Background
This study aimed to determine the characteristics of computed tomography perfusion (CTP) patterns and their utility in predicting antiseizure medication (ASM) resistance in patients with nonconvulsive status epilepticus (NCSE).
Methods
We retrospectively reviewed patients diagnosed with NCSE at Inje University Haeundae Paik Hospital Epilepsy Center between March 2015 and March 2022. CTP patterns were analyzed for those patients. A hyperperfusion pattern (HPP) in CTP was defined as a region of both increased cerebral blood flow and cerebral blood volume that did not necessarily follow the vascular territories. The primary endpoint was the responses to ASMs according to CTP patterns.
Results
Fourteen (74%) of the 19 included patients met the criteria for definite NCSE, with the remaining 26% showing nonepileptiform activities with fluctuating quasirhythmic delta activities at >0.5 Hz on electroencephalogram. Three of the four patients who had HPPs with thalamic involvement were refractory to ASMs, whereas all eight patients who had HPPs without thalamic involvement were responsive to ASMs (p = 0.018). Although HPPs themselves were not associated with ASM responses, HPPs with thalamic involvement were associated with resistance to ASMs.
Conclusions
HPP with thalamic involvement in CTP might be associated with ASM resistance. Therefore, CTP may be useful for predicting ASM resistance in NCSE patients.

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease involving localized inflammatory thickening of the intracranial or spinal dura mater without an identified cause. Seizure is a very unusual presentation of IHP. We present a 58-year-old-female patient with seizures caused by IHP. This case indicates that although IHP is rare, it has the potential to cause seizures.

Duchenne muscular dystrophy (DMD) is a progressive form of muscular dystrophy caused by mutations in the dystrophin gene. Patients with DMD are more likely to have cerebral infarction than normal populations, possibly due to low ejection fraction and cardiomyopathy, and also higher epilepsy prevalence. Careful history taking and neurological examination are needed for differentiating new symptoms from preexisting weakness in DMD. Here, we present a young male with DMD and acute ischemic stroke followed by recurrent seizures.

Syncopes are the most common non-epileptic attacks mimicking epileptic seizures. Among them, cardiogenic syncope is potentially life threatening. A 49 year old man was refered for the recurrent episodes of loss of consciousness with tonic posture and upward eyes deviation. The electrocardiogram showed polymorphologic ventricular tachycardia during attacks, which normalized after that. He was treated with isoproterenol and symptoms subsided. Here, we report a case of ventricular tachycardia manifested as epileptic seizures.

Background: Triphasic waves are one of the electroencephalographic patterns that can be usually seen in metabolic encephalopathy. The aim of this study is to compare the clinical and electrophysiologic profiles between patients with and without triphasic waves in metabolic encephalopathy, and reassess the significance of triphasic waves in metabolic encephalopathy. Methods: We recruited 127 patients with metabolic encephalopathy, who were admitted to our hospital. We divided these admitted patients into two groups; those with and without triphasic waves. We analyzed the difference of duration of hospitalization, mortality rate during admission, Glasgow Coma Scale, severity of electroencephalographic alteration, and presence of acute symptomatic seizures between these two groups. Results: Of the 127 patients with metabolic encephalopathy, we excluded 67 patients who did not have EEG, and 60 patients finally met the inclusion criteria for this study. Patients with triphasic waves had more severe electroencephalographic alterations, lower Glasgow Coma Scale, and more acute symptomatic seizures than those without triphasic waves. After adjusting the clinical variables, Glasgow Coma Scale and acute symptomatic seizures were only significantly different between patients with and without triphasic waves. Conclusions: We demonstrated that patients with triphasic waves in metabolic encephalopathy had more significant impairment of the brain function.

Periodic lateralized epileptiform discharges(PLEDs) are usually seen in acute and subacute cerebral lesions. Occasionally PLEDs could be observed in persistent structural lesions. We observed PLEDs-plus in a patient with right basal ganglionic hemorrhage, at 10 months and 13 months after the stroke. The patients suffered two seizures 3 months and 5 days before recording of EEG. PLEDs-plus may persist as an interictal abnormal finding and the rhythmic dischargeof that may be increased by a seizure.

Background
and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated thefactors affecting development of epilepsy following spontaneous lobar ICH.Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospitalwith spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died withinfew days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epilepticseizure and died five and eight months later each. Medical history was obtained through medical record and by telephoneinterview. Statistical analyses were performed using Chi-square test, Student

Although the pathophysiologic mechanism is unknown, there has been long-running debate on whether periodic discharges suchas periodic lateralized epileptiform discharges (PLEDs) and generalized periodic epileptiform discharges are an ictal or interictalEEG pattern. The goal of this review is to give evidence that such periodic discharges on EEG are not ictal phenomenon and justrepresent underlying acute brain damage. This review includes coma with epileptiform EEG pattern and its prognostic andtherapeutic implications. Based on previous reports, rather than taking the view PLEDs represent either an underlying ictal processor an electrographic correlate of neuronal injury, it would be more reasonable that PLEDs are considered as a dynamicpathophysiological state in which unstable neurobiological processes create an ictal-interictal continuum.

We present a recordings of 37-year-old woman with simultaneous ictal scalp and subdural electrodes. The ictal rhythmon subdural electrocorticography (ECoG) started earlier (median 24.5 sec) and ended later (median 2.0 sec) compared toictal rhythm on scalp EEG. Eight ictal ECoG recordings were well localized to left temporal area, whereas ictal scalp EEGrecordings were not. Our case shows the obvious timing relations between two recordings, and different electrophysiologicinformation about localization of ictal onset zone.