• Anxiety and mood
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• v.19 no.2
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• pp.56-60
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• 2023

Progressive supranuclear palsy (PSP) is rare atypical Parkinsonism accompanied by various psycho-behavioural problems. In this case report, we describe the diagnostic and treatment progress of a 65-year-old PSP patient who visited the psychiatric clinic with a depressed mood and lumbar pain resulting in a suicide attempt. Over the course of 30 months of treatment, typical characteristics of PSP, such as postural instability, dyskinesia, cognitive dysfunction and supranuclear gaze palsy, became prominent, and magnetic resonance imaging and the F-18 FP-CIT positron emission tomography revealed midbrain atrophy and reduced dopamine uptake in the basal ganglia. When treating elderly patients with depression, parkinsonism symptoms such as gait disturbances, frequent falls, tremors, and rigidity should be closely examined.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.73-80
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• 2007

Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.47-55
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• 1996

Progressive supranuclear palsy (PSP) is a parkinson-plus syndrome characterized clinically by supranuclear ephthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormality and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using $^{99m}Tc$-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.881-890
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• 2022

Objectives: This study investigated the effect of complex Korean medicine treatment on decreased mental status in a progressive supranuclear palsy patient with a cerebrovascular accident. Case presentation: The patient was treated with Korean medicine composed of herbal medicine (modified Guibi-tang), acupuncture, moxibustion, and cupping combined with Western medicine (a dopamine precursor and an anticholinergic) and physical therapy. The Glasgow Coma Scale, Mini-Mental State Examination, and Hoehn and Yahr Scale were used to evaluate the effects of the treatments. After treatment, Glasgow Coma Scores increased from 9-10 to 12-13, and Mini-Mental State Examination for dementia screen scores increased from 1 to 2. The Hoehn and Yahr score remained at 5. There were no side effects of the treatment. Conclusion: This study suggests that complex Korean medicine treatments may be effective for the decreased mental status of a progressive supranuclear palsy patient with a cerebrovascular accident, but further studies are needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.352-358
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• 2017

Frontotemporal dementia, the second most common cause of early onset dementia, is a neurodegenerative clinical syndrome characterized by progressive deficits in behavior, executive function and language. Although motor symptoms in frontotemporal dementia are represented by motor neuron disease, parkinsonism and progressive supranuclear palsy syndrome, there have been no reports of motor weakness caused by the direct involvement of central motor nervous systems in frontotemporal dementia. Moreover, no association between clinical dementia groups and complex regional pain syndrome has been reported. We diagnosed a rare case with motor weakness and complex regional pain syndrome of lower limbs due to central nervous system lesion in a patient with frontotemporal dementia by magnetic resonance imaging, electrodiagnostic study and three phase bone scan. Following steroid therapy for complex regional pain syndrome, pain was improved. Functional improvement was noted after rehabilitation therapy, including functional electrical stimulation, muscle strengthening exercise and gait training during hospitalization. This case report suggests that rehabilitation therapy for motor weakness in frontotemporal dementia could be effective for improving overall function.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.25-34
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• 2015

■ Objectives The purpose of this case report is to show the effect of korean medicine on a progressive supranuclear palsy patient with gait disturbance and dizziness. ■ Methods A patient with gait disturbance and dizziness diagnosed as progressive supranuclear palsy was treated with herbal medicine, acupuncture, electro-acupuncture, moxibustion. The period of admission is 16 days and we evauated the improvements of symptoms by the Unified Parkinson's Disease Rating Scale(UPDRS), Numeric Rating Scale(NRS) and Global Assessment(G/A). ■ Results After taking Modified Bosimhwan andbeing treated by acupuncture therapy, improvements of gait disturbance and dizziness are observed. ■ Conclusion This case report proved the effect of Korean medicine on progressive supranuclear palsy.