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A Case Report of an Internuclear Ophthalmoplegia Patient caused by Pontine Infarction Treated by Korean Medicine Treatment Including Yukmijihwang-tang

교뇌 경색으로 인한 핵간안근마비 환자의 육미지황탕을 활용한 한의 증례보고 1례

  • Kim, Du-ri (Dept. of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Lee, Hyun-seung (Dept. of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Ahn, Jae-yoon (Dept. of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Moon, Byung-soon (Dept. of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Yun, Jong-min (Dept. of Internal Medicine, College of Oriental Medicine, Wonkwang University)
  • 김두리 (원광대학교 한의과대학 내과학교실) ;
  • 이현승 (원광대학교 한의과대학 내과학교실) ;
  • 안재윤 (원광대학교 한의과대학 내과학교실) ;
  • 문병순 (원광대학교 한의과대학 내과학교실) ;
  • 윤종민 (원광대학교 한의과대학 내과학교실)
  • Received : 2019.03.29
  • Accepted : 2019.05.30
  • Published : 2019.05.30

Abstract

Internuclear Ophthalmoplegia (INO) is characterized by lesion side eye's adduction limitation in lateral horizontal gaze and nystagmus in the abducting eye due to lesions in the Medial Longitudinal Fasciculus (MLF). Brainstem infarction is one of the causes of INO, but related issues have seldom been reported in the Korean medical literature. The present case was a pontine infarction patient with INO who complained of diplopia and eye movement disorder. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion for 30 days. Her changes in clinical symptoms were measured with a Numeric Rating Scale (NRS) and a length of External Ocular Movement (EOM), in which the patient's right eyeball moved to the left from the midline in the left gaze. After treatment, her clinical symptoms were improved. Diplopia decreased from NRS 10 to NRS 2, and eye movement disorder was improved such that EOM increased from 1mm to 5 mm. Therefore, integrative Korean medicine treatment may be effective in the treatment of INO patients caused by pontine infarction.

Keywords

References

  1. Korean Stroke Society. Stroke. Seoul: PanMun Education; 2017, p. 3, 90.
  2. The Epidemiology Research Council of the Korean Stroke Society. Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society. Korean Stroke Society. http://www.stroke.or.kr/bbs/?code=epidemic1. 2018. Searched at March 20, 2019
  3. The Korean Neurological Association. Textbook of Neurology. 2nd ed. Seoul: PanMun Education; 2012, p. 25, 287-9, 294.
  4. Hanna KL, Hepworth LR, Rowe FJ. The treatment methods for post-stroke visual impairment: A systematic review. Brain and Behavior 2017;7(5):e00682. https://doi.org/10.1002/brb3.682
  5. Park J, Kim YS, Cho KH, Mun SK, Jung WS. A Study of Central and Peripheral type of Eye Movement Impairment - Focused on 3 Cases Treated with Oriental Medical Treatment. Korean J Orient Int Med2012;33(4):599-608.
  6. Jung KS, Park HJ, Kim SH, Ahn HJ, Ock MK. A Clinical Study on One Case of Exotropia Caused by Unilateral-internuclear- ophthalmoplegia due to Pontine Infarction. Journal of Korean Acupuncture & Moxibustion Society2006;23(3):241-7.
  7. Shin JA, Son DH, Lee TH, Byun DS, Yoon HS, Jang IS. 3 Cases of Korean Medicine about Eyeball Movement Disturbance due to 3th, 4th, and 6th Cranial Nerve Palsy. Korean J Orient Int Med 2003;24(3):626-34.
  8. Fenichel Gerald M. Clinical Pediatric Neurology. 6th ed. Philadelphia: Saunders; 2009, p. 325-6.
  9. Kochar PS, Kumar Y, Sharma P, Kumar V, Gupta N, Goyal P. Isolated medial longitudinal fasciculus syndrome: Review of imaging, anatomy, pathophysiology and differential diagnosis. Neuroradiol J 2018;31(1):95-9. https://doi.org/10.1177/1971400917700671
  10. Choi JY, Kim HS, Lee YC. A Case of Bilateral Internuclear Ophthalmoplegia. J Korean Ophthalmol Soc 1997;38(6):1050-5.
  11. Association of Korean Medicine Professors for Cardiology and Neurological Medicine. Cardiovascular and Neurological Medicine in Korean Medicine I. Seoul: Woori Medical Books; 2018, p. 254.
  12. Noh SS. Otolaryngology. Seoul: Iljungsa; 1999, p. 167, 219.
  13. Nanjing Chinese Medicine Graduate School. Correction &interpretation of Zhu bing yuan hou lun. Beijing: Peaple's Medical Publishing House; 1983, p. 781-2.
  14. Hu J. Donguibogam. Seoul: Bubin Publishers; 2007, p. 619, 638.
  15. Yun YK. Korean medicine prescription and commentary. Seoul: Uisungdang; 2011, p. 508-9.
  16. Shin MK. Clinical Traditional Herbalogy. Seoul: Younglimsa; 2010, p. 233, 236, 259, 326, 332, 351, 547.
  17. Keane JR. Internuclear ophthalmoplegia: unusual causes in 114 of 410 patients. Arch Neurol 2005;62(5):714-7. https://doi.org/10.1001/archneur.62.5.714
  18. Wu YT, Cafiero-Chin M, Marques C. Wall-eyed bilateral internuclear ophthalmoplegia: review of pathogenesis, diagnosis, prognosis and management. Clin Exp Optom 2015;98(1):25-30 https://doi.org/10.1111/cxo.12200
  19. Bolanos I, Lozano D, Cantu C. Internuclear ophthalmoplegia: causes and long-term follow-up in 65 patients. Acta Neurol Scand 2004;110(3):161-5. https://doi.org/10.1111/j.1600-0404.2004.00278.x