A Case Report of the Patient with Multiple System Atrophy Evaluated by Unified Multiple System Atrophy Rating Scale (UMSARS)

Unified Multiple System Atrophy Rating Scale(UMSARS)로 평가한 다계통 위축증 환자 1례에 대한 증례 보고

  • Jeong, Seong-Sik (Dept. of Oriental Internal medicine, National Medical Center) ;
  • An, Tae-Han (Dept. of Oriental Internal medicine, National Medical Center) ;
  • Park, So-Im (Dept. of Oriental Internal medicine, National Medical Center) ;
  • Kim, Jin-Won (Dept. of Oriental Internal medicine, National Medical Center) ;
  • Seo, Ho-Seok (Dept. of Oriental Internal medicine, National Medical Center) ;
  • Ryu, Chun-Gil (Dept. of Neuropsychiatry, National Medical Center) ;
  • Lee, Ji-Su (Dept. of Oriental Acupuncture and Moxibustion, National Medical Center)
  • 정성식 (국립중앙의료원 한방진료부 한방내과) ;
  • 안태한 (국립중앙의료원 한방진료부 한방내과) ;
  • 박소임 (국립중앙의료원 한방진료부 한방내과) ;
  • 김진원 (국립중앙의료원 한방진료부 한방내과) ;
  • 서호석 (국립중앙의료원 한방진료부 한방내과) ;
  • 유춘길 (국립중앙의료원 한방진료부 한방신경정신과) ;
  • 이지수 (국립중앙의료원 한방진료부 침구과)
  • Published : 2012.03.30

Abstract

Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disorder characterized clinically by various combinations of parkinsonian, autonomic, cerebellar, or pyramidal signs and pathologically by cell loss, gliosis, and ${\alpha}$-synuclein-positive glial cytoplasmic inclusions in several brain and spinal cord structures. This is a clinical report about a 69-year-old female who had MSA treated by oriental medical treatment and evaluated by Unified Multiple System Atrophy Rating Scale (UMSARS). The patient was treated with herb medicine Chungsimyeonj-aeumgami(淸心蓮子飮加味), acupuncture, moxibustion and cupping. After treatment, the patient's symptoms improved meaningfully and the score decreased in UMSARS Part I, II. This suggests that oriental medical treatment could be effective to improve MSA patients' symptoms. It is necessary to have more observations and many cases of patients with MSA.

Keywords

References

  1. Wenning GK, ShlomoYB, Magalhaes M, Daniel SE, Quinn NP. Clinical features and natural history of multiple system atrophy. Brain 1994;117:835-45. https://doi.org/10.1093/brain/117.4.835
  2. Papp MI, Lantos PL. The distribution of oligodendroglial inclusions in multiple system atrophy and its relevance to clinical symptomatology. Brain 1994;117:235-43. https://doi.org/10.1093/brain/117.2.235
  3. Wenning GK, Tison F, Ben-Shlomo Y, Daniel SE, Quinn NP. Multiple system atrophy: a review of 203 pathologically proven cases. Movement Disorders 1997;12(2):133-47. https://doi.org/10.1002/mds.870120203
  4. Quinn N. Multiple system atrophy. In: Marsden CD, Fahn S, eds. Movement disorder 3. London: Butterworths-heinemann Ltd; 1994, p. 262-81.
  5. Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999;163:94-8. https://doi.org/10.1016/S0022-510X(98)00304-9
  6. Quinn NP. Multiple system atrophy-the nature of the beast. J Neurosurg Psychiatry 1989;(suppl):78-89.
  7. 황도연. 방약합편. 서울: 영림사; 2002, p. 213-4.
  8. Wenning GK, Tison F, Seppi K, Sampaio C, Diem A, Yekhlef F, et al. Development and validation of the Unified Multiple System Atrophy Rating Scale(UMSARS). Movement Disorders 2004;19:1391-402. https://doi.org/10.1002/mds.20255
  9. 이승희, 김성균, 신현수, 이한배, 진속창, 김민석, 등. 올리브교소뇌 위축증 환자 1례에 대한 증례보고. 대한한방내과학회지 2002;23(3):511-8.
  10. 김태훈, 나병조, 이준우, 이차로, 윤상필, 정우상, 등. 연하장애를 호소하는 올리브교소뇌 위축증 환자에 구법을 적용한 치험례. 대한한방내과학회 춘계학술대회 2004;131-6.
  11. 이제원, 장우석, 백경민. 현훈을 호소하는 올리브교소뇌위축증 양한방 협진 치험 1례. 동서의학 2010;35(4):73-83.
  12. 백윤선, 조은영, 최효재, 정승현. 보행실조를 주소로 하는 소뇌성 다계통위축증 환자 1례에 대한 증레보고. 대한한방내과학회 춘계학술대회지 2008;119-25.
  13. 변형식, 박주영, 임정태, 김미영, 김창현, 정우상, 등. 다계통 위축증 환자의 전침 및 뜸 치료에 의한 배뇨장애 치험 1례. 대한한방내과학회 추계학술대회지 2008;196-203.
  14. 대한침구학회 교재편찬위원회. 침구학 하. 파주: 집문당; 2008, p. 253.
  15. Parati EA, Fetoni V, Germiniani GC, Soliveri P, Giovannini P, Testa D, et al. Response to L-dopa in multiple system atrophy. Clin Neuropharmacol 1993;16(2):139-44. https://doi.org/10.1097/00002826-199304000-00006
  16. Wenning GK, Geser F, Ndayisaba JP, Boesch S, Seppi K, Ostergaard K, et al. Presentation, Diagnosis, and Management of Multiple System Atrophy in Europe: final analysis of the european multiple system atrophy registry. Movement Disorders 2010;25:2604-12. https://doi.org/10.1002/mds.23192
  17. 김철우, 김형돈. 국시 본초학 제2판. 서울: 군자출판사; 2007, p. 311, 313, 385.