and VEPs findings, the patient group was reclassified into 15(50%), 11(36.6%) and 4(13.7%) respectively. Six subjects shifted toward the next superior classification degree (probable-definite;5, possible-probable;1). In conclusion, the authors predict that in the diagnosis of multiple sclerosis VEPs would be very useful, noninvasive, simple and reproducible procedures not only in confirming clinically suspected lesion but also in detecting clinically unsuspected lesion of optic nerve.

A Clinical Study on Sodium Valproate: Anticonvulsant and Side Effects

To assess the anticonvulsant effect and toxicity, 47 patients of seizure disorder were given Sodium Valproate by the administration method based on the principle of single dose plasma level (one point method). The evaluation periods of drug effects were from 3 months to over 12. Results are summarized as follows. 1. The age distribution of subjects ranges from 16 to 53 years old with mean age of 24.5. Ratio of male to female is 5.1:4.9. 2. Anticonvulsant effect of Na Valproate was good for simple and complex absences, fair for generalized tonicclonic seizures and partial seizures with secondary generalization, and poor for simple partial seizures. 3. Drowsiness was the most freguently notified side effect, and other symptoms, complained were epigastric discomfort, headache, dizziness, nausea, increased appetite and anorexia in that order of frequency. Laboratory tests including blood chemistry showed no significant changes.

Application of Modified Western Aphasia Battery to 11 Korean Aphasics

The purpose of this paper is to present a form of aphasia test, Modified Western Aphasia Battery (MWAB), which can be a practical method of examing and classifying Korean aphasic patients. This scorable test has five subtests: information, fluency, comprehension, repetition and naming. The authors have examined 11 aphasics and 34 normal control with this test, and report its methods and results.

Two Cases of Septo-optic Dysplasia

Septo-optic dysplasia is an uncommon developmental disorder consisting of septum pellucidum angenesis, optic nerve hypoplasia, congenital nystagmus, seizure and multiple endocrine dysfunction. Clinically mild forms of septo-optic dysplasia and syndrome of absent septum pellucidum are now easily detected by computed tomography. We report two cases of septo-optic dysplasia with consistent radiographic findings with the anomaly.