A Case of True Myoclonic Epilepsy of Childhood

The myoclonic epilepsies of infancy and early childhood pose the most difficult problems in the diagnosis and classification of epilepsies because they are often confused with the Lennox-Gastaut syndrome sharing a number of common features. However, their correct differentiation is easily justifiable because some of the myoclonic epilepsies of early childhood have better prognosis than the Lennox-Gastaut syndrome. We experienced and treated a 4-year-old boy who had normal intellectual function but frequent myoclonic and generalized clinic-tonic-clinic seizures, which were successfully controlled by anti-epileptic drugs. Hence we report a case with brief review of literatures.

Survival Prediction of Ganglio-thalamic Hemorrhage Accompanying Intraventricular Hemorrhage Using CT Scan Indices

To develop a survival prediction model and to use it as a therapeutic guideline a series of 66 cases with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage were analyzed retrospectively. They were classified into the benign and fatal groups according to their final outcomes. Fourteen indices obtained from the initial CT scans were final outcomes. Fourteen indices obtained from the initial CT scans were subjected to multivariate discriminant analysis. The resultant discriminant function(Z) included the amount of hematoma in the parenchyme(AH), bicaudate cerebroventricular index(BCCI) maximum fourth ventricular width(FVW), and third cerebroventricular ratio(TCR) in an order of decreasing discriminating power and was as follows: Z = -3.2639 + 0.3508 X 10(-1) X AH + 6.8816 X BCCI + 0.1139 X FVW-5.7794 X TCR. This function predicted survivability with accuracy of 84.9% when it was applied to the original subjects. The conclusion is that AH, BCCI, FVW, and TCR are the potent predictors of the survival of patients with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage.

Effect of Steroid Treatment in Myasthenia Gravis

Twenty-one myasthenic patients were treated with high-dose daily prednisone regimen at Seoul National University Hospital from May 1983 to January 1985. Observations in relation to dosage, drug schedule, clinical responses, and sideeffects led us to following conclusions concerning the management of myasthenia gravis with steroid. In addition, factors influencing the result were considered. 1) Among 21 patients, twenty(95%) showed clinical improvement of variable degrees. 2) Significant improvement could be expected especially in male patients, in older patients, and in those with duration of myasthenia gravis less than 6 months prior to treatment. Performance of thymectomy or thymothymectomy, thymic pathology, and clinical grade at the time of therapy were not considered to affect the outcome. 3) Ten cases (48%) suffered from initial exacerbations, most of which occurred within the first four days of treatment. Steroid-induced crises developed in four cases with preexisting brittle or severe generalized myasthenia. 4) Period taken to show the initial response and the maximum improvement varied widely but majority of them occurred within 15 days and 70 days respectively. 5) Off-day weakness during the alternate-day schedule required special cautions and, if persitent, immediate return to daily schedule was desirable. 6) Thymectomy prior to steroid treatment was not always necessary but, when both regimens were scheduled together, preparation therapy with steroid thought to be more favorable. 7) Aside from initial exacerbations side-effects during the treatment were not remarkable, all of which disappeared with reduction of dosage.