The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case Report of a Guillain-Barre Syndrome Patient Suspected of Having Acute Transverse Myelitis Treated with Korean Medicine

급성 횡단성 척수염으로 의심된 길랑바레증후군 환자에 대한 한방 치료 증례보고 1례

  • Da-young An (Dept. of Internal Korean Medicine, College of Korean Medicine, Sangji University) ;
  • Chae-eun Kim (Dept. of Internal Korean Medicine, College of Korean Medicine, Sangji University) ;
  • Mi-kyung Kim (Dept. of Internal Korean Medicine, College of Korean Medicine, Dong-Guk University) ;
  • Seung-ho Sun (Dept. of Internal Korean Medicine, College of Korean Medicine, Sangji University)
  • 안다영 (상지대학교 한의과대학 내과학교실) ;
  • 김채은 (상지대학교 한의과대학 내과학교실) ;
  • 김미경 (동국대학교 한의과대학 내과학교실) ;
  • 선승호 (상지대학교 한의과대학 내과학교실)
  • Received : 2023.06.28
  • Accepted : 2023.12.25
  • Published : 2023.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

A 67-year-old female patient diagnosed with acute transverse myelitis visited our hospital in February 2023. Consultation papers indicated that she was diagnosed with acute transverse myelitis and that she complained of quadriparesis and numbness in both hands and feet. However, her spine magnetic resonance imaging (MRI) did not clearly indicate that she suffered from acute transverse myelitis. She was then sent to a high-level hospital and diagnosed with Guillain-Barre Syndrome through electromyography, cerebrospinal fluid test, and spine MRI. On March 2023, she visited our hospital again, still complaining about weakness in both hands and inability to walk. She was treated with Korean medicine, including acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine such as Yanggyeoksanhwatang and Sipimijihwang-tanggami. After three months, she was discharged on cane walking. The manual muscle test (MMT) grade of her upper limbs increased from 3-/3-/3-/3- (shoulder/elbow/wrist/fingers) to 4/4/4/3+, and the MMT grade of her lower limbs increased from 2/2/2/2 (pelvis/knee/ankle/feet) to 4/4/4-/4-. Her numbness in both feet disappeared, and her numbness in both hands decreased from a numeric rating scale of 7 to 2. No adverse events were reported during treatment. This case implies the therapeutic potential of Korean medicine for Guillain-Barre Syndrome, especially for those who had delayed diagnosis and missed the opportunity to get plasma exchange.

Keywords

References

  1. Guillain G, Barre JA, Strohl A. Sur un syndrome de radiculo-nevrite avec hyperalbuminose du liquode cephalo-rachidien sans reaction cellulaire: remarques sur les caracteres cliniques et graphiques des reflexes tendineux. Bell Mem Soc Med Paris 1916;40:1462-70. 
  2. Rho JK, Kwon OS, Lee KH, Myong HJ. A Clinical Study on Guillain-Barr'e Syndrome. J Korean Neurol Assoc 1984;2(1):3-13. 
  3. Fauci A, Braunwald E, Kasper D, Hauser S, Longo D, Jameson J, et al. Harrison's Principles of Internal Medicine 17th edition. Seoul: MIP; 2010, p. 3203-7. 
  4. Van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol 2008;7(10):939-50.  https://doi.org/10.1016/S1474-4422(08)70215-1
  5. Yoon BA, Bae JS, Kim JK. Recent Concepts of Guillain-Barre Syndrome. J Korean Neurol Assoc 2019;37(1):8-19.  https://doi.org/10.17340/jkna.2019.1.2
  6. Kerr DA, Ayetey H. Immunopathogenesis of acute trans-verse myelitis. Curr Opin Neurol 2002;15(3):339-47.  https://doi.org/10.1097/00019052-200206000-00019
  7. Bhat A, Naguwa S, Cheema G, Gershwin ME. The epidemiology of transverse myelitis. Autoimmun Rev 2010;9(5):A395-9.  https://doi.org/10.1016/j.autrev.2009.12.007
  8. Journal of Clinical Neurology. Textbook of Neurology volume 3. Seoul: panmuneducation; 2011, p. 66. 
  9. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 2003;3(4):310-6.  https://doi.org/10.1111/j.1530-7085.2003.03034.x
  10. Lee BL, Lee KH, Lee JH, Chun JM, Lee HY, Cung SH, at al. Clinical Characteristics of Acute Transverse Myelitis in Childhood. Annals of Child Neurology 2008;16(1):50-61. 
  11. Park WK, Lee HJ, Byun WM. MRI Findings of Guillain-Barre Syndrome. J Korean Radiol Soc 1997;36:561-5.  https://doi.org/10.3348/jkrs.1997.36.4.561
  12. Association of Korean Medicine College for Cardiology and Neurological Medicine. Cardiovascular and Neurological Medicine in Korean Medicine. Seoul: Gunjapublisher; 2020, p. 289-304. 
  13. Kim HJ, Lee EJ, Lee SH, Chang GT. A Literature Study on Treatment of Guillain-Barre Syndrome Based on Traditional Chinese Medicine Journals. J Pediatr Korean Med 2015 August;29(3):21-31.  https://doi.org/10.7778/jpkm.2015.29.3.021
  14. Kim JY, Kim EJ, Kim YS, Bae HS, Lee KS. Two Cases of Chest Fever with Dysphoria in Stroke Patients Treated with Yangkyuksanhoa-tang. Korean J Orient Int Med 2002;23(2):292-7. 
  15. Jung DY, Ha HK, Lee HY, Lee JA, Lee NH, Lee JK, et al. Stimulation of the Immune Response by Yanggyuksanhwa-tang. J of Sasang Constitutional Medicine 2010;22(4):77-84. 
  16. Zhang XY, Xu JD, Wang Y, Wu CY, Zhou J, Shen H, et al. Comparing steamed and wine-stewed Rehmanniae Radix in terms of Yin-nourishing effects via metabolomics and microbiome analysis. Journal of Ethnopharmacology 2023;311:116424. 
  17. Ma JY, Lee MY, Kim HM, Choo YK, Choi BK, Jung KY. Shibimijihwang-tang elevates intracellular ATP and choline content in the cerebral cortex of ovariectomized rats. J Ethnopharmacol 2000 Sep;72(1-2):77-85.  https://doi.org/10.1016/S0378-8741(00)00206-3
  18. Liu SW, Guo J, Wu WK, Chen ZL, Zhang N. Treatment of Uncomplicated Recurrent Urinary Tract Infection with Chinese Medicine Formula: A Randomized Controlled Trial. Chin J Integr Med 2019;25(1):16-22.  https://doi.org/10.1007/s11655-017-2960-4
  19. Wui YL. Se-euideukhyobang. 3rd edition. Shanghai in China: Shanghai Scientific & Technical Publishers; 1997, p. 307. 
  20. Hong CY, Seo SG, Na SG, Cho HS, Lee MK, Jin MH, et al. Study on the Anti-stress Effect of Chenwangbosim-Dan Extract∘Fermented Rice Extract (GABA ː gamma-aminobutyric acid 30%) Complex: A double-blind, randomized, placebo-controlled study. Kor J Herbol 2023;38(2):1-7. 
  21. Park MY, Won JH, Kim SC. Acupuncture & Moxibustion Bibliographic Studies on the Wei symptom for Clinical Treatment. Korean J Oriental Physiology & Pathology 2012;26(6):842-8. 
  22. Kim HJ, Ji YS, Lee SM, Jeon JH, Kim YI. A Systematic Review of Clinical Study of Bee Venom Acupuncture. J Acupunct Res 2013;30(4):151-9.  https://doi.org/10.13045/acupunct.2013031
  23. Choi YJ, Cho HJ, Lee HW, Choi BO, Park KD, Choi KG. Guillain-Barre syndrome concomitant with acute myelitis. J Korean Neurol Assoc 2005;23(1):124-7. 
  24. Lee DK. A case of acute motor axonal Guillain-Barre syndrome combined with acute cervical-upper thoracic transverse myelitis. Korean J Clin Neurophysiol 2001;3(2):172-5.