• Title/Summary/Keyword: Delayed paralysis

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Delayed Post-Traumatic Spinal Cord Infarction with Quadriplegia: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.279-283
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    • 2021
  • Traumatic spinal cord infarction is a rare condition that causes serious paralysis. The regulation of spinal cord blood flow in injured spinal cords remains unknown. Spinal cord infarction or ischemia has been reported after cardiovascular interventions, scoliosis correction, or profound hypotension. In this case, a 52-year-old man revisited the emergency center with motor and sensory abnormalities in all four extremities 56 hours after a motor vehicle collision. Despite the clinical presentation and imaging examination, there were no specific findings on the patient's first visit to the trauma center. Cervical spine computed tomography angiography showed a narrow vertebral artery, and diffusion-weighted imaging revealed spinal cord infarction from C3 to C5 with high signal intensity. It should be kept in mind that delayed-onset spinal cord infarction may occur in minor or major trauma patients as a result of head and neck injuries.

Delayed Neuropsychiatric Sequalae with Reversible Quadriplegia after Carbon Monoxide Intoxication : A Case Report (일산화탄소에 기인한 Delayed Neuropsychiatric Sequalae 환자에서 발생한 사지 불완전마비 증례보고 1례)

  • Ryu, Ju Young;Kim, Min Ji;Lee, Kang Wook;Cho, Hyun Kyoung;Yoo, Ho Ryong;Seol, In Chan;Kim, Yoon Sik
    • The Journal of Korean Medicine
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    • v.39 no.3
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    • pp.73-80
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    • 2018
  • Carbon monoxide poisoning leads to hypoxia, which eventually leads to tissue ischemia. The delayed neuropsychiatric syndrome can arise in the period from 4 days to 5 weeks following carbon monoxide poisoning. This case report describes a male who suffered from delayed sequelae after self-inflicted carbon monoxide poisoning. At the time of admission, he had symptoms of quadriplegia, both upper limb ankylosis, gait disturbance, and dysuria. He was treated with acupuncture, electro-acupuncture, physical therapy, and Uwhangchungsim-won. Paraplegia improved considerably after 7 days in hospital, and paralysis of the both upper extremities improved after 14 days in hospital. He was able to walk holding on to his wheelchair after 28 days in hospital. He was hospitalized for 55 days and was discharged from the hospital in a fine condition for everyday life. This case report suggests the possibility that korean medicine for delayed neuropsychiatric syndrome.

A Case Report on Facial Nerve Palsy after Tooth Extraction and Korean Medical Treatments (발치 후 병발한 안면마비 환자에 대한 한의학적 치료 사례 보고)

  • Kim, Dae Hun;Kim, Yu Ri;Bae, Ji Min;Hong, Seung Pyo;Koo, Bon Kil;Kim, Jae Kyu;Lee, Byung Ryul;Yang, Gi Young
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.211-220
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    • 2016
  • Objectives : Facial nerve palsy is a rare but well-known complication that occurs after a tooth extraction. The paralysis follows the injection of a local anesthetic, but patients typically recover after a few hours. However, there are a number of reports of delayed paralysis, and the cause of delayed facial palsy remains uncertain. This study is the first case report detailing how Korean medicine can be used to treat facial nerve palsy following tooth extraction. This study reports our experience of a patient's favorable recovery. Methods : A 25-year-old male patient experienced acute facial palsy after four premolar teeth were extracted. He was hospitalized in the Pusan National University Korean Medical Hospital. We provided complex Korean traditional medical treatments such as acupuncture, cupping, use of a hot water steamer, and herbal medicine for 18 days. Results : Using the Yanagihara Grading Score, we found improvements in the patient's voluntary facial movement as his score increased from 22 to 34. Furthermore, his accompanying symptoms, such as dry eye and facial pain, disappeared. However, the patient reported transient pain around acupoints after the acupuncture intervention. Conclusion : Our study suggests that Korean medical treatments might be effectively used to treat facial nerve palsy after tooth extraction, although further research should be conducted due to the limited number of cases in this area.

Amelioration of experimental autoimmune encephalomyelitis by Ishige okamurae

  • Ahn, Meejung;Kim, Jeongtae;Yang, Wonjun;Choi, Yuna;Ekanayake, Poornima;Ko, Hyunju;Jee, Youngheun;Shin, Taekyun
    • Anatomy and Cell Biology
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    • v.51 no.4
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    • pp.292-298
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    • 2018
  • Experimental autoimmune encephalomyelitis (EAE) is a T-cell-mediated autoimmune central nervous system disease characterized by inflammation with oxidative stress. The aim of this study was to evaluate an anti-inflammatory effect of Ishige okamurae on EAE-induced paralysis in rats. An ethanolic extract of I. okamurae significantly delayed the first onset and reduced the duration and severity of hind-limb paralysis. The neuropathological and immunohistochemical findings in the spinal cord were in agreement with these clinical results. T-cell proliferation assay revealed that the ethyl-acetate fraction of I. okamurae suppressed the proliferation of myelin basic protein reactive T cells from EAE affected rats. Flow cytometric analysis showed $TCR{\alpha}{\beta}^+$ T cells was significantly reduced in the spleen of EAE rats with I. okamurae treatment with concurrent decrease of inflammatory mediators including tumor necrosis $factor-{\alpha}$ and cyclooxygenase-2. Collectively, it is postulated that I. okamurae ameliorates EAE paralysis with suppression of T-cell proliferation as well as decrease of pro-inflammatory mediators as far as rat EAE is concerned.

Time Course of Symptom Disappearance after Microvascular Decompression for Hemifacial Spasm

  • Oh, Eun-Tak;Kim, Eun-Young;Hyun, Dong-Keun;Yoon, Seung-Hwan;Park, Hyeon-Seon;Park, Hyung-Chun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.245-248
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    • 2008
  • Objective : This study is to investigate time course of symptom disappearance in patients whose spasm relieved completely after microvascular decompression (MVD). Methods : Of 115 patients with hemifacial spasm (HFS) who underwent MVD from April 2003 to December 2006, 89 patients who had no facial paralysis after operation and showed no spasm at last follow-up more than 1.5 years after operation were selected. Symptom disappearance with time after MVD was classified into type 1 (symptom disappearance right after operation), type 2 (delayed symptom disappearance) and type 3 (unusual symptom disappearance). Type 2 was classified into type 2a (with postoperative silent period) and type 2b (without silent period). Results : Type 1, type 2a, type 2b and type 3 were 38.2%, 48.37%, 124% and 1.1%, respectively. Delayed disappearance group (type 2) was 60.7%. Post-operative symptom duration in all cases ranged from 0 to 900 days, average was 74.6 days and median was 14 days. In case of type 2, average post-operative symptom duration was 115.1 days and median was 42 days. Five and 3 patients required more than 1 year and 2 years, respectively, until complete disappearance of spasm. In type 2a, postoperative silent period ranged from 1 to 10 days, with an average of 24 days. Conclusion : Surgeons should be aware that delayed symptom disappearance after MVD for HFS is more common than it has been reported, silent period can be as long as 10 days and time course of symptom disappearance is various as well as unpredictable.

A Case of Delayed Facial Palsy and Dizziness in Miller-Fisher Syndrome (Miller-Fisher 증후군에서 나타난 지연형 안면마비 및 현훈 치험 1례)

  • Song, Mi-Sa;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.254-261
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    • 2019
  • Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.

Intermediate syndrome after dermal exposure to organophosphate insecticide

  • Lee, Su Bin;Ryu, Seung Ho;Park, Doo Yong;Park, Jong-Ho;Kim, Jee Young
    • Annals of Clinical Neurophysiology
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    • v.20 no.1
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    • pp.41-43
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    • 2018
  • ntermediate syndrome (IMS) typically occurs at 24-96 hours following organophosphate (OP) poisoning, after an acute cholinergic crisis, but before OP-induced delayed polyneuropathy. It is characterized by proximal muscle weakness and respiratory insufficiency, which is a major contributing factor of OP-related morbidity and mortality. We report an atypical IMS case showing rapid-onset ascending paralysis and respiratory disturbance with an acute cholinergic crisis occurring 4-5 days after skin exposure to OP.

Analyzing clinical and genetic aspects of axonal Charcot-Marie-Tooth disease

  • Kwon, Hye Mi;Choi, Byung-Ok
    • Journal of Genetic Medicine
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    • v.18 no.2
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    • pp.83-93
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is the most common hereditary motor and sensory peripheral neuropathy. CMT is usually classified into two categories based on pathology: demyelinating CMT type 1 (CMT1) and axonal CMT type 2 (CMT2) neuropathy. CMT1 can be distinguished by assessing the median motor nerve conduction velocity as greater than 38 m/s. The main clinical features of axonal CMT2 neuropathy are distal muscle weakness and loss of sensory and areflexia. In addition, they showed unusual clinical features, including delayed development, hearing loss, pyramidal signs, vocal cord paralysis, optic atrophy, and abnormal pupillary reactions. Recently, customized treatments for genetic diseases have been developed, and pregnancy diagnosis can enable the birth of a normal child when the causative gene mutation is found in CMT2. Therefore, accurate diagnosis based on genotype/phenotypic correlations is becoming more important. In this review, we describe the latest findings on the phenotypic characteristics of axonal CMT2 neuropathy. We hope that this review will be useful for clinicians in regard to the diagnosis and treatment of CMT.

A Study on Perceived Family Support and Anxiety in Hemiplegic Patients (편마비 환자가 지각한 가족지지와 불안과의 관계 연구)

  • 이명해;강현숙
    • Journal of Korean Academy of Nursing
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    • v.21 no.1
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    • pp.50-62
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    • 1991
  • The purposes of this study were to identify causal factors of Anxiety and to analyze correlation between perceived family support and anxiety in hemiplegic patients. The subjects of this study were 88 hospitalized hemiplegic patients at Kyung - Hee Oriental medicine Hospital. Data were collected by using interview with questionaire from Jan. 15 to Mar, 31, 1990. The measurement tools used by this researcher were Kang's family support scale, Spielberger's trait anxiety scale and the other anxiety scale which was developed by this researcher, approved it's reliability and validity. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and the hypothesis was tested by pearson correlation, partial correlation. The results of the study were as follow. 1) The analysis of causal factor of anxiety higher anxiety these three cases ; \circled1 1st causal factor was the delayed recovery of paralyzed upper limbs(2.42$\pm$1.27). \circled2 End causal factor was the dysfunction of physical ability(2.30$\pm$1.29). \circled3 3rd causal factor was difficulty for walking(2.30$\pm$0.83) and the anxiety level(2.02$\pm$0.83) of physical factor was the highest level than any other factors. 2) The hypothesis that the more perceived family support level is the less anxiety level of patient was supported(r=-.29, p=.003). 3) The analysis of the general characteristics exerting influences on anxiety level patients ; (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalizatiot side of paralysis). In this analysis, any factor has not a statistical significance.(p>.05). 4) The analysis of the relationship about effective factors of family support level by the general characteristics of patient (sex, age, marrital status, religious, education level, occupation, economic status, experience of hospitalization, care giver, the period of hospitalization, side of paralysis). In this analysis, there was significant difference on perceived family support between married and bereaved patients(t=-2.68, p= .009) As a result of this study, anxiety level of physical factor was higher than any other factors (psychological factor, social factor) and the delayed recovery of paralyzed upper limbs is the largest causal factor of anxiety of physical factor. Meanwhile, the relationship between the degree of family support and the level of anxiety was negatively correlated but the degree of relationship was low. Therefore, one can infer from this study that sufficient information about recovery of physical problems and family support were effective in preventing and reducing anxiety in hemiplegic patient.

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A Clinical Study on the Functional Outcome in Stroke (중풍 환자의 기능 회복에 관한 임상적 고찰)

  • Kwon, Jung-Nam;Kim, Young-Kyun;Cho, Eun-Hee
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.647-657
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    • 2001
  • In the oriental medicine field, researches have been in progress regarding oriental medical factors. I also carried out a clinical study on stroke, from which I discovered meaningful results about important factors that impact on the prognosis of stroke. We studied 132 patients after diagnosis of stroke through a Brain-CT scan and MRI sea, to the oriental internal medicine department at the Hospital affiliated to Oriental Medical College, Dongeui University. All the patients showed meaningful improvement in the examination of their symptoms after four weeks, compared with the first week. Between strokes involving meridian system and strokes involving internal organs, the symptom of paralysis caused by strokes involving meridian system, which patients were in favorable initial condition, had improved significantly and that by strokes involving internal organs had not. The group whose initial bowel movement since the stroke was delayed, whose coating on the tongue was thick or the tongue was dry, whose pulse was tachycardiac, or who had a history of hypertension or diabetics showed a significantly worse symptom after 4 weeks than that of groups in the opposite cases.

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