• Title/Summary/Keyword: Both lower extremities weakness

Search Result 36, Processing Time 0.017 seconds

Overlapping Guillain-Barr$\acute{e}$ syndrome and Bickerstaff's brainstem encephalitis associated with Epstein Barr virus

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
    • /
    • v.57 no.10
    • /
    • pp.457-460
    • /
    • 2014
  • A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed to be a sign of overlapping Guillain-Barr$\acute{e}$ syndrome (GBS). In addition, BBE and Fisher syndrome, which are clinically similar and are both associated with the presence of the immunoglobulin G anti-GQ1b antibody, represent a specific autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia and ataxia. A 2-year-old boy presented with rapidly progressive ophthalmoplegia, ataxia, hyporeflexia, weakness of the lower extremities, and, subsequently, disturbance of consciousness. He experienced bronchitis with watery diarrhea and had laboratory evidence of recent infection with Epstein-Barr virus (EBV). He was diagnosed as having overlapping GBS and BBE associated with EBV and received treatment with a combination of immunoglobulin and methylprednisolone, as well as acyclovir, and had recovered completely after 3 months. In addition, he has not experienced any relapse over the past year. We suggest that combinations of symptoms and signs of central lesions (disturbance of consciousness) and peripheral lesions (ophthalmoplegia, facial weakness, limb weakness, and areflexia) are supportive of a diagnosis of overlapping GBS and BBE and can be helpful in achieving an early diagnosis, as well as for the administration of appropriate treatments.

Effects of Aquatic Exercise on Skinfold Thickness and Circumference of Upper and Lower Extremities in Patients with Rheumatoid Arthritis (수중운동 프로그램이 류마티스 관절염 환자의 사지 피부두겹 두께와 둘레에 미치는 영향)

  • Kim, Jon-Im;Kim, In-Ja;Lee, Eun-Ok
    • Journal of muscle and joint health
    • /
    • v.2 no.2
    • /
    • pp.131-146
    • /
    • 1995
  • Many arthritis patients experience weakness of muscles in extremities mainly due to disuse atrophy and weight gain because of the limited activities and exercises. This study examines the effects of the 6-week aquatic-exercise program on the body fat and the muscle of the rheumatoid arthritis patients. Seventeen patients in the experimental group and 18 in the control group were assigned depending on their preference and physical condition. These patients had more than 3 points of pain out of 10, deformities in knee, wrist and ankle joints. The amount of aquatic exercise increases from 35 minutes in the first week to 60 minutes in the 6th week. In the resting period they discussed their own experiences about exercise, personal and family affairs, and performed some recreation programs in order to increase the self-efficacy and promote the relationship with other patients by the group activities. Skinfold thickness and circumferences of both extremities were measured before and after experiment to compare the difference. For testing the body fat Saham Model was used. Prior to the experiment two group's body weight, skinfold thickness and skin circumferences were not significantly different which indicates the homogeneity of two groups. Body weight and most parts of skinfold thickness of the experimental group were significantly lower than the control group after 6-week aquatic exercise program. Circumference was not significantly lower than the control after the program. These findings indicate the in-crease of muscle sizes and the reduction of the body fat. Therefore a more active application of aquatic exercise into a variety of clients is strongly suggested.

  • PDF

Clinical Study for Tremor in 30 Admission Cases (진전(震顫)을 주(主) 증상(症狀)으로 입원(入院)한 환자(患者) 30례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Park, Ji-un;Lee, Sang-ryong
    • Journal of Haehwa Medicine
    • /
    • v.10 no.1
    • /
    • pp.437-451
    • /
    • 2001
  • The clinical study was carried out the 30 patients with tremor who were treated in Daejeon University Oriental Hospital from 1 April 1997 to 31 March 2001. The results were summarized as follows. 1. The ratio of female was higher, especially in the psychosomatic tremor, the ratio of female was higher and in the age distribution the aged over 50 were higher frequence. 2. The case without past history was most, the most ordinary preceding disease was hypertention and the next was diabetes, drinking history had no concern with tremor, first visit was most, in the psychosomatic tremor complication by relation was the most inducing factor and both parkinson tremor and essential tremor were no inducing factor. 3. Tremor appeared to be busy in extremities, parkinson tremor appeared to be accompanied with musculoskeletal system symptoms and they were in descending order lower limb weakness, extremities numbness, general body weakness e.t.c. both essential tremor and psychosomatic tremor appeared to be accompanied with psychosomatic symptoms and they were in descending order dizziness, headache e.t.c. 4. In classification of Four Human coporeal constitution the number of patients, Tae-Eum-In(太陰人) was most, the prescription drugs of tranquillizing the liver and relieving anxiety such as GYEJIYONGGOLMORYETANG(桂枝加龍骨牡蠣湯) and nourishing Yin, blood and relieving anxiety such as SAMULANSINTANG(四物安神湯) were used to be busy. 5. The rate of treatment was collectively improved and was higher in the yaung age than in the old age, the period of the clinical history was the shorter within one month, the rate of improvement was the better.

  • PDF

Late Occurrence of Cervicothoracic Ossification of Posterior Longitudinal Ligaments in a Surgically Treated Thoracic OPLL Patient

  • Hyun, Seung-Jae;Kim, Jong-Soo;Hong, Seung-Chyul
    • Journal of Korean Neurosurgical Society
    • /
    • v.47 no.1
    • /
    • pp.55-57
    • /
    • 2010
  • Ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine is rare, even in the Far East. A 45-year-old female presented with a 4month history of progressive motor weakness in the lower extremities, numbness below the midthoracic area, and spastic gait disturbance. Neuroradiological examinations revealed massive OPLLs at the T4-T6 levels with severe anterior compression of the spinal cord. Anterior decompressive corpectomies with bone grafts were performed from T4 to T6 using a trans-thoracic approach. After surgery, the patient made an uneventful recovery. However, eleven years after surgery, the patient developed recurrent lower extremity weakness and spastic gait disturbance. De novo OPLLs at the C6-T2 levels were responsible for the severe spinal cord compression on this occasion. After second surgery, paralysis in both legs was resolved. We present a rare case of late cervicothoracic OPLL in a patient surgically treated for thoracic OPLL.

Spinal Cavernous Hemangioma Causing Sudden Paraplegia in a 23-Month-Old Kid

  • Cho, Jae-Hoon;Chung, You-Nam;Wang, Kyu-Chang;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.4
    • /
    • pp.273-276
    • /
    • 2006
  • Although cavernous angioma itself is not rare, the epidural spinal localization is uncommon and makes preoperative differential diagnosis difficult. An extraordinary case of a thoracic epidural cavernous angioma in very young age, causing sudden paraplegia is presented. Only 79 cases have been reported in the literatures and among them, this kid was the youngest. A 23-month-old boy was referred to us with a 2-day history of sudden both lower limb weakness. Two days before admission, he got up at morning and was unable to stand and even to move the legs. MRI revealed an epidural mass surrounding spinal cord associated with cord compression at the level of the C5 through T3. Through posterior approach with exposure of C6 to T3 level, the hematomatous mass was removed subtotally due to intraoperative bleeding and its ventral location. After the first operation, the weakness of bilateral lower extremities was improved so as to move gainst the gravity. But the next day, the limb weakness was aggravated as same as preoperative status due to mass effect of new hematoma. The second operation was performed to remove the hematoma and to control the bleeding focus. Several weeks later, the limb weakness was improved and he was able to walk. The literatures about spinal cavernous angioma are reviewed.

A Case of Psychogenic Tremor Improved by Complex Korean Medicine Treatment Including Cheongshimondam-tang-gamibang and Acupuncture Treatment - A Case Report (청심온담탕가미방과 침구치료를 포함한 복합한의치료로 호전된 심인성 떨림 환자 1례 - 증례보고)

  • Jihyun Lee;Seokyeong Yoon;Hyoenjun Cheon;Sungjun Joo;Jisu Lee;Jungtae Leem;Yanghee Han
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.6
    • /
    • pp.1186-1197
    • /
    • 2022
  • Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.

Electroacupuncture for the Treatment of the Chemotherapy-induced Peripheral Neuropathy in Breast Cancer Patient: A Case Report (전자침술로 호전된 유방암 환자의 항암화학요법 유발 말초신경병증 증례보고)

  • Park, Ji Hye;Lee, Jin Sun;Cho, Chong Kwan;Yoo, Hwa Seung
    • Journal of Korean Traditional Oncology
    • /
    • v.20 no.1
    • /
    • pp.1-9
    • /
    • 2015
  • Objectives : The purpose of this study is to report the effect of electroacupuncture on chemotherapy induced peripheral neuropathy in breast cancer patient. Methods : The patient is a female with chemotherapy induced peripheral neuropathy (CIPN) who was diagnosed with breast cancer and suffering from paresthesia of extremities after chemotherapy of docetaxel. The patient was treated with electroacupuncture (15 minutes per one time) twice a day for 14 days. The clinical outcomes were measured by Patient Neurotoxicity Questionnaire (PNQ) grade and visual analogue scale (VAS). Results : In this case, PNQ Item 1 (numbness) grade was improved from D to C, Item 2 (weakness) grade was from C to B. The score of upper limbs VAS was decreased from 7 to 2, lower limbs was from 7 to 5 respectively. Edema of both extremities was also improved. Conclusions : This case study suggests that electroacupuncture therapy may have significant effects of CIPN in breast cancer patient.

Cauda Equina Syndrome following Caudal Anesthesia in a Patient with Metastatic Spine Tumor -A case report- (척추 암전이 환자에서 미추마취후 발생한 마미증후군 -증례 보고-)

  • Lee, Jun-Hak;Park, Seung-Hee;Lee, Ki-Nam;Moon, Jun-Il
    • The Korean Journal of Pain
    • /
    • v.10 no.1
    • /
    • pp.134-137
    • /
    • 1997
  • We report a case of cauda equine syndrome following caudal anesthesia possibly caused by metastatic spine tumor. Male, 80-year-old, who had prostatic carcinoma with $L_3$ and $L_4$ spine metastasis was scheduled for bilateral orchiectomy. Twenty two-gauge needle was introduced at sacral hiatus and 15 ml of 2% lidocaine administered. The next morning, patient complained of perineal numbness and urination difficulty. During the next several day patient had episodes of fecal incontinence and motor weakness on both lower extremities. This case reminded us that neuroaxial blocks such as spinal, epidural and caudal anesthesia, should be used with extreme care in patients having neoplasm with high incidence of spine metastasis.

  • PDF

Degenerative Spondylolisthesis in Thoracic Spine

  • Kim, Eui-Hyun;Kuh, Sung-Uk;Cho, Yong-Eun;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
    • /
    • v.37 no.4
    • /
    • pp.313-315
    • /
    • 2005
  • A 66 year-old woman was admitted to our hospital for progressive weakness of both lower extremities since a month ago. Imaging study, based on plain X-ray, computed tomography and magnetic resonance image revealed spinal stenosis owing to anterior slipping of T10/11 segment. Degenerative spondylolisthesis is common in the lumbar spine and rarely occurs in the cervical spine. But there was no report of degenerative spondylolisthesis in thoracic spine. The authors experienced a case of degenerative spondylolisthesis in the thoracic spine. And we achieved a satisfactory result with posterior decompressive laminectomy alone.

Bilateral Sciatic Neuropathy Following Rhabdomyolysis: A Case Report (횡문근융해증 이후 나타난 양측 좌골신경병: 증례보고)

  • Lee, Sang Yoon;Cha, Jun Min;Kim, Seong Woo;Jeon, Ha Ra
    • Journal of Electrodiagnosis and Neuromuscular Diseases
    • /
    • v.20 no.2
    • /
    • pp.139-143
    • /
    • 2018
  • Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.