• Title/Summary/Keyword: 다발신경병증

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A Case Report of Korean Medicine Therapy including Duhuo Jisheng Tang and Pharmacoacupuncture for a Chronic Inflammatory Demyelinating Polyneuropathy Patient Complaining Weakness and Numbness in Lower Extremity (하지 위약감 및 저림을 호소하는 만성 염증성 탈수초성 다발신경병증 환자에 대한 독활기생탕과 약침을 포함한 한의복합치료 증례보고 1례)

  • Ye-Chae Hwang
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.159-168
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    • 2024
  • This case study aims to report Korean medicine treatment's response to weakness and numbness in chronic inflammatory demyelinating polyneuropathy (CIDP) patient. The patient received Korean medicine treatment during hospitalization, including Duhuo Jisheng Tang and pharmacoacupuncture. The assessment was performed using the Functional Independence Measure (FIM), Numeric Rating Scale (NRS) for numbness, and Oswestry Disability Index (ODI). After 21 days of treatment, the FIM improved from 82 to 126, NRS improved from 6 to 2, and ODI improved from 37 to 8. There were no side effects after receiving Korean medicine. This case suggests that Korean medicine treatment can induce treatment response for lower extremity weakness and numbness in CIDP patients.

Quantitative Analysis of Electrophysiological Characteristics of CIDP and CMT Type 1: Sensory Nerve Research (CIDP와 CMT 1형의 전기생리학적 특성에 대한 정량 분석: 감각신경연구)

  • Kang, Ji-Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.151-157
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

A Clinical Study of Intercostal Neuropathy after Rib Fracture (늑골 골절 후 발생한 늑간 신경병증의 임상적 연구)

  • Kang, Jung-Hun;Lee, Seog-Ki;Seo, Min-Bum;Na, Jeong-Yeop;Jang, Jae-Hyouk;Kim, Kweon-Young
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.53-57
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    • 2010
  • Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

Diagnosis of Coronary Artery Disease using Myocardial Perfusion SPECT in Patients with Diabetes Mellitus: Analysis of Risk Factors (당뇨병 환자에서 심근관류 SPECT을 이용한 관동맥질환의 진단: 위험인자 분석)

  • Seo, Ji-Hyoung;Kang, Seong-Min;Bae, Jin-Ho;Jeong, Shin-Young;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.155-162
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    • 2006
  • Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

특집 - 당뇨병환자의 튼튼한 혈관 유지하기

  • Hong, Eun-Gyeong
    • The Monthly Diabetes
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    • s.216
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    • pp.10-13
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    • 2007
  • 요즈음은 인터넷이나 대중매체를 통해 일반인들도 다양한 질병에 대한 많은 정보를 얻을 수 있다. 이에 속하는 것으로 당뇨병은 대표적 만성질환이며 누구나 한번쯤은 들어 본 적이 있는 질환일 것이다. 현대와 같이 고도로 의학이 발달한 상황에서도 만성질환은 완치되는 것이 아니고 평생 관리를 해야하는 질병이기 때문에 많은 환자들이 살아가는 동안 서서히 지치게 되고 관리를 소홀히 하게 됨으로써 당뇨병성 신경병증, 망막증, 신증, 대혈관병증(뇌졸중, 심혈관질환, 말초혈관질환) 등과 같은 합병증의 발생으로 일상생활에 지장을 받게 된다. 따라서 당뇨병환자는 일생 주기적으로 검사와 함께 자신에게 맞는 약을 복용하고 경우에 따라서는 인슐린 주사까지 맞음으로써 지속적인 혈당관리를 하여 합병증의 발생을 최소화 하는 것이 필요하다. 이상에 언급한 다양한 합병증 중 가장 중요한 사망원인은 심혈관질환으로 40세 이후에 발생한 당뇨병환자에서 전체 사망 원인의 50% 이상을 차지한다. 또한 대부분의 당뇨병성 만성합병증이 적극적인 혈당관리로 효과적인 예방이 가능한 반면 심혈관질환과 같은 대혈관합병증은 혈당조절이 잘 되고 있는 환자에서도 당뇨병 발생 기간과 무관하게 발생하고 또 여러 혈관에 걸쳐 다발적이고 광범위하게 발생하므로 원인이 되는 다른 위험요소들에 대한 관리가 함께 이루어져야 한다.

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A Case Study of Alcoholic Polyneuropathy Improved with Hyangbujapalmul-tang (향부자팔물탕으로 호전된 알코올성 다발신경병증 치험 1례)

  • Song Choi;Hye-Sun Park
    • Journal of Sasang Constitutional Medicine
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    • v.35 no.4
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    • pp.55-64
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    • 2023
  • Objectives This study was aimed to report improvement of Soeumin patient diagnosed with Alcoholic Polyneuropathy using Hyangbujapalmul-tang. Method The 41-year-old man had severe foot pain, sensory slow down and ataxic gait. The patient was diagnosed Soeumin and medicated with Hyangbujapalmul-tang three times a day. Clinical improvement was evaluated with blood test, ataxic gait evaluation, deep tendon reflex and visual analogue scale (VAS). Results The symptoms of foot pain, sensory slow down and ataxic gait were dramatically improved after treatment. Conclusions Constitutional treatment for foot pain, sensory slow down and ataxic gait diagnosed with Alcoholic Polyneuropathy are potentially effective.

Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Pros (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란: 긍정적인 관점에서)

  • Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.29-32
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    • 2008
  • Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

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Chronic Inflammatory Demyelinating Polyneuropathy Associated with HIV-Infection (사람면역결핍바이러스 감염과 연관된 만성염증탈수초다발신경병증)

  • Huh, So-Young;Ahn, Bo-Young;Oh, Se-Jin;Park, Yeong-Eun;Kim, Dae-Seong
    • Annals of Clinical Neurophysiology
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    • v.13 no.2
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    • pp.97-100
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    • 2011
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated polyneuropathy. Corticosteroids, intravenous immunoglobulin (IVIG) and plasmapheresis have been reported to be effective treatment. Rarely, CIDP can occur in the patients with HIV infection. The clinical features and electrophysiological findings of CIDP are known to be similar in patients with and without HIV infection. We report a 30-year-old male with HIV infection associated CIDP who improved after the administration of intravenous immunoglobulin and long term oral prednisone.

The Usefulness of Sural/Ulnar Amplitude Ratio in the Diagnosis of Early stage of Diabetic Polyneuropathy (초기 당뇨병성 다발신경병증에서 비복/척골 감각신경활동전위 진폭 비의 진단적 유용성)

  • Chang, Young-Hee;Roh, Hakjae;Ahn, Moo-Young;Moon, Hee Soo;Bae, Jong-Seok;Kim, Byoung Joon
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.34-38
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    • 2003
  • Backgrounds and Objectives: In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/ulnar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subjects. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 agematched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1.1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polyneuropathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

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