Journal of Oriental Neuropsychiatry (동의신경정신과학회지)

The Korean Society of Oriental Neuropsychiatry (대한한방신경정신과학회)
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A Case Report of Post-Stroke Delirium Patient Using Complex Korean Medicine Treatment Including Scalp Electroacupuncture

뇌졸중 후 섬망의 두부 침전기자극술을 포함한 한의복합치료에 대한 증례 보고 1례

  • Jong-Min Kim (Department of Korean Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Hyonjun Chun (Department of Rehabilitation Medicine of Korean Medicine, Dong-Shin Korean Medicine Hospital) ;
  • Ju Yeon Cho (Department of Korean Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Seung Woo Song (Department of Korean Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Ga Hyun Lee (Department of Korean Neuropsychiatry, Dong-Seo Korean Medical Center) ;
  • Se Jin Park (Department of Korean Neuropsychiatry, Dong-Seo Korean Medical Center)
  • 김종민 (동서한방병원 한방신경정신과) ;
  • 전현준 (목동동신한방병원 한방재활의학과) ;
  • 조주연 (동서한방병원 한방신경정신과) ;
  • 송승우 (동서한방병원 한방신경정신과) ;
  • 이가현 (동서한방병원 한방신경정신과) ;
  • 박세진 (동서한방병원 한방신경정신과)
  • Received : 2023.11.12
  • Accepted : 2023.12.27
  • Published : 2023.12.30
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Abstract

Objectives: This case study aimed to provide evidence of the combined use of Korean Medicine treatments, including electroacupuncture (EA) on scalp acupoints, as a useful intervention for post-stroke delirium. Methods: The patient in this study was diagnosed with Cerebral Infarction in Right Corpus Callosum and post-stroke delirium. The patient received eight sessions of EA on scalp acupoints, rehabilitation medicine treatment, and other Korean Medicine treatments such as acupuncture and herbal medicine. Evaluation of treatment effectiveness was done mainly through the Memorial Delirium Assessment Scale Korean (MDAS-K) and Mini-Mental State Examination Korean (MMSE-K). Results: MDAS-K score dropped from 20 to 9 and MMSE-K score increased from 15 to 21 during hospitalization, showing improvement in symptoms. Conclusions: Combined use of Korean medicine treatments including EA on scalp acupoints may be an effective treatment for post-stroke delirium.

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References

  1. Association AP. DSM 5: American Psychiatric Association; 2013.
  2. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-22. https://doi.org/10.1016/S0140-6736(13)60688-1
  3. Bilek AJ, Richardson D. Post-stroke delirium and challenges for the rehabilitation setting: A narrative review. J Stroke Cerebrovasc Dis. 2023;32(8):107149.
  4. Fleischmann R, Andrasch T, Warwas S, Kunz R, Gross S, Witt C, et al. Predictors of post-stroke delirium incidence and duration: Results of a prospective observational study using high-frequency delirium screening. Int J Stroke. 2023;18(3):278-84. https://doi.org/10.1177/17474930221109353
  5. Shi Q, Presutti R, Selchen D, Saposnik G. Delirium in acute stroke: a systematic review and meta-analysis. Stroke. 2012;43(3):645-9. https://doi.org/10.1161/STROKEAHA.111.643726
  6. Rollo E, Brunetti V, Scala I, Callea A, Marotta J, Vollono C, et al. Impact of delirium on the outcome of stroke: a prospective, observational, cohort study. J Neurol. 2022; 269(12):6467-75. https://doi.org/10.1007/s00415-022-11309-2
  7. Boettger S, Jenewein J, Breitbart W. Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects. Palliat Support Care. 2015;13(4):1079-85. https://doi.org/10.1017/S1478951514001059
  8. Basciotta M, Zhou W, Ngo L, Donnino M, Marcantonio ER, Herzig SJ. Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults. J Am Geriatr Soc. 2020;68(3):544-50. https://doi.org/10.1111/jgs.16246
  9. Bilek AJ, Richardson D. Post-stroke delirium and challenges for the rehabilitation setting: A narrative review. J Stroke Cerebrovasc Dis. 2023;32(8):107149.
  10. Levy I, Attias S, Ben-Arye E, Bloch B, Schiff E. Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis. Int J Geriatr Psychiatry. 2017;32(5):492-508. https://doi.org/10.1002/gps.4685
  11. Min SS, Kim YK, Kwon JN. Clinical Report on the Byun-jo Accompanied Delirium. Journal of Korean Oriental Physiology and Pathology. 2005;19(6):1715-9.
  12. Liu AJ, Li JH, Li HQ, Fu DL, Lu L, Bian ZX, et al. Electroacupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. American Journal of Chinese Medicine. 2015;43(8):1541-66. https://doi.org/10.1142/S0192415X15500883
  13. Cai YY, Zhang CS, Liu SN, Wen ZH, Zhang AL, Guo XF, et al. Electroacupuncture for Poststroke Spasticity: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2017;98(12):2578- 89. https://doi.org/10.1016/j.apmr.2017.03.023
  14. Zhong LD, Wang J, Li F, Bao X, Liu HY, Wang P. The Effectiveness of Acupuncture for Dysphagia after Stroke: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine. 2021;2021:8837625.
  15. Cai W, Ma W, Li YJ, Wang GT, Yang H, Shen WD. Efficacy and safety of electroacupuncture for post-stroke depression: a randomized controlled trial. Acupuncture in Medicine. 2022;40(5):434-42. https://doi.org/10.1177/09645284221077104
  16. Liu R, Chen SS, Wang J. Electroacupuncture for poststroke anxiety disorder on the base of the heart-brain theory: A randomized controlled trial. World Journal of Acupuncture-Moxibustion. 2020;30(1):23-8. https://doi.org/10.1016/j.wjam.2020.02.008
  17. Shi S, Wang MY, Liu XF, Han SW, Zhu PY. Scalp Electro-acupuncture Promotes Angiogenesis after Stroke in Rats by Activation of Wnt/beta-Catenin Signal Pathway. Evidence-Based Complementary and Alternative Medicine. 2022; 2022:1649605.
  18. Riley DS, Barber MS, Kienle GS, Aronson JK, von Schoen-Angerer T, Tugwell P, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017;89:218-35. https://doi.org/10.1016/j.jclinepi.2017.04.026
  19. Breitbart W, Rosenfeld B, Roth A, Smith MJ, Cohen K, Passik S. The Memorial Delirium Assessment Scale. Journal of Pain and Symptom Management. 1997;13(3): 128-37. https://doi.org/10.1016/S0885-3924(96)00316-8
  20. El Husseini N, Katzan IL, Rost NS, Blake ML, Byun E, Pendlebury ST, et al. Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke. 2023;54(6):e272-e91. https://doi.org/10.1161/STR.0000000000000430
  21. Zhang Z, Meng X, Liu W, Liu Z. Clinical Features, Etiology, and 6-Month Prognosis of Isolated Corpus Callosum Infarction. Biomed Res Int. 2019;2019:9458039.
  22. Xiaoqin Huang XD, Haiqing Song, Qian Zhang, Jianping Jia, Tianyi Xiao, Jian Wu. Cognitive impairments associated with corpus callosum infarction: a ten cases study. Int J Clin Exp Med. 2015:21991-8.
  23. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research. 1975;12(3):189-98. https://doi.org/10.1016/0022-3956(75)90026-6
  24. Stollings JL, Kotfis K, Chanques G, Pun BT, Pandharipande PP, Ely EW. Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med. 2021;47(10):1089-103. https://doi.org/10.1007/s00134-021-06503-1
  25. Kim HI, Kim GW, Koo BS, Yoo JH. A Case of Delirium with Traumatic Subdural Hemorrhage Patient Healed by Hwaeo-jeon. Journal of Oriental Neuropsychiatry. 2005; 16(2):189-99.
  26. Noh HS, Ha YK, Yi CS, Hong SC, Park SW, Choi DJ, et al. A Case Report of a Patient with a Left Middle Cerebral Artery Infarction and Delirium Treated with Korean Medicine. The Journal of Internal Korean Medicine. 2017;38(2): 138-45. https://doi.org/10.22246/jikm.2017.38.2.138
  27. Lim SM, An JJ, Choi Y, Kim YJ, Yoo HR, Park YC, et al. The Effect of Dodamtang (DDT) on Brain damage and Hypertension. The Society of Internal Korean Medicine. 2001; 22(4):503-12.
  28. Mizoguchi K, Ikarashi Y. Multiple Psychopharmacological Effects of the Traditional Japanese Kampo Medicine Yokukansan, and the Brain Regions it Affects. Front Pharmacol. 2017;8:149.
  29. Kim SH, Lee YJ, Yang JY, Cho KH, Moon SK, Jung WS, et al. Two cases of Ukgansan-gami on Sleep-related Behavior Disorder after Stroke. The Journal of the Society of Stroke on Korean Medicine. 2019;20(1):9-16.
  30. Lee, Byung J, Kim, Dong H, Kim Sung H. Study on Seunggitangryu (承氣湯類) of Sanghannon(傷寒論). Research Institute of Korean Medicine. 1999;8(1):205-21.
  31. Jin GY, Jin LL, Jin BX, Zheng J, He BJ, Li SJ. Neural control of cerebral blood flow: scientific basis of scalp acupuncture in treating brain diseases. Front Neurosci. 2023;17:1210537.
  32. Chavez LM, Huang SS, MacDonald I, Lin JG, Lee YC, Chen YH. Mechanisms of Acupuncture Therapy in Ischemic Stroke Rehabilitation: A Literature Review of Basic Studies. Int J Mol Sci. 2017;18(11).
  33. Cai YY, Zhang CS, Liu SN, Wen ZH, Zhang AL, Guo XF, et al. Electroacupuncture for Poststroke Spasticity: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation. 2017;98(12):2578-89. https://doi.org/10.1016/j.apmr.2017.03.023
  34. Ma C, Zhou Y, Yi W, Zhou X, Guo W, Xu X, et al. Electroacupuncture of the Baihui and Shenting acupoints for vascular dementia in rats through the miR-81/IL-16/PSD-95 pathway. Ann Transl Med. 2022;10(10):540.
  35. Su K, Hao W, Lv Z, Wu M, Li J, Hu Y, et al. Electroacupuncture of Baihui and Shenting ameliorates cognitive deficits via Pten/Akt pathway in a rat cerebral ischemia injury model. Front Neurol. 2022;13:855362.
  36. Tang SC, Liu JM, Liu GL. [Clinical observation on effect of electric acupuncture at Sishencong in treating insomnia]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007;27(11):1030-2.