밀러피셔 증후군 환자에 대한 한방 치험 1례

A case of Miller Fisher Syndrome treated with Traditional Korean Medicine

  • 이현규 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 서원주 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 김재학 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 조기호 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 문상관 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 정우상 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 권승원 (경희대학교 대학원 임상한의학과 순환.신경내과학교실) ;
  • 진철 (경희대학교 대학원 임상한의학과 순환.신경내과학교실)
  • Lee, Hyunku (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Suh, Won-joo (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Kim, Jae hak (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Cho, Ki-Ho (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Moon, Sang-Kwan (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Jung, Woo-Sang (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Kwon, Seungwon (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University) ;
  • Jin, Chul (Dept. of Clinical Korean medicine, Cardiology and Neurology, Graduate school, Kyung-Hee University)
  • 발행 : 2019.12.15

초록

■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with Miller Fisher Syndrome. ■ Methods A patient with Ataxia, Diplopia, Mydriasis diagnosed as Miller Fisher Syndrome was treated with herbal medication, acupuncture, electro-acupuncture, and press needles. Then we evaluated the improvement with the size of pupil, NRS(Numeral Rating Scale) of Diplopia, Assessment for Gait disturbance. ■ Results We could observe decrease in pupil size and NRS of Diplopia and improve in assessment for gait disturbance after the TKM treatment. ■ Conclusion This case showed the effect of TKM treatment on Miller Fisher syndrome.

키워드

참고문헌

  1. Collier J. Peripheral neuritis. Edinburg Med J 1932;39:672-88.
  2. 대한신경과학회. 신경학. 3판. 서울, 범문에듀케이션. 2017. pp.214.
  3. James W. Miller Fisher's Syndrome. Semin Neurol. 2012;32(5):512-6.2 https://doi.org/10.1055/s-0033-1334470
  4. 이성균, 임은경, 조영기 외. 말초신경병증으로 진단된 하지위증환자의 치험 1례. 동의생리병리학회지. 2005;19(6):1689-93.
  5. 이승현, 최성용, 이성균 외. 말초신경병증으로 진단된 편측 족하수 환자의 치험 1례. 대한침구학회지. 2006;23(1):217-23.
  6. 이효민, 석정임, 이동국. 재발 Miller Fisher 증후군 1예. 대한임상신경생리학회지. 2007;9(1): 26-8.
  7. Koga M, Gilbert M, Li J, et al. Antecedent infection in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology. 2005;64:1605-11. https://doi.org/10.1212/01.WNL.0000160399.08456.7C
  8. Koga M, Gilbert M, Li J, et al. Antecedent infection in Fisher syndrome: a common pathogenesis of molecular mimicry. Neurology. 2005;64:1605-11. Curr Opin Neurol. 2006;19:451-7. https://doi.org/10.1212/01.WNL.0000160399.08456.7C
  9. Slavick HE, Shapiro RA. Fisher Syndrome associated with Epstein Barr virus. Arch Neurol. 1982;38:134-5. https://doi.org/10.1001/archneur.1981.00510020092018
  10. Lo YL. Clinical and immunological spectrum of the Miller Fisher syndrome. Muscle Nerve. 2007;36(5):615-27 https://doi.org/10.1002/mus.20835
  11. Riche G, Caudie C, Vial C, Bourrat C. Recurrent Miller Fisher syndrome and anti-GQ1b antibodies. Rev Med Interne 1998;19:192-5. https://doi.org/10.1016/S0248-8663(97)80719-9
  12. Buchwald B, Weishaupt A, Toyka KV et al. Pre- and postsynaptic blockade of neuromuscular transmission by Miller Fisher syndrome IgG at mouse motor nerve terminals. Eur J Neurosci. 1998;10:281-90. https://doi.org/10.1046/j.1460-9568.1998.00053.x
  13. Berlit P, Rakicky J. The Miller Fisher syndrome. Review of the literature. J Clin Neuroophthalmol. 1992;23:57-63.
  14. Swick HM, McQuillen MP. The use of steroid in the treatment of idiopathic polyneuritis. Neurology 1976;26:205-15. https://doi.org/10.1212/WNL.26.3.205
  15. Goodall JA, Kosmidis JC, Geddes AM. Effect of corticosteroids on course of Guillain-Barre syndrome. Lancet. 1974;1:524-6. https://doi.org/10.1016/S0140-6736(74)92712-3
  16. Hughes RA, Wijdicks EF, Barohn R, et al. Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: immunotherapy for Guillain-Barre syndrome: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2003;61(6):736-40. https://doi.org/10.1212/WNL.61.6.736
  17. Overell JR, Hsieh ST, Odaka M, Yuki N, Willison HJ. Treatment for Fisher syndrome, Bickerstaff's brainstem encephalitis and related disorders. Cochrane Database Syst Rev. 2007;(1):CD004761
  18. Mori M, Kuwabara S, Fukutake T et al. Intravenous immunoglobulin therapy for Miller Fisher syndrome. Neurology 2007;68(14):1144-6 https://doi.org/10.1212/01.wnl.0000258673.31824.61
  19. James W. Teener. Miller Fisher's Syndrome. Seminars in Neurology. 2012;32(5):512-6. https://doi.org/10.1055/s-0033-1334470
  20. 정은정, 최동준, 고창남 외. MillerFisher증후군 1예에 대한 임상적 고찰. J Korean Oriental Med. 2000;20(4):98-105.
  21. 노진환, 고창남, 조기호 외. 위증에 대한 동서의학적 고찰. The Journal of Internal Korean Medicine. 1996;17(1): 81-106.
  22. 김정제. 동양의학 진료요감. 서울: 동양희학연구원. 2007;176.
  23. 홍정애, 송미연, 최인화 외. 益氣補血湯이 C57BL/6 마우스의 育毛촉진 및 Cytokine 변화에 미치는 영향. J Korean Oriental Med. 2010;31(1):138-52.
  24. 유주영, 이강욱, 조민경 외. 한방치료로 호전된 Miller Fisher 증후군 환자 증례보고. J. Int. Korean Med. 2016;37(4):661-8. https://doi.org/10.22246/jikm.2016.37.4.661
  25. 성기문, 허래경, 송봉근. 공진단이 MCAO모델 흰쥐에서 gliosis 억제에 미치는 영향. 대한한방내과학회지. 2009;30:674-84.
  26. 황성연, 이가위, 이승호 외. 加減拱辰丹(WSY-1075)의 접촉성 피부염 유발 모델동물에 대한 개선효과. 대한한의학방제학회지. 2013;21(1):131-41. https://doi.org/10.14374/HFS.2013.21.1.131
  27. 장용훈. 拱辰丹이 强精補氣作用에 미치는 영향. 대구한의과대학 대학원. 1989.
  28. 최금희, 박치상. 공진단(拱辰丹)의 성분 분석 및 항산화(坑酸化) 작용에 미치는 영향. 대한본초학회지. 2007;22:51-63.
  29. 김장현. 拱辰丹이 면역반응, 항피로 및 내분비기능에 미치는 영향. 경희대학교대학원. 1990
  30. 김홍준, 황성연, 목지예 등. Balb/c 마우스에서 Ovalbumin 면역반응에 대한 加減拱辰丹 추출물의 억제효과. 대한본초학회지. 2009;24:127-35.
  31. 차혜진, 이지원, 서영민 등. 밀러피셔증후군의 불면증 환자 치험 1례. 동의신경정신과 학회지. 동의신경정신과학회지. 2009;20(3):229-36.
  32. 두인선, 김진만, 홍철희 등. Miller Fisher 증후군의 동안신경마비에 대한 치험1례. 동의생리병리학회지. 2003;17(3):842-5.
  33. Ryou JH, Kim HW, Park MG. Pupil size in the dark in normal adults. J Korean Ophthalmol Soc. 1996;37(10):1722-9.
  34. Thomas K, Evdoxia T, Jens B et al. Comparison of a digital and a handheld infrared pupillometer for determining scotopic pupil diameter. J Cataract Refract Surg. 2003;29 (1):112-7. https://doi.org/10.1016/S0886-3350(02)01898-9
  35. 정우재, 전인철, 강지훈. 근시안에서 암순응상태의 동공크기. 한국안광학회지. 2013;18(2):197-202. https://doi.org/10.14479/jkoos.2013.18.2.197