• Title/Summary/Keyword: 근육마비

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Facial Motor Evoked Potential Techniques and Functional Prediction during Cerebello-pontine Angle Surgery (소뇌교각 수술 중에 안면운동유발전위의 검사방법과 기능적 예측인자)

  • Baek, Jae-Seung;Park, Sang-Ku;Kim, Dong-Jun;Park, Chan-Woo;Lim, Sung-Hyuk;Lee, Jang Ho;Cho, Young-Kuk
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.470-476
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    • 2018
  • Facial motor evoked potential (FMEP) by multi-pulse transcranial electrical stimulation (mpTES) can complement free-running electromyography (EMG) and direct facial nerve stimulation to predict the functional integrity of the facial nerve during cerebello-pontine angle (CPA) tumor surgery. The purpose of this paper is to examine the standardized test methods and the usefulness of FMEP as a predictor of facial nerve function and to minimize the incidence of facial paralysis as an aftereffect of surgery. TES was delivered through electrode Mz (cathode) - M3/M4 (anode), and extracranially direct distal facial muscle excitation was excluded by the absence of single pulse response (SPR) and by longer onset latency (more than 10 ms). FMEP from the orbicularis oris (o.oris) and the mentalis muscle simultaneously can improve the accuracy and success rate compared with FMEP from the o.oris alone. Using the methods described, we can effectively predict facial nerve outcomes immediately after surgery with a reduction of more than 50% of FMEP amplitude as a warning criterion. In conclusion, along with free-running EMG and direct facial nerve stimulation, FMEP is a useful method to reduce the incidence of facial paralysis as a sequela during CPA tumor surgery.

Clinical Features of Parsonage-Turner Syndrome (Parsonage-Turner Syndrome의 임상 양상)

  • Oh, Joo-Han;Jo, Ki-Hyun;Choi, Hye-Yeon;Gong, Hyun-Sik;Oh, Chung-Hee;Yoon, Jong-Pil;Kim, Tae-Woo
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.131-136
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    • 2008
  • Purpose: Parsonage-Turner syndrome is a rare disorder with sudden onset of severe pain around the shoulder girdle, followed by weakness of the shoulder muscles. The purpose of the current study was to describe the clinical features associated with this condition and to review the literature. Materials and methods: A retrospective study of the Parsonage-Turner syndrome was carried out for 6 patients seen from December 2005 to July 2008. The clinical and radiographic data was collected by medical records and telephone interviews. Five patients were males and one was female with ages ranging between 20-68 years (mean, 43.5). The mean follow-up period was 19.1 months (range, 14-27 months). Results: The intense pain around shoulder continued for 1 day to 3 weeks and decreased spontaneously at a mean of 3.3 weeks (range, 2-5 weeks) after onset of pain. Weakness in the involved muscles had developed at a mean of four weeks (range, 2-7 weeks). At the end of follow-up, five patients had an improvement of their strength and one patient had regained full strength. Electromyography was the most helpful in diagnosis. Conclusion: Parsonage-Turner syndrome is a self-limited disorder with a good outcome. Understanding of the course will assist in the diagnosis and treatment.

Ultrastructural and Neurophysiological Changes Observed Following Injection of Morphine, Meperidine and Pentazocine in the Sciatic Nerves of Rabbits (가토의 좌골신경에 Morphine, Meperidine, Pentazocine을 주사한 후 미세형태학적 및 신경생리학적 변화)

  • Cheun, Jae-Kyu;Kim, Sae-Yune;Bae, Jung-In
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.213-220
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    • 1992
  • The sciatic nerves of anesthetized rabbits were exposed and stimulated by a nerve stimulator in order to observe the myoneural response. These rabbits were divided into three groups and respectively injected with morphine (Group 1), meperidine(Group 2) and pentazocine (Group 3). The sciatic nerves were stimulated periodically and gait changes were observed to see the myoneural activity after the injections. When the distal part of the sciatic nerves were stimulated by the nerve stimulator after the respective drug injections, the normal muscle twitch responses were observed in all the progressional stages of Group 1. However, in Group 2 and 3, the muscle twitch responses decreased gradually, finally disappearing after approximately 10 minutes in these two groups. Complete motor paralysis continued for about 60 minutes. The muscle reactions returned to normal approximately 90 minutes after injection. Specimens drug-injected tissues were severed 4 hours, 24 hours and 1 week after injection respectively. These tissue were investigated under light as well as electron microscopy. The tissue revealed rare to moderate vacuolizations scattered in the axons of the myelinated and unmyelinated nerves of some of the specimens; however, there were no significant pathologic lesions. These results provide evidence that neurophysiologically, meperidine and pentazocine have a local anesthetic-like effect such as motor paralysis, but morphine does not. In addition, the results indicated that neurohistologically, the three narcotics have no significant toxic effects on the nerve tissue.

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Two Cases of Respiratory Failure After Recovery of Cholinergic Crisis in Organophosphate Poisoning: The Intermediate Syndrome (유기인제 중독에서 콜린성 위기 회복후 급성 호흡부전을 보인 Intermediate Syndrome 2예)

  • Cho, Dae-Kyoung;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae;Chung, Keun-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.247-254
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    • 1999
  • Respiratory failure is the most serious manifestation and usual cause of death in acute organophosphate poisoning, and is common in acute cholinergic crisis. But the respiratory failure may appear suddenly in a patient who is recovering from the cholinergic crisis, even while receiving conventional therapy. These are case report of 37 years old male and 24 years old female with intermediate syndrome in organophosphate poisoning. The two patients ingested organophosphate(fenthion and mixture of DDVP with chlorpyrifos respectively) incidentally and in a sucide attempt respectively. After apparent recovery from the cholinergic crisis with a conventional therapy but before the expected onset of delayed polyneuropathy, the respiratory failure appeared suddenly with a muscular weakness, affecting predominantly the proximal limb muscles, neck flexors, territories of several motor cranial nerves. The two patients needed mechanical ventilatory support and recovery from the intermediate syndrome was complete in both patients, although one subsequently developed hypoxic encephalopathy. The clinical manifestation and electrophysiologic study support the clinical diagnosis of intermediate syndrome. The syndrome carries a risk of death. because of respiratory paralysis, if not recognized early and treated adequatedly. Prompt endotrachial intubation and mechanical ventilatory support is the cornerstone of treatment of the intermediate syndrome. Therefore, all patient should be observed in a hospital for up to 5 days after poisoning.

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Polioencephalomyelitis in Pigs Experimentally Infected with Porcine Enterovirus Isolated in Korea: I. Histopathological Observations (Enterovirus 감염에 의한 자돈의 Polioencephalomyelit: I. 병리조직학적 관찰)

  • Shin, Tae-kyun;Lee, Cha-soo
    • Korean Journal of Veterinary Research
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    • v.25 no.2
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    • pp.103-112
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    • 1985
  • A total of 1-0 colostrum-deprived pigs (1 or 2-day-old) and 6 pigs (35-day-old), which had been raised by natural maternal nursing, were used to study the pathogenicity of the porcine enteroviruses by the intracerebral and intramuscular routes of inoculation, which the enterovirus were isolated from the diseased pigs in Korea. The porcine enteroviruses produced an identical polioencephalomyelitis in colostrum-deprived pigs and 35-day-old pigs, which manifested clinical signs and histopathological changes. Clinically it was characterized by incoordination, rise in rectal temperature, ataxia, flaccid paralysis in all the experimental groups. Histopathologically, the lesions were present in both grey and white matter at all levels of central nervous system, though usually more severe in the grey matter. These changes were characterized by meningeal infiltration, degeneration of nerve cells, neuronophagia, diffuse and focal gliosis, glial nodules and perivascular lymphocytic infiltrations. Ganglionitis of the dorsal root ganglia was frequently observed. On the basis of the clinical and histopathological changes mentioned above, it was concluded that porcine enteroviruses isolated in Korea were pathogenic strains which could produce polioencephalomyelitis in pigs. The most severe Jisease was prcduced by the inoculation of both enterovirus and hog cholera vaccine in the 35-day-old pigs at a time when colostral immunity presumably was low. The porcine enterovirus infections seemed to be associated with certain stress factor such as hog cholera vaccine in or immediately following the weanling period.

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The Effect of Abdominal Draw-in Maneuver with Leg Movements on Transversus Abdominis Thickness and Trunk Control in Stroke Patients (다리 움직임을 동반한 복부 드로우-인 기법이 뇌졸중 환자의 배가로근 두께와 몸통 조절에 미치는 영향)

  • Kang, Jeong-Il;Moon, Young-Jun;Jeong, Dae‐Keun
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.287-294
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    • 2020
  • The purpose of this study was, base on the observation that the leg movement has effect on muscles around trunk, to provide clinical fundamental data to develop effective abdominal draw-in technique by investigating the effect of abdominal draw-in exercise accompanying leg movement on the thickness of transversus abdominis muscle and trunk control ability in patients with stroke. The subjects were assigned randomly to experimental group I (n=9) on which the abdominal draw-in technique is applied and experimental group II (n=9) on which the abdominal draw-in technique accompanying leg movement is applied. The thickness of transversus abdominis muscle in the affected side and the trunk control ability were measured before and after treatment using ultrasonography and trunk impairment scale. A session of 30 minutes per day were performed four days a week for four weeks and the measured outcomes were analyzed. The in-group comparison showed significant difference both thickness of transversus abdominis muscle during abdominal draw-in technique application (p<0.01) and trunk control ability (p<0.001) between before and after treatment. The significant difference between two groups were observed only in trunk control ability (p<0.05). It was concluded that the abdominal draw-in technique accompanying leg movement is an intervention that has positive effect not only on transversus abdominis muscle but also on tunk control ability by inducing more efficient contraction reaction in muscles around trunk through autonomic pelvic movement caused by leg movement.

Influence of Functional Electrical Stimulation during Gait Training on Motor Unit Action Potential (기능적전기자극을 이용한 보행훈련이 편마비 환자의 하퇴근육의 근전위활동에 미치는 영향)

  • Kang, Yang-Hoon;Seo, Sam-Gi;Lee, Jeong-Woo;Yoon, Se-Won;Kim, Yong-Eok;Kim, Tae-Youl
    • Journal of the Korean Academy of Clinical Electrophysiology
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    • v.5 no.1
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    • pp.33-43
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    • 2007
  • This study divided 35 hemiplegia patients into control group having standard physical therapy and gait training and functional electrical stimulation(FES) group using FES during gait training in order to examine the effects of applying FES to ankle joint dorsiflexor on motor unit action potential. Stimulation conditions of FES were pulse rate 35 pps, pulse width $250{\mu}s$, and on-time 0.3 second, treatment hour was 30 min. and treatment period was once a day for five days a week through six weeks. For functional evaluations before and after treatment, root mean square(RMS) were measured and the following conclusions were obtained. : In RMS analysis of motor unit action potential, gastrocnemius was significantly reduced in both weight bearing(p<.001) and bearing condition (p<.05). In conclusion, application of FES to hemiplegia patients in recovery stage during gait training decreased RMS and it was interpreted that it was caused by mitigation of muscular spasticity by reduction of motor unit.

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Molecular diagnosis of Niemann-Pick type C presenting with neonatal cholestasis and hepatosplenomegaly (지속되는 신생아 담즙 정체증과 간비비대를 주소로 내원하여 유전자분석으로 확진된 C형 Niemann-Pick병)

  • Jeong, Min-Hee;Ko, Jung-Min;Kim, Gu-Hwan;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.200-203
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    • 2007
  • Niemann-Pick type C is an inborn error of metabolism that affects lipid degradation and storage, which is characterized by hepatosplenomegaly and progressive neurological symptoms. A 7-month-old girl with jaundice was presented cholestasis and hepatosplenomegaly. Laboratory study showed elevated acid phosphatase, angiotensin converting enzyme and mild decrease of cholesterol. Characteristic foamy cell and sea-blue histiocytes in bone marrow biopsy consistent with Niemann-Pick disease. Niemann-Pick type C was suspected by past medical history and findings of physical examination. Therefore, molecular analysis was performed and found mutations of NPC1 gene. We report the first Korean case of type C Niemann-Pick disease confirmed by mutation analysis.

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A proposal of injection points of botulinum toxin into temporal region for chronic migraine (만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시)

  • Kim, Young Gun;Bae, Jung Hee;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.1-6
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    • 2017
  • Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

Dental management of the patient difficulty in swallowing (섭식연하장애와 치과적 관리)

  • Hyun, Hong-Keun
    • The Journal of the Korean dental association
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    • v.53 no.11
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    • pp.789-794
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    • 2015
  • Swallowing disorders or dysphagia, which are difficulties with the act of swallowing, can occur at different phases such as oral, pharyngeal, and esophageal phase in the swallowing process. These disorders can be caused by structural, functional abnormalities or psychological problems. Dentists can actively provide patients suffering from dysphagia with comprehensive professional care, especially from the cognitive stage of food to the pharyngeal stage of the swallow. Many cases of dysphagia can be improved with careful managements based on dental professionals' knowledge, including meticulous evaluation of masticatory and swallowing functions, training on eating and swallowing, and fabrication of palatal or lingual augmentation prosthesis. The important thing is that prevention of these disorders through the oral health care instruction and planned follow-up dental visit at periodic intervals in order to manage the problems caused by anatomical, functional, and psychological reason.