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KMID : 0438219730100010499
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Korea University Medical Journal
1973 Volume.10 No. 1 p.499 ~ p.513
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Clinical Studies of Epileptics in Korea
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Abstract
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In order to reveal the clinical pictures of epileptics in Korea, 518 cases who were given the diagnosis of epilepsy at the Neuropsychiatry Department of Woo Sok Hospital, Korea University, Medical College, from Jan. 1965 to Jul. 1972, were investigated in this study. In this study those epileptics, who had the evidences of brain injury, tumor, cerebral degenerative disease, and other cerebral and systemic diseases which were supposed to influence the cerebral functions, were excluded.
The results were as follows:
1. In the distributions of clinical types, grand mal epilepsy occupied 57.53%, focal motor seizure 16.22%, psychic and psychomotor seizure 6.95%, unclassified seizure 5.21%, centrencephalic and focal seizure 3.47%, mixed type 2.90%, petit mal epilepsy 2.70%, myoclonic seizure 1.54%, autonomic seizure 1.54%, focal sensory seizure 0.97%, and infantile spasms 0.97%.
2. As to the age of onset, 23.17% of total patients had their first attack at the ages between 10 and 14, 16.60% at the ages between 15 and 19, and 15.83% at the ages between 5 and 9. As a consequence, more than 55% of total patients had their first attack before the age of 20.
According to the various clinical types, 24.16% of the grand mal epileptics had their first attack at the ages between 10 and 14, more than half of the petit mal epileptics at the ages between 5 and 9, a half of the epileptics with myoclonic seizure before the age of 4, and all of the epileptics with infantile spasms had their first attack before the age of 4.
3. It was found that 60.81% of total patients experienced aura. Among the patients with aura, 46.35% of them expressed their aura through psychical phenomena, 21.90% of them through viscerosensory and motor phenomena, 21.27% of them through somato-senory and motor phenomena, and 10.48% of them through special sensory organs, As to the nature of auras, headache 21.27% of them, dizziness 8.89%, and abdominal distress was rated 6.35% suspectively.
4. As to the precipitating factors, the most frequent one was psychic factor and it occupied 46.07% of the patients with precipitating factor. Among psychic factors, sleeping which was supposed to be related to nocturnal seizure occupied 25.49% of them. Physio-chemical factor occupied 43.86% of the patients with precipitating factor. Among physio-chemical factors, hyperventilation occupied 19.10% of them.
5. As to the frequency of seizure, the patients who had frequency of "less than one a month but more than two a year" occupied 35.14% of total patients. According to each clinical types, the grand mal epileptics tended to have the frequency of "less than one a month but more than two a year". In petit mal epilepsy, myoclonic seizure and infantile spasms, the frequency of "more than two times daily" was dominantly revealed.
6. The presumed etiological factors which were considered to be associated with the convulsive seizure, occupied 26.83% of total patients. Among those factors, infection was rated 43.88% and head trauma was rated 32.37%
7. The epileptics producing abnormal E.E.G. were 54.83% of total patients and 71.50% of these epileptics were distributed to the range of ages between 4 and 15. According to the each clinical types, the abnormal E.E.G. was recorded in the proportion of 80.00% of patients with infantile spasms, 78.57% of patients with petit mal epilepsy and 75.00% of patients with myoclonic seizure.
8. The patients who has suffered from febrile convulsion(in their early life) occupied 19.69% of total patients.
It was concluded that the distribution of clinical types, age of onset, frequency of seizure, and frequency of normal and abnormal E.E.G. of the epileptics in Korea were almost similar with the reports of Gibbs, Lennox, Penfield ect. who are the western authorities in epilepsy. And it was suggested that further studies were neccessary for the other different clinical manifestations from the western reports such as aura, precipitating factor, presumed etiological factor and episode of febrile convulsion.
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