Journal of Acupuncture Research

Korean Acupuncture & Moxibustion Medicine Society (대한침구의학회)
권호 표지
DOI QR코드

DOI QR Code

A Case Report on the Use of Korean Medicine Treatment for a Patient with Dysarthria Caused by Progressive Bulbar Palsy (PBP)

  • Ahn, Jae Hyun (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Sung Yoon (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Park, Jun Hyeong (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Cho, Jeongjae (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Choi, Do Young (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Seung Hoon (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Jae Dong (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University)
  • Received : 2017.01.05
  • Accepted : 2017.02.01
  • Published : 2017.02.20
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : To introduce a rare case of a patient with Progressive Bulbar Palsy (PBP) and suggest the possibility of treatment using electroacupuncture and Korean Medicine. Methods : A 61-year-old man with PBP, complaining of dysarthria, was treated with electroacupuncture and Korean Medicine, from June 16 to July 10, 2015. Improvements in symptoms were measured using the speech mechanism screening test (SMST), measurement of tongue and orbicularis oris motility, and speech handicap index (SHI). Results : The scores of SMST, motility of tongue and orbicularis oris showed a tendency for gradual improvement with 25 days of Korean Medicine Treatment after admission, but conversation was still impossible. In SHI scores, one point increased in the speech domain and one point decreased in the psycho-social domain, and three points increased in the other domain. Conclusion : Electroacupuncture and Korean Medicine Treatment improved dysarthria caused by PBP, but not completely. Korean Medicine Treatment seems effective in the management of accompanying symptoms such as black hairy tongue, dry mouth, and general condition. The symptoms of PBP are similar to those of amyotrophic lateral sclerosis and there is controversy regarding the classification of PBP. The most important aspect of treating a patient with PBP is an early diagnosis and devising appropriate rehabilitation strategies.

Keywords

References

  1. Chafic Karam, Stephen N. Scelsa, Daniel J. L. Macgowan. The clinical course of progressive bulbar palsy. Amyotroph Lateral Scler. 2010;11(4):364-8. https://doi.org/10.3109/17482960903513159
  2. Hughes TAT, Wiles CM. Neurogenic dysphagia: the role of the neurologist. J Neurol Neurosurg Psychiatry. 1998;64(5):569-72. https://doi.org/10.1136/jnnp.64.5.569
  3. Talacko AA, Reade PC. Progressive bulbar palsy: a case report of a type of motor neuron disease presenting with oral symptoms. Oral Surg Oral Med Oral Pathol. 1990;69(2):182-4. https://doi.org/10.1016/0030-4220(90)90325-M
  4. Cerero Lapiedra R, Moreno Lopez LA, Esparza Gomez GC. Progressive bulbar palsy: a case report diagnosed by lingual symptoms. J Oral Pathol Med. 2002;31(5):277-9. https://doi.org/10.1034/j.1600-0714.2002.310505.x
  5. Motoi Y, Satoh K, Matsumine H, et al. A 49-year-old man with progressive bulbar palsy and respiratory failure. No To Shinkei. 1998;50(1):93-100.
  6. Shin KM, Chee SH. Syndrome of Progressive Bulbar Palsy in Amyotrophic Lateral Sclerosis. A Case Report. Ewha Med. J. 1980;3(1):33-8. https://doi.org/10.12771/emj.1980.3.1.33
  7. Fujiwara Y, Oguri K, Shimada Y. Masseter spasticity successfully treated with neuroablations of the bilateral mandibular nerves for a patient with progressive bulbar palsy. Anesth Analg. 2005;101(3):927.
  8. Kim TK, Moon SK. A case report of a progressive bulbar palsy patient. Uirim. 2001;275:86-8.
  9. Jung SY, Shin MJ. Characteristics of speech mechanism and motor abilities in adults who stutter. Audiology and Speech Research (ASR). 2016;12(3):164-75. https://doi.org/10.21848/asr.2016.12.3.164
  10. G. K. Bachher, K. Dholam, P.S. Pai. Effective rehabilitation after partial glossectomy. Indian J Otolaryngol Head Neck Surg. 2002;54(1):39-43. https://doi.org/10.1007/BF02911004
  11. Lee HJ, Hong SP, Park BS, Choi JW, Koo SK. The Improvement of Tongue Mobility and Articulation after Frenotomy in Patient with Ankyloglossia. Korean J Otorhinolaryngol-Head Neck Surg. 2010;53(8):491-6. https://doi.org/10.3342/kjorl-hns.2010.53.8.491
  12. Rinkel RN, Verdonck-de Leeuw IM, van Reij EJ, Aaronson NK, Leemans CR. Speech handicap index in patients with oral and pharyngeal cancer: better understanding of patients' complaints. Head Neck. 2008;30(7):868-74. https://doi.org/10.1002/hed.20795
  13. Jacobson G, Johnson A, Grywalski C, et al. The Voice Handicap Index (VHI): development and validation. AmJ Speech Lang Pathol 1997;6:66-70.
  14. Al-Majed AA, Neumann CM, Brushart TM, Gordon T. Brief electrical stimulation promotes the speed and accuracy of motor axonal regeneration. J Neurosci. 2000;20(7):2602-8. https://doi.org/10.1523/JNEUROSCI.20-07-02602.2000
  15. R S Howard, R W Orrell. Management of motor neurone disease. Postgrad Med J. 2002;78(926):736-41. https://doi.org/10.1136/pmj.78.926.736
  16. Brooks BR, Miller RG, Swash M, Munsat TL. El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord. 2000;1(5):293-9. https://doi.org/10.1080/146608200300079536
  17. Adams RD, Victor M, Ropper AH. Chapter 39 Degenerative diseases of the nervous system. In: Adams RD, Victor M, Ropper AH, editors. Principles of Neurology. 6th ed. New York: Mc-Graw Hill. 1997:1091.

Cited by

  1. 다발성 뇌경색으로 인한 거짓연수마비 환자의 연하장애 및 어삽에 유효하였던 한방 치료 1례 - 반하후박탕을 중심으로 vol.39, pp.2, 2017, https://doi.org/10.22246/jikm.2018.39.2.139