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Article: Principles of antiepileptic drug treatment of epilepsy.

Yamatogi, Yasuko

2004 Volume 58, Issue 3, Page(s) S3–6

Abstract: For the successful treatment of epilepsy, accurate diagnosis of epilepsy and epileptic seizures, and proper selection of antiepileptic drugs (AED) according to the classification of epileptic syndromes are fundamentally important. Efficacy of AED ... ...

Abstract	For the successful treatment of epilepsy, accurate diagnosis of epilepsy and epileptic seizures, and proper selection of antiepileptic drugs (AED) according to the classification of epileptic syndromes are fundamentally important. Efficacy of AED treatment, however, depends not only on its pharmacological action but also on its efficient use, namely a rationally thinking tailor-made treatment considering the characteristics of each patients, i.e. individual differences in pharmacokinetics, factors influencing AED concentrations, AED interactions, and comprehensively their life style and psychosocial factors.
MeSH term(s)	Aging/metabolism ; Anticonvulsants/adverse effects ; Anticonvulsants/blood ; Anticonvulsants/pharmacokinetics ; Anticonvulsants/therapeutic use ; Drug Interactions ; Epilepsy/diagnosis ; Epilepsy/drug therapy ; Humans
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2004-06
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	1292906-2
ISSN	1440-1819 ; 1323-1316
ISSN (online)	1440-1819
ISSN	1323-1316
DOI	10.1111/j.1440-1819.2004.01244_1.x
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Article: [Early myoclonic encephalopathy(EME)].

Yamatogi, Yasuko

Ryoikibetsu shokogun shirizu

2002 , Issue 37 Pt 6, Page(s) 108–112

MeSH term(s)	Diagnosis, Differential ; Electroencephalography ; Epilepsies, Partial/diagnosis ; Epilepsies, Partial/etiology ; Epilepsies, Partial/physiopathology ; Humans ; Infant ; Myoclonus/diagnosis ; Myoclonus/etiology ; Myoclonus/physiopathology ; Prognosis ; Syndrome
Language	Japanese
Publishing date	2002
Publishing country	Japan
Document type	Journal Article ; Review
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Article: Erratum to "Safety of zonisamide therapy: prospective follow-up survey.".

Ohtahara, Shunsuke / Yamatogi, Yasuko

Seizure

2007 Volume 16, Issue 1, Page(s) 87–93

Abstract: Zonisamide safety was evaluated based on a postmarketing surveillance study of patients treated for 1-3 years. Nine hundred twenty-eight children and 584 adult (ages 1 month to 79 years), including 372 newly-diagnosed patients, received zonisamide for ... ...

Abstract	Zonisamide safety was evaluated based on a postmarketing surveillance study of patients treated for 1-3 years. Nine hundred twenty-eight children and 584 adult (ages 1 month to 79 years), including 372 newly-diagnosed patients, received zonisamide for partial and generalized epilepsies. Of the intractable patients, 1088 received zonisamide in combination with other antiepileptic drugs (AED), and 52 successfully transitioned to zonisamide monotherapy. A total of 1089 adverse events occurred in 476 (31.5%) of 1512 patients. Incidence of adverse effects was significantly lower among patients receiving zonisamide monotherapy than in those receiving polytherapy: 21% (18.9% of children, 29.4% of adults) versus 35.6% (30.4% of children, 41.7% of adults), respectively. The total incidence of adverse effects was lower for children (26.2%) than for adults (39.9%). Most common adverse events included mental/psychiatric symptoms (19.4%), gastrointestinal symptoms (8.7%), and neurological symptoms (6.5%). Effects that seemed unique to zonisamide were impairment of mental function, motivation or volition, and hipohidrosis. Urinary calculi were detected in only two patients (0.13%). Teratogenicity was evaluated in six patients. Two patients on zonisamide monotherapy and three on polytherapy delivered normal children. One of four patients on polytherapy conceived a fetus with a skull defect with cerebral and cerebellar dysgenesis, namely anencephaly.
MeSH term(s)	Abnormalities, Drug-Induced/etiology ; Adolescent ; Adult ; Age Factors ; Aged ; Anticonvulsants/adverse effects ; Anticonvulsants/therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Epilepsy/drug therapy ; Female ; Follow-Up Studies ; Gastrointestinal Diseases/chemically induced ; Gastrointestinal Diseases/epidemiology ; Humans ; Incidence ; Infant ; Isoxazoles/adverse effects ; Isoxazoles/therapeutic use ; Male ; Mental Disorders/chemically induced ; Mental Disorders/epidemiology ; Middle Aged ; Product Surveillance, Postmarketing ; Zonisamide
Chemical Substances	Anticonvulsants ; Isoxazoles ; Zonisamide (459384H98V)
Language	English
Publishing date	2007-01-22
Publishing country	England
Document type	Journal Article ; Corrected and Republished Article
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2006.01.005
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Article ; Online: Vitamin B(6) treatment of intractable seizures.

Ohtahara, Shunsuke / Yamatogi, Yasuko / Ohtsuka, Yoko

Brain & development

2011 Volume 33, Issue 9, Page(s) 783–789

Abstract: Vitamin B(6) (VB(6))-related seizures include clinical seizures associated with VB(6) deficiency and dependency. Both types of seizures are suppressed by VB(6). We proposed VB(6)-responsive seizures as the third category of VB(6)-related seizures in 1977. ...

Abstract	Vitamin B(6) (VB(6))-related seizures include clinical seizures associated with VB(6) deficiency and dependency. Both types of seizures are suppressed by VB(6). We proposed VB(6)-responsive seizures as the third category of VB(6)-related seizures in 1977. Vitamin B(6)-responsive seizures decrease or disappear in response to high-dose oral VB(6). Seizure onset in most of our cases occurred within the first year of life, although this varied between 3 months and 5 years. Etiologically, such cases were not only idiopathic or cryptogenic, but also symptomatic and associated with organic brain lesions. The tryptophan load test was usually negative. Vitamin VB(6)-responsive seizures or epilepsy were usually West syndrome (WS), however may also include Lennox-Gastaut syndrome, grand mal or partial motor seizures. High-dose VB(6) treatment administered to 216 consecutive WS cases had an overall response rate of 13.9%, being high not only in cryptogenic cases (32%), but also in symptomatic WS (11.5%) associated with identifiable brain pathologies. Notably, responsive patients had excellent long-term seizure and mental outcomes without the need for conventional antiepileptic medication. A gradual increase in clinical response to VB(6) was noted with increasing the VB(6) dose from 30 to 50-100mg/day, and a dramatic increase in clinical response with high-dose VB(6) (100-400mg). Little clinical response was noted with administration of low dose VB(6) (10-30 mg/day). Thus, high-dose oral VB(6) treatment is recommended in all WS patients at time of initial treatment for a minimum of 10 days, considering the safety and rapid onset of efficacy, usually within 1 week, of this treatment.
MeSH term(s)	Adolescent ; Anticonvulsants/therapeutic use ; Child ; Child, Preschool ; Clinical Trials as Topic ; Humans ; Infant ; Seizures/drug therapy ; Seizures/etiology ; Vitamin B 6/therapeutic use ; Vitamin B 6 Deficiency/complications ; Vitamin B 6 Deficiency/drug therapy
Chemical Substances	Anticonvulsants ; Vitamin B 6 (8059-24-3)
Language	English
Publishing date	2011-10
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	604822-5
ISSN	1872-7131 ; 0387-7604
ISSN (online)	1872-7131
ISSN	0387-7604
DOI	10.1016/j.braindev.2011.01.010
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Article: Multiple independent spike foci and epilepsy, with special reference to a new epileptic syndrome of "severe epilepsy with multiple independent spike foci".

Yamatogi, Yasuko / Ohtahara, Shunsuke

Epilepsy research

2006 Volume 70 Suppl 1, Page(s) S96–104

Abstract: Background: Markand and Blume first realized the specificity of the EEG pattern of multiple independent spike foci (MISF) in the late 1970s; its close relation with hypsarrhythmia and slow spike-waves, extensive bilateral brain lesion, and intractable ... ...

Abstract	Background: Markand and Blume first realized the specificity of the EEG pattern of multiple independent spike foci (MISF) in the late 1970s; its close relation with hypsarrhythmia and slow spike-waves, extensive bilateral brain lesion, and intractable seizures. But they did not recognize it as an epileptic syndrome. On the other hand, the authors had been taken notice of severe epilepsy with MISF (SE-MISF) as a peculiar clinico-electrical entity showing "generalized seizures", and pointed out its close relation to Lennox-Gastaut syndrome (LGS) from the long-term follow-up of LGS. Summary points: SE-MISF is characterized by (1) interictal EEG showing multiple independent spike foci (three or more foci in both hemisphere, i.e. at least one in each hemisphere) and diffuse slowing of the background activity. Diffuse epileptic discharges are rare. (2) The main seizure type is frequent generalized minor seizures, often tonic spasms. (3) Mutual transition is often observed between the age-dependent epileptic encephalopathies, i.e. Ohtahara syndrome, West syndrome and LGS. (4) The age at epilepsy onset is early, but the onset of SE-MISF is variable. (5) It is often associated with mental retardation and neurological abnormalities, usually severe. (6) Etiology is variable and largely nonspecific, including prenatal, perinatal, and postnatal cerebral pathologies. (7) Prognoses for seizures and psychomotor development are poor. Seizures are very intractable and may cause psychomotor deterioration. Conclusion: SE-MISF may be classified into symptomatic generalized epilepsy, namely a diffuse encephalopathy with mutual transition between other age-dependent epileptic encephalopathies. This characteristic entity may be acknowledged as a new epileptic syndrome.
MeSH term(s)	Age of Onset ; Aging/physiology ; Child ; Child, Preschool ; Diagnosis, Differential ; Electroencephalography ; Epilepsy, Generalized/diagnosis ; Epilepsy, Generalized/etiology ; Epilepsy, Generalized/physiopathology ; Humans ; Infant ; Prognosis ; Seizures/physiopathology
Language	English
Publishing date	2006-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	632939-1
ISSN	1872-6844 ; 0920-1211
ISSN (online)	1872-6844
ISSN	0920-1211
DOI	10.1016/j.eplepsyres.2006.01.013
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Article: Ohtahara syndrome: with special reference to its developmental aspects for differentiating from early myoclonic encephalopathy.

Ohtahara, Shunsuke / Yamatogi, Yasuko

Epilepsy research

2006 Volume 70 Suppl 1, Page(s) S58–67

Abstract: Unlabelled: Ohtahara syndrome (OS) is well known as a peculiar early onset epileptic syndrome with serious prognosis. The outline of OS, mainly in relation to the evolution with age, and differentiation from related conditions, particularly early ... ...

Abstract	Unlabelled: Ohtahara syndrome (OS) is well known as a peculiar early onset epileptic syndrome with serious prognosis. The outline of OS, mainly in relation to the evolution with age, and differentiation from related conditions, particularly early myoclonic encephalopathy (EME) were mentioned. Results: Etiologically, structural brain lesions are most probable in OS, and non-structural/metabolic disorders in EME. Clinically, tonic spasms are the main seizures in OS, while myoclonia and frequent partial motor seizures in EME. Another difference is noted in EEG findings: suppression-bursts (SB) are consistently observed in both waking and sleeping states in OS, but suppression-bursts become more apparent in sleep in EME. The course observation clarifies differences between both syndromes; SBs evolve to hypsarrhythmia around 3-4 months of age, and sometimes further to diffuse slow spike-waves in OS. In contrast, in EME suppression-bursts may persist up to late childhood after a transient evolution to hypsarryhtmia in the middle to late infancy. Transition between syndromes is also specific; OS evolves to West syndrome, and further to Lennox-Gastaut syndrome with age, but EME persists long without such evolution excepting a transient phase of West syndrome. Conclusion: These clinicoelectrical characteristics and differential points strongly indicate the efficiency of the developmental study to delineate both syndromes.
MeSH term(s)	Age of Onset ; Diagnosis, Differential ; Electroencephalography ; Epilepsies, Myoclonic/diagnosis ; Epilepsies, Myoclonic/etiology ; Epilepsies, Myoclonic/therapy ; Epilepsy, Generalized/diagnosis ; Epilepsy, Generalized/etiology ; Epilepsy, Generalized/therapy ; Humans ; Infant ; Infant, Newborn ; Mental Disorders/etiology ; Psychomotor Disorders/etiology ; Syndrome
Language	English
Publishing date	2006-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	632939-1
ISSN	1872-6844 ; 0920-1211
ISSN (online)	1872-6844
ISSN	0920-1211
DOI	10.1016/j.eplepsyres.2005.11.021
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Article: Safety of zonisamide therapy: prospective follow-up survey.

Ohtahara, Shunsuke / Yamatogi, Yasuko

Seizure

2004 Volume 13 Suppl 1, Page(s) S50–5; discussion S56

Abstract: Zonisamide safety was evaluated based on a postmarketing surveillance study of patients treated for 1-3 years. Nine hundred twenty-eight children and 584 adults (ages 1 month to 79 years), including 372 newly-diagnosed patients, received zonisamide for ... ...

Abstract	Zonisamide safety was evaluated based on a postmarketing surveillance study of patients treated for 1-3 years. Nine hundred twenty-eight children and 584 adults (ages 1 month to 79 years), including 372 newly-diagnosed patients, received zonisamide for partial and generalized epilepsies. Of the intractable patients, 1008 received zonisamide in combination with other antiepileptic drugs (AED), and 52 successfully transitioned to zonisamide monotherapy. A total of 1089 adverse events occurred in 476 (31.5%) of 1512 patients. Incidence of adverse effects was significantly lower among patients receiving zonisamide monotherapy than in those receiving polytherapy: 21% (18.9% of children, 29.4% of adults) versus 35.6% (30.4% of children, 41.7% of adults), respectively. The total incidence of adverse effects was lower for children (26.2%) than for adults (39.9%). Most common adverse events included mental/psychiatric symptoms (19.4%), gastrointestinal symptoms (8.7%), and neurological symptoms (5.8%). Effects that seemed unique to zonisamide were impairment of mental function, motivation or volition, and hypohidrosis. Urinary calculi were detected in only two patients (0.13%). Teratogenicity was evaluated in six patients. Two patients on zonisamide monotherapy and three on polytherapy delivered normal children. One of four patients on polytherapy conceived a fetus with a skull defect with cerebral and cerebellar dysgenesis.
MeSH term(s)	Abnormalities, Drug-Induced/etiology ; Adolescent ; Adult ; Age Factors ; Aged ; Anticonvulsants/adverse effects ; Anticonvulsants/therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Epilepsy/complications ; Epilepsy/drug therapy ; Female ; Follow-Up Studies ; Gastrointestinal Diseases/chemically induced ; Gastrointestinal Diseases/epidemiology ; Humans ; Incidence ; Infant ; Isoxazoles/adverse effects ; Isoxazoles/therapeutic use ; Male ; Mental Disorders/chemically induced ; Mental Disorders/epidemiology ; Middle Aged ; Product Surveillance, Postmarketing
Chemical Substances	Anticonvulsants ; Isoxazoles ; zonisamide (459384H98V)
Language	English
Publishing date	2004-12
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	1137610-7
ISSN	1532-2688 ; 1059-1311
ISSN (online)	1532-2688
ISSN	1059-1311
DOI	10.1016/j.seizure.2004.04.006
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Article: Epileptic encephalopathies in early infancy with suppression-burst.

Ohtahara, Shunsuke / Yamatogi, Yasuko

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

2003 Volume 20, Issue 6, Page(s) 398–407

Abstract: Early infantile epileptic encephalopathy with suppression-burst, or Ohtahara syndrome (OS), and early myoclonic encephalopathy (EME) are epileptic encephalopathies with onset of frequent seizures in the neonatal and early infancy period and with a ... ...

Abstract	Early infantile epileptic encephalopathy with suppression-burst, or Ohtahara syndrome (OS), and early myoclonic encephalopathy (EME) are epileptic encephalopathies with onset of frequent seizures in the neonatal and early infancy period and with a characteristic EEG pattern, namely, suppression-burst, in which higher-voltage bursts of slow waves mixed with multifocal spikes alternate with isoelectric suppression phase. Their nosologic independence is now widely accepted, although some controversy initially occurred because of their common characteristics such as age of onset, EEG features, seizure intractability, and poor prognosis. Major differences between the two syndromes include (1) tonic spasms in OS versus partial seizures and erratic myoclonias in EME, (2) continuous suppression-burst pattern in both waking and sleeping states in OS versus this EEG pattern almost limited to sleep in EME, and (3) static structural brain damage in OS versus genetic or metabolic disorders in EME. The most important differentiating point is their evolutional pattern with age, which may reflect their pathophysiologic difference. Ohtahara syndrome evolves to West syndrome and further to Lennox-Gastaut syndrome with age, but EME demonstrates no unique evolution; namely, it continues as such for a long time or changes into partial epilepsy or severe epilepsy with multiple independent spike foci.
MeSH term(s)	Electroencephalography ; Epilepsies, Myoclonic/epidemiology ; Epilepsies, Myoclonic/physiopathology ; Epilepsies, Myoclonic/therapy ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Seizures/physiopathology ; Seizures/therapy ; Syndrome ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2003-12-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605640-4
ISSN	1537-1603 ; 0736-0258
ISSN (online)	1537-1603
ISSN	0736-0258
DOI	10.1097/00004691-200311000-00003
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Article: Severe epilepsy with multiple independent spike foci.

Yamatogi, Yasuko / Ohtahara, Shunsuke

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

2003 Volume 20, Issue 6, Page(s) 442–448

Abstract: Summary: Severe epilepsy with multiple independent spike foci is an electroclinical entity with the following characteristics: (1) EEG showing multiple independent spike foci (three or more foci in both hemisphere, i.e., at least one in each hemisphere) ...

Abstract	Summary: Severe epilepsy with multiple independent spike foci is an electroclinical entity with the following characteristics: (1) EEG showing multiple independent spike foci (three or more foci in both hemisphere, i.e., at least one in each hemisphere) and diffuse slowing of the background activity, (2) very frequent multiple types of seizures but mainly generalized minor seizures, (3) frequent association with mental retardation and neurologic abnormalities, (4) underlying causes of various nonspecific prenatal, perinatal, and postnatal cerebral conditions, and (5) poor prognoses for seizures and psychomotor development. It represents a diffuse encephalopathy with mutual transition between other age-dependent epileptic encephalopathies. This electroclinical condition may be appropriately named Markand-Blume-Ohtahara syndrome, after Markand and Blume, who initially described in detail the EEG pattern of multifocal spike discharges with its major clinical correlates, and Ohtahara, who extensively studied the group of patients with both clinical and EEG characteristics and proposed the concept of severe epilepsy with multiple independent spike foci, classifying it as one type of generalized epilepsy.
MeSH term(s)	Age Factors ; Brain/physiopathology ; Electroencephalography ; Epilepsy/physiopathology ; Epilepsy/prevention & control ; Evoked Potentials ; Humans ; Movement Disorders/etiology ; Movement Disorders/physiopathology ; Prevalence ; Prognosis ; Syndrome ; Therapeutics
Language	English
Publishing date	2003-12-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605640-4
ISSN	1537-1603 ; 0736-0258
ISSN (online)	1537-1603
ISSN	0736-0258
DOI	10.1097/00004691-200311000-00006
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Article: Early-infantile epileptic encephalopathy with suppression-bursts, Ohtahara syndrome; its overview referring to our 16 cases.

Yamatogi, Yasuko / Ohtahara, Shunsuke

Brain & development

2002 Volume 24, Issue 1, Page(s) 13–23

Abstract: Ohtahara syndrome (OS) is characterized by frequent tonic spasms, with or without clustering, of early onset within a few months of life, and a suppression-burst (S-B) pattern in electroencephalography (EEG). Tonic spasms occur in not only waking but ... ...

Abstract	Ohtahara syndrome (OS) is characterized by frequent tonic spasms, with or without clustering, of early onset within a few months of life, and a suppression-burst (S-B) pattern in electroencephalography (EEG). Tonic spasms occur in not only waking but also sleeping state in most cases. Partial seizures are observed in about one-third of cases. Brain imagings reveal structural abnormalities including malformations, notably asymmetric lesions in most cases.S-B pattern is persistently observed regardless of circadian cycle. Bursts of 1-3s duration alternate with nearly flat suppression phase of 2-5s at an approximately regular rate; 5-10s of burst-burst interval. Some asymmetry in S-B is noted in about two-thirds of cases. Ictal EEG of tonic spasms shows principally desynchronization with or without initial rapid activity. Tonic spasms appear concomitant with bursts. Characteristic age-dependent evolution from OS to West syndrome (WS) in many cases, and further from WS to Lennox-Gastaut syndrome (LGS) in some, proceed concomitantly with EEG transition from S-B to hypsarrhythmia at around age 3-6 months, and further from hypsarrhythmia to diffuse slow spike-waves at around age 1. Under the inclusive concept of the age-dependent epileptic encephalopathy, OS, WS, and LGS have common characteristics such as age preference, frequent minor generalized seizures, and continuous massive epileptic EEG abnormality. Mutual transition suggests the same pathophysiology among three syndromes and the age factor should be considered as the common denominator responsible for the manifestation of each of their own specific clinico-electrical features. Namely, these syndromes may be the age-specific epileptic reaction to various non-specific exogenous brain insults, acting at the specific developmental stages.
MeSH term(s)	Age of Onset ; Electroencephalography ; Epilepsy, Generalized/diagnosis ; Epilepsy, Generalized/etiology ; Epilepsy, Generalized/physiopathology ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases/diagnosis ; Infant, Newborn, Diseases/etiology ; Infant, Newborn, Diseases/physiopathology ; Male ; Spasms, Infantile/diagnosis ; Spasms, Infantile/etiology ; Spasms, Infantile/physiopathology
Language	English
Publishing date	2002-01
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	604822-5
ISSN	0387-7604
ISSN	0387-7604
DOI	10.1016/s0387-7604(01)00392-8
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