Young Noh

Publications (3)10.26 Total impact

• Article: Topiramate increases the risk of valproic acid-induced encephalopathy.

  Young Noh, Dong Wook Kim, Kon Chu, Soon-Tae Lee, Keun-Hwa Jung, Hye-Jin Moon, Sang Kun Lee
  [show abstract] [hide abstract]
  ABSTRACT: Metabolic encephalopathy is a rare but serious complication of valproic acid (VPA) therapy that usually presents with impaired consciousness or increased seizure frequency. Although it has been suggested that topiramate (TPM) increases the risk of VPA-induced encephalopathy, the additional risk in patients receiving TPM therapy has not been evaluated. We reviewed all adult patients who took VPA between January 2005 and February 2009 at the Seoul National University Hospital and identified patients with VPA-induced encephalopathy based on clinical and electroencephalography (EEG) data. Information on sex, age, serum ammonia level, serum VPA level, liver function test, and EEG was collected from patient registry and medical data. We enrolled 8,372 patients who received VPA therapy and 1,236 patients who received VPA/TPM combination therapy. We identified 11 patients with VPA-induced encephalopathy (0.13%), 7 of whom received a combination therapy of VPA and TPM. The odds ratio of VPA-induced encephalopathy with TPM over that without TPM was 10.16. There were no significant differences in sex distribution, number of antiepileptic agents, ammonia level, VPA serum level, underlying diseases, dosage of VPA, duration of VPA treatment, treatment of encephalopathy, and outcomes between the two groups. Our study showed that the prevalence of VPA-induced encephalopathy is approximately 0.1% among patients treated with VPA and that the risk of this condition, although still low, can increase by approximately 10 times in the presence of TPM therapy. Based on these results, we suggest that TPM should be carefully used in patients receiving VPA treatment.
  Epilepsia 06/2012; · 3.96 Impact Factor
• Article: Rotational vertebral artery syndrome due to compression of nondominant vertebral artery terminating in posterior inferior cerebellar artery.

  Young Noh, O-Ki Kwon, Hyo-Jung Kim, Ji Soo Kim
  [show abstract] [hide abstract]
  ABSTRACT: Rotational vertebral artery syndrome (RVAS) is characterized by recurrent attacks of paroxysmal vertigo, nystagmus, and ataxia induced by head rotation. We report on a patient who developed atypical RVAS due to compression of the vertebral artery (VA) terminating in the posterior inferior cerebellar artery (PICA). A 59-year-old man suffered from vertigo and nystagmus induced by leftward head rotation and oculography showed right beating horizontal-torsional and downbeat nystagmus. Cerebral angiography showed hypoplastic right VA terminating in PICA without connection to the basilar artery. The basilar artery received its flow from the left VA only and branched out both anterior inferior cerebellar arteries. Cerebral angiography revealed a complete occlusion of the right distal VA at the level of the C1-2 junction when the head was rotated to a leftward position. In contrast, the blood flow through the left vertebral and basilar arteries remained intact while turning the head to either side. The hemodynamic compromise observed in our patient with RVAS indicates that isolated vertigo and nystagmus may occur due to transient ischemia of the inferior cerebellum or lateral medulla.
  Journal of Neurology 03/2011; 258(10):1775-80. · 3.47 Impact Factor
• Article: Clinical and angiographic factors related to the prognosis of cavernous sinus dural arteriovenous fistula.

  Keun-Hwa Jung, Bae Ju Kwon, Kon Chu, Young Noh, Soon-Tae Lee, Young-Dae Cho, Moon Hee Han, Jae-Kyu Roh
  [show abstract] [hide abstract]
  ABSTRACT: Endovascular occlusion of the fistula has been the most widely accepted treatment for cavernous sinus dural arteriovenous fistula (CS-dAVF). Although the CS-dAVF prognosis is generally good, physicians have noted poor recoveries, paradoxical worsening, or recurrences in some cases. In this study, we sought to identify factors that influence the prognoses of CS-dAVF patients. We enrolled 76 patients diagnosed with CS-dAVF by conventional angiography in this study and analyzed their medical records for a mean follow-up period of 20 months. We assessed the clinical and radiological factors associated with poor recovery, paradoxical worsening, and recurrence. The 76 CS-dAVF patients (25 men, 51 women, ages 24 to 77 years) underwent treatment via transvenous and/or transarterial embolization. Initially, we achieved successful occlusion in 64 patients (84.2%). Of the treated patients, 53 (69.7%) were cured, 14 (18.4%) showed significant improvement, and nine (11.8%) remained static or worsened. Poor recovery was associated with significant residual shunt after embolization and with a late-restrictive CS-dAVF type. Among the 64 initially occluded patients, paradoxical worsening was more frequent in patients who had a greater number of draining veins. Recurrence was more prevalent in younger patients. CS-dAVF can have eccentric features, such as lasting symptoms, paradoxical worsening, and recurrence after embolization. Poor recovery was associated with residual shunt and with the late-restrictive type, paradoxical worsening was associated with number of draining veins, and recurrence occurred more often in younger patients.
  Neuroradiology 12/2010; 53(12):983-92. · 2.82 Impact Factor