Objective: To assess associations of adolescents' lifestyle habits with their daytime functioning... more Objective: To assess associations of adolescents' lifestyle habits with their daytime functioning in Japan. Methods: A total of 2,722 questionnaires obtained from pupils in grades 5 to 12 in Japan were assessed by the multiple comparison test to determine significant differences in the lifestyle habits among the self-reported academic performance categories (AP1: very good; AP2: good; AP3: not good; AP4: poor). Results: The average non-school-day screen time of AP4 pupils was significantly longer than that of AP1 pupils in elementary and junior high schools. In junior and senior high schools, AP4 pupils showed more sleepiness and higher occurrence of breakfast skipping than AP2 pupils. In all school types, sleep duration showed no significant differences among the self-reported academic performance categories. Discussion: Avoiding sleepiness, breakfast skipping, and heavy media usage is expected to ensure adolescents' daytime functioning. Although not studied here, napping might improve adolescents' daytime functioning.
Objective: We carried out a questionnaire survey to investigate the uses of melatonin and ramelte... more Objective: We carried out a questionnaire survey to investigate the uses of melatonin and ramelteon in Japanese children. Methods: We sent a questionnaire to councilors of the Japanese Society of Child Neurology by e-mail, and sent the same questionnaire to members of the Japanese Society of Pediatric Psychiatry and Neurology by postal mail. Results: During the first phase of the survey, 220 responses were obtained, and 45% of the respondents prescribed melatonin. Imported supplements and chemical reagents were used by 64% and 29% of melatonin prescribers, respectively. Some prescribed melatonin without patient consent or institutional approval. In patients with pervasive developmental disorder, cerebral palsy, attention-deficit hyperactivity disorder, Rett syndrome, and visual disturbance, melatonin was prescribed by 37%, 29%, 10%, 6%, and 6% of the respondents, respectively. In terms of sleep disorders, melatonin was prescribed by 49% and 42% of respondents in patients with circadian rhythm disorders and insomnia, respectively. Ramelteon was prescribed by 52% of respondents. Regarding types of target diseases and sleep disorders, the use of ramelteon differed little from that of melatonin. In the second phase of the survey on the use of melatonin, 23 doctors prescribed the drug for 254 patients. The daily effective dose ranged from 0.2 mg to 8 mg in patients aged 2 months to 37 years. In more than 60% of the patients who took melatonin, PDD was diagnosed. In the patients with melatonin for insomnia, 90% and 25% had difficulty falling asleep and disorders in circadian rhythm, respectively. Conclusions: Both melatonin and ramelteon were widely prescribedin Japanese children. Melatonin tended to be used without sufficient ethical consideration in Japan, indicating the necessity of melatonin as medicine. Then, careful determination of an applicable dose are required in future studies.
Diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy are useful to... more Diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy are useful tools in identifying the cause of cerebral lesions. We report serial simultaneous diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy of hemiconvulsion-hemiplegia-epilepsy syndrome. In this case, the involved hemisphere revealed high intensity on diffusion-weighted images and slight hyperperfusion on brain blood perfusion scintigraphy 7 days after the seizure. Accordingly, neurotoxic, rather than ischemic, cellular edema might be the cause of hemiconvulsion-hemiplegia-epilepsy syndrome in the acute phase.
We present here a 5-year-old girl with acute encephalities with refractory, repetitive partial se... more We present here a 5-year-old girl with acute encephalities with refractory, repetitive partial seizures (AERRPS), a new clinical entity defined by the following five criteria: 1. acute encephalitis with a prolonged acute phase of more than 2 weeks, 2. persistent partial seizures with identical phenotype both in the acute and recovery phase, 3. seizures frequently evolving into convulsive status especially during the acute phase, 4. extremely intractable, and 5. no causative lesion or agent is identified. Interestingly, her seizures had completely diminished from the fifty-sixth day of her illness with concomitant appearance of choreo-ballistic involuntary movements. After the 120th day of the illness, seizures evolved again, though the involuntary movements persisted. This transient disappearance of intractable seizures might provide a clue to the pathophysiology of seizures in AERRPS.
This article reviewed the insomnia in children, according to the second edition of the internatio... more This article reviewed the insomnia in children, according to the second edition of the international classification of sleep disorders. In addition, Yonaki (sleep-related night time crying) and the consensus statement on pharmacologic management of insomnia in children and adolescents were introduced. Furthermore, a novel clinical entity-asynchronization-, parts of whose symptoms were presumable due to the behaviorally induced insufficient sleep syndrome due to inadequate sleep hygiene, was also introduced.
Background:Both late and irregular caloric intakes are becoming common, especially among young ad... more Background:Both late and irregular caloric intakes are becoming common, especially among young adults. This study aimed to investigate features of pupils in Japan following different dinner habits.Methods:Dinner habits were categorized into 3 types: non-late regular, regular but late, and irregular. Questionnaires of 2722 pupils in grades 5 to 12 were included, and a multiple comparison test was conducted to investigate the differences of lifestyle factors among the 3 dinner-pattern categories.Results:Only half of grade 5 and 6 pupils had non-late regular dinners. The rate of pupils who had regular but late dinners increased from elementary school (11.8%) to senior high school (41.1%) via junior high school (15.1%). More than 30% of pupils took dinner irregularly. The pupils taking non-late regular dinner showed the earliest bedtime and the longest sleep duration among the 3 dinner-time habit categories and also revealed the best academic performance and sleepiness scores. The pupils taking regular but late dinner showed the highest grade, the latest bedtime, the shortest sleep duration, the longest school-day screen time scores, and the worst sleepiness and self-reported academic performance scores. Irregular dinner-takers showed the longest after-school activities.Conclusions:Further attention should be given to both late and irregular dinner habits of pupils in terms of supporting their health. Further studies are needed to recommend suitable dinner timings for pupils by assessing optimal levels of variable lifestyle factors, including after-school activity.
Objective: To assess associations of adolescents' lifestyle habits with their daytime functioning... more Objective: To assess associations of adolescents' lifestyle habits with their daytime functioning in Japan. Methods: A total of 2,722 questionnaires obtained from pupils in grades 5 to 12 in Japan were assessed by the multiple comparison test to determine significant differences in the lifestyle habits among the self-reported academic performance categories (AP1: very good; AP2: good; AP3: not good; AP4: poor). Results: The average non-school-day screen time of AP4 pupils was significantly longer than that of AP1 pupils in elementary and junior high schools. In junior and senior high schools, AP4 pupils showed more sleepiness and higher occurrence of breakfast skipping than AP2 pupils. In all school types, sleep duration showed no significant differences among the self-reported academic performance categories. Discussion: Avoiding sleepiness, breakfast skipping, and heavy media usage is expected to ensure adolescents' daytime functioning. Although not studied here, napping might improve adolescents' daytime functioning.
Objective: We carried out a questionnaire survey to investigate the uses of melatonin and ramelte... more Objective: We carried out a questionnaire survey to investigate the uses of melatonin and ramelteon in Japanese children. Methods: We sent a questionnaire to councilors of the Japanese Society of Child Neurology by e-mail, and sent the same questionnaire to members of the Japanese Society of Pediatric Psychiatry and Neurology by postal mail. Results: During the first phase of the survey, 220 responses were obtained, and 45% of the respondents prescribed melatonin. Imported supplements and chemical reagents were used by 64% and 29% of melatonin prescribers, respectively. Some prescribed melatonin without patient consent or institutional approval. In patients with pervasive developmental disorder, cerebral palsy, attention-deficit hyperactivity disorder, Rett syndrome, and visual disturbance, melatonin was prescribed by 37%, 29%, 10%, 6%, and 6% of the respondents, respectively. In terms of sleep disorders, melatonin was prescribed by 49% and 42% of respondents in patients with circadian rhythm disorders and insomnia, respectively. Ramelteon was prescribed by 52% of respondents. Regarding types of target diseases and sleep disorders, the use of ramelteon differed little from that of melatonin. In the second phase of the survey on the use of melatonin, 23 doctors prescribed the drug for 254 patients. The daily effective dose ranged from 0.2 mg to 8 mg in patients aged 2 months to 37 years. In more than 60% of the patients who took melatonin, PDD was diagnosed. In the patients with melatonin for insomnia, 90% and 25% had difficulty falling asleep and disorders in circadian rhythm, respectively. Conclusions: Both melatonin and ramelteon were widely prescribedin Japanese children. Melatonin tended to be used without sufficient ethical consideration in Japan, indicating the necessity of melatonin as medicine. Then, careful determination of an applicable dose are required in future studies.
Diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy are useful to... more Diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy are useful tools in identifying the cause of cerebral lesions. We report serial simultaneous diffusion-weighted magnetic resonance images and brain blood perfusion scintigraphy of hemiconvulsion-hemiplegia-epilepsy syndrome. In this case, the involved hemisphere revealed high intensity on diffusion-weighted images and slight hyperperfusion on brain blood perfusion scintigraphy 7 days after the seizure. Accordingly, neurotoxic, rather than ischemic, cellular edema might be the cause of hemiconvulsion-hemiplegia-epilepsy syndrome in the acute phase.
We present here a 5-year-old girl with acute encephalities with refractory, repetitive partial se... more We present here a 5-year-old girl with acute encephalities with refractory, repetitive partial seizures (AERRPS), a new clinical entity defined by the following five criteria: 1. acute encephalitis with a prolonged acute phase of more than 2 weeks, 2. persistent partial seizures with identical phenotype both in the acute and recovery phase, 3. seizures frequently evolving into convulsive status especially during the acute phase, 4. extremely intractable, and 5. no causative lesion or agent is identified. Interestingly, her seizures had completely diminished from the fifty-sixth day of her illness with concomitant appearance of choreo-ballistic involuntary movements. After the 120th day of the illness, seizures evolved again, though the involuntary movements persisted. This transient disappearance of intractable seizures might provide a clue to the pathophysiology of seizures in AERRPS.
This article reviewed the insomnia in children, according to the second edition of the internatio... more This article reviewed the insomnia in children, according to the second edition of the international classification of sleep disorders. In addition, Yonaki (sleep-related night time crying) and the consensus statement on pharmacologic management of insomnia in children and adolescents were introduced. Furthermore, a novel clinical entity-asynchronization-, parts of whose symptoms were presumable due to the behaviorally induced insufficient sleep syndrome due to inadequate sleep hygiene, was also introduced.
Background:Both late and irregular caloric intakes are becoming common, especially among young ad... more Background:Both late and irregular caloric intakes are becoming common, especially among young adults. This study aimed to investigate features of pupils in Japan following different dinner habits.Methods:Dinner habits were categorized into 3 types: non-late regular, regular but late, and irregular. Questionnaires of 2722 pupils in grades 5 to 12 were included, and a multiple comparison test was conducted to investigate the differences of lifestyle factors among the 3 dinner-pattern categories.Results:Only half of grade 5 and 6 pupils had non-late regular dinners. The rate of pupils who had regular but late dinners increased from elementary school (11.8%) to senior high school (41.1%) via junior high school (15.1%). More than 30% of pupils took dinner irregularly. The pupils taking non-late regular dinner showed the earliest bedtime and the longest sleep duration among the 3 dinner-time habit categories and also revealed the best academic performance and sleepiness scores. The pupils taking regular but late dinner showed the highest grade, the latest bedtime, the shortest sleep duration, the longest school-day screen time scores, and the worst sleepiness and self-reported academic performance scores. Irregular dinner-takers showed the longest after-school activities.Conclusions:Further attention should be given to both late and irregular dinner habits of pupils in terms of supporting their health. Further studies are needed to recommend suitable dinner timings for pupils by assessing optimal levels of variable lifestyle factors, including after-school activity.
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Papers by Jun Kohyama