• 한방재활의학과학회지
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• 제28권1호
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• pp.161-166
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• 2018

This report describes the miniscalpel-acupuncture treatment of a 68-yr-old woman who had abnormal posture and involuntary dystonic movements of the head and neck. She suffered muscle contracture associated symptoms after she fell injured in 2014. Her neck had abnormal posture findings due to muscle tension. The spasms gradually worsened and did not respond to botulinum toxin injections. Involuntary dystonic movements may be due to peripheral post-traumatic cervical dystonia. Outcomes support cervical dystonia may be managed effectively with miniscalpel-acupuncture. Further research is recommended.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1996년도 제6회 학술대회 심포지움
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• pp.86-86
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• 1996

연축성 발성장애(spasmodic dysphonia)는 아직까지 그 원인을 정확히 밝혀내지 못하고 있는 만성적인 발성장애로 과거에는 경직성 발성장애(spastic dysphonia)로 불리던 질환이다. 연축성 발성장애는 두 종류 즉, 내전형(adductor)과 외전형(abductor)으로 나누어지며 이중 내전형이 대부분이다. 외전형 연축성 발성장애는 발성도중에 성대가 갑자기 불수의적으로 외전되면서 음성이 중단되므로 원활히 대화하기가 힘든 질환이다. 이러한 질환은 국소적 근긴장이상(fecal dystonia)의 일종이다. 현재까지 연축성 발성장애의 치료법으로 사용되고 있는 것으로는 언어치료, botulium 독소주입술, 편측반회후두신경절 단술, 반회후두신경분쇄술, 상후두신경절단술, 갑상연골성형술, implantable stimulator 등이 있다. 연축성 발성장애 환자에 $Botox^{circledR}$ 주입에 관한 보고는 주로 내전형에 대해서만 보고되고 있으며 외전형에 대하여 보고된 예는 매우 적다. (중략)

• 생물정신의학
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• 제22권4호
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• pp.155-162
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• 2015

Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naïve patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.148-152
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• 2018

Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder and one of the most common muscular dystrophies affecting adults. Charcot-Marie-Tooth (CMT) disease, a common hereditary neuropathy, is characterized by atrophy of the distal limbs and peripheral nerve abnormalities. The authors report a rare case involving a 24-year-old female who was diagnosed simultaneously with both DM1 and CMT1A based on the results of a nerve conduction study (NCS). The patient, who had previously been diagnosed with DM1, was admitted for lower extremity pain. Her electrodiagnostic examination continued to reveal severe sensorimotor demyelinating polyneuropathy, and a genetic study was performed to confirm whether she had other hereditary neuropathies, except DM1, that suggested CMT1A, the most common phenotype of CMT. Severe abnormalities in an NCS in a DM1 patient may suggest the incidental coexistence of hereditary neuropathies, and further evaluations, such as genetic studies, should be performed for proper diagnosis.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.69-78
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• 2021

Background: Approximately 30% of people suffer from chronic neck and shoulder pain. Chronic neck and shoulder pain arise due to the exposure to continuous low loading and monotonous work. This is a common musculoskeletal disorder in a society. As physical therapists, we should give appropriate treatment to these people. Methods: A total of 26 patients with chronic neck and shoulder myalgia were randomly allocated into two experimental groups. First, 13 patients received shoulder strength training, while the other 13 patients received cervical mobilization. Outcome measures included bilateral pressure pain threshold by using an algometer at upper trapezius, visual analogue scale (VAS) to express their pain scale, and muscle tension by using myoton pro device pre-intervention and after the final treatment. Results: The VAS and muscle tension in upper trapezius significantly decreased (p<.05) in both groups; however, no differences between two groups were observed (p>.05). The pressure pain threshold in upper trapezius significantly increased (p<.05) in both groups; yet, again, the differences between the groups did not reach statistical significance (p>.05). Conclusion: As methods of treatment, shoulder-specific strength training and cervical mobilization can be appropriate approaches to the treatment of neck and shoulder musculoskeletal disorder.

• Clinical Pain
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• 제19권1호
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• pp.40-44
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• 2020

The foot or lower extremity is rarely the initial site in adult-onset dystonia, whereas dystonia in children often begins in the foot. Isolated lower extremity dystonia in adults is rarely on a primary basis. Oral anti-dystonic medications have been found unsatisfactory in providing adequate symptomatic relief. On the other hand, botulinum toxin injections have been reported as beneficial. It is also known that personalized orthosis can be an effective solution for patients of dystonia. The purpose of this report is to demonstrate a case of primary focal foot dystonia that was effectively treated with botulinum toxin injection and the custom-made ankle-foot orthosis.

• 대한한방내과학회지
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• 제44권5호
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• pp.948-956
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• 2023

The purpose of this study is to report a case of cervical dystonia and the effects of a series of traditional Korean medicine treatments applied to the patient. The patient was treated with conventional treatment and traditional Korean medicine consisting of acupuncture, moxa, chuna therapy, and herbal medicine (Hoesu-san-gami) for 48 days. Progress was measured by Tsui's score, the Toronto Western Spasmodic Torticollis Rating Scale, and the Neck Disability Index. We observed some improvements in the patient's symptoms: Tsui's score of 15 to 11, TWSTRS of 63.3 to 47.8, and NDI of 24 to 17. These findings indicate that the application of traditional Korean medicine to cervical dystonia can yield decent clinical outcomes.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.100-105
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• 2017

Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권1호
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• pp.133-138
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• 1997

Prader-Willi 증후군(Prader-Willi Syndrome, PWS)은 $50{\sim}-70%$ 정도의 환자에서 염색체 15번에 이상이 있음이 보고된 유전적인 질환으로서, 그 특징적인 임상양상은 심한 근긴장의 저하(hypotonia), 반사소실(areflexia), 섭식의 곤란(feeding difficulty), 저체온증(hypothermia), 성기왜소증(microgenitalia), 음낭저형성증(hypoplastic scrotum), 대식증(polyphagia), 포만감의 감소와 비만, 정신운동발달의 지연, 저성선기능증(hypogonadism) 및 안면과 척추의 기형 등이다. 또한 행동상의 여러 문제들이 동반되는데 분노발작, 피부를 심하게 뜯거나 발모광, 과도한 식욕과 관련된 음식 도벽증이 나타나므로 정신과적 치료가 필요하다. 본 증례는 14세된 PWS환자로서 비만과 대식증, 도벽증, 학업부진 및 생활부적응 문제 등으로 2주간의 입원과 약 1년간의 추적기간 동안 약물요법(fluoxetine 투여)과 행동요법, 그리고 가족요법을 받아 왔다. 장기간의 Fluoxetine투여를 통하여 비만과 식욕의 조절에는 효과가 만족스럽지 않았으나 우울감과 감정문제, 자살사고 및 행동문제들은 호전되었다.