A Clinical Study on Lennox-Gastaut Syndrome

PURPOSE: Lennox-Gastaut syndrome is an intractable epilepsy which is comprised of several types of etiology and generalized seizures. It also combines with mental retardation. The present study was made to ascertain the clinical study on Lennox-Gastaut syndrome in Korea. METHODS: From January, 1985 to December, 1995, 31 children, diagnosed with Lennox-Gastaut syndrome at Kyung Hee University Hospital, were analyzed retrospectively. RESULTS: The ratio of male to female was 2.4:1. With regard to etiology, idiopathic form was found in 7 cases (22.6%) and symptomatic form in 24 cases (77.4%). Transition from West syndrome to Lennox-Gastaut syndrome was observed in 14 cases (45.2%). The most common type of seizure was tonic seizure which was seen in 19 cases (61.3%) and atypical absence, myoclonic seizure and atonic seizure were also observed. The most common clinical signs and symptoms were mental retardation, but others such as progressive loss of psychomotor function and attention deficit were also frequently associated with this syndrome. The EEG usually had abnormal background activity, slow spike and wave complexes and often showed multifocal abnormalities. In spite of intractable epilepsy, 18 cases (58.1%) were controlled with complex anticonvulsant therapy. CONCLUSION: Lennox-Gastaut syndrome manifested itself in children aged 1-6 years and had polyetiology. Most tonic seizures and mental retardation were observed. After complex anticonvulsant therapy with vigabatrin, complete remission was induced in many cases.

Clinical Study and Diagnostic Value of the Lung Perfusion Scan in Foreign Body Aspiration

PURPOSE: Early diagnosis of foreign body aspiration and removal of the inhaled material may save the patient from chronic illness and may prevent serious complications. At present the diagnostic problems of bronchial foreign bodies are being solved by using the lung scanning technique. Therefore, we investigated the clinical study and diagnositic value of the lung perfusion scan in foreign body aspiration. METHODS: Eighteen cases of airway obstruction due to foreign bodies were treated in the department of pediatrics, Kyung Hee University Hospital. We retrospectively, reviewed patient records to determine the clinical findings, radiologic findings, and findings of the perfusion lung scan. RESULTS: Fifteen cases (83.2%) out of 18 were less than 2 years of age, and the male to female ratio was 1.3:1. Vegetables, especially peanuts were the most common aspirated foreign bodies, and accounted for 72.2% of the cases. Of all foreign body obstructions, 61% were lodged in the main bronchi and there was no significant difference between the right and left main bronchus. In radiologic findings, obstructive emphysema (50%) was most common, followed by atelectasis (33%), mediastinal shifting (23.3%) and pneumonia (22.2%), respectively. There were more severe defects and a higher incidence of abnormalities in cases with prolonged periods after inhalation than that of shorter duration cases. CONCLUSION: Lung perfusion scanning is useful in the diagnosis of foreign body aspiration which presents a vague history of aspiration, insufficient clinical manifestation and normal chest radiologic findings. Our results show that perfusion scan can be helpful particularly in cases of long duration foreign body obstruction.