• The Journal of Internal Korean Medicine
• /
• v.24 no.4_2
• /
• pp.975-986
• /
• 2003

Introduction: Guillain-Barre syndrome(GBS) is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, a loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. Recently there is an opinion that Acute Inflammatory Demyelinating Polyradiculoneuropathy'(AIDP) is more effective than 'GBS' for the symptoms. These symptoms are applicable to rheumatic arthritis(痺), flaccid paralysis of limb(?) caused by wind, cold and dampness(風, 寒, 濕) from an oriental medical view point. On this, we reported one case that diagnosed as 'complex of rheumatic arthritis(痺) and flaccid paralysis of limb(?)' at our oriental medical hospital. Result: we considered these symptoms as 'complex of rheumatic arthritis(痺), flaccid paralysis of limb(?)'. In accordance with the result, we treated the patient with Chung-Sang Tong-Jung On-Ha(淸上通中溫下). We concluded that external factors such as wind, cold and dampness(風, 寒, 濕) and internal factors like vital energy's disharmony(生氣不調和) affected the patient.

• Clinical and Experimental Pediatrics
• /
• v.59 no.sup1
• /
• pp.161-164
• /
• 2016

Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.

• Molecules and Cells
• /
• v.38 no.11
• /
• pp.1013-1021
• /
• 2015

Most of the axons in the vertebrate nervous system are surrounded by a lipid-rich membrane called myelin, which promotes rapid conduction of nerve impulses and protects the axon from being damaged. Multiple sclerosis (MS) is a chronic demyelinating disease of the CNS characterized by infiltration of immune cells and progressive damage to myelin and axons. One potential way to treat MS is to enhance the endogenous remyelination process, but at present there are no available treatments to promote remyelination in patients with demyelinating diseases. Sulfasalazine is an anti-inflammatory and immune-modulating drug that is used in rheumatology and inflammatory bowel disease. Its anti-inflammatory and immunomodulatory properties prompted us to test the ability of sulfasalazine to promote remyelination. In this study, we found that sulfasalazine promotes remyelination in the CNS of a transgenic zebrafish model of NTR/MTZ-induced demyelination. We also found that sulfasalazine treatment reduced the number of macrophages/microglia in the CNS of demyelinated zebrafish larvae, suggesting that the acceleration of remyelination is mediated by the immunomodulatory function of sulfasalazine. Our data suggest that temporal modulation of the immune response by sulfasalazine can be used to overcome MS by enhancing myelin repair and remyelination in the CNS.

• Journal of Environmental Health Sciences
• /
• v.24 no.3
• /
• pp.35-40
• /
• 1998

This study was conducted to examine the pathological changes of rat peripheral nervous system during exposure to tellurium known to be a demyelinating agent by using teasing nerve fiber method and quantitative light microscopic analysis by image analyzer. The pellet containing 1.2% of tellurium were fed for 3, 5, 7, 9, 13 days to male wistar rats (21 days old) and then neurologic symptom and the feature of nerve fiber myelination were studied. From this study, following results were obtained. In 3 days treated group, it showed various neurologic symptom and teased nerve fiber showed slight irregularity of the myeline sheath. In 5 days and 7 days treated groups, it showed the segmental demyetination in larger size fiber and widening of nodes of ranvier. In 9 days and 13 days treated groups, the remyelinated fibers were observed and it was generally small in size. We consequently suggest that teasing nerve fiber method and quantitative analysis of nerve fiber were useful pathologic screening method of neurotoxicity of the peripheral nervous system.

• Annals of Clinical Neurophysiology
• /
• v.6 no.1
• /
• pp.57-60
• /
• 2004

The sixty two-year-old woman was admitted with facial diplegia and ataxic gait. Neurological examination revealed areflexia and sensory ataxia with decreased sensation of position and vibration in both lower extremities. Electrophysiologic study suggest motor dominant demyelinating polyneuropathy and bilateral facial neuropathy. CSF study revealed no cells and increased proteins. After intravenous immunoglobulin therapy, sensory ataxia and electrophysiological study had markedly improved for 3 months.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.4
• /
• pp.245-248
• /
• 2013

Guillain-Barr$\acute{e}$ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.

• Journal of Korean Physical Therapy Science
• /
• v.2 no.2
• /
• pp.533-544
• /
• 1995

Multiple sclerosis is a chronic, pregressive, demyelinating, disease of the central nervous system. It is named for the formation of disseminated scarlike lesions primarily in the central white mattrer of the brain and spinal cord. These plaques are commonly found in the regions of the optic tracts, third and fourth ventricles, basal ganglia, midbrain, pons, and spinal cord. Multiple sclerosis is an unpredictable disease, typically presenting with an exacerbating-remitting course, although other clinical courses have been recognized. Common clinical findings include disturbances in sensation, muscle strength, tone, fatigue, coordination, vision, communication, bladder and bowel function, and cognitive and behavioral function. Physical therapy of the patient with multiple sclerosis is centered around decreasing symptoms, improving function, prevention secondary complications, and promoting successful psychological adjustment. It requires the comprehensive efforts of a health care team to provide coordinated and continuing care.

• The Korean Journal of Pain
• /
• v.27 no.1
• /
• pp.77-80
• /
• 2014

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system associated with longitudinally extensive myelitis and optic neuritis. It is characterized by relapses that lead to blindness and paralysis sequelaes. But, this is rare disease; therefore high clinical suspicion for a correct diagnosis and proper examinations are not easy. However, early diagnosis is essential to prevent sequelae. We report the case of NMO with headache. A 30-year male patient who suffered headache visited our pain clinic because of aggravated pain despite treatment. The cause of the pain was revealed as NMO by more detailed previous history and examination.

• Journal of Korean Neurosurgical Society
• /
• v.48 no.3
• /
• pp.301-304
• /
• 2010

Metronidazole is commonly used for brain abscess but is not well known for its neurotoxic complications. Metronidazole-induced encephalopathy (MIEP) is toxic encephalopathy associated with the use of metronidazole. We experienced a case of brain abscess which developed reversible severe MIEP during treatment period. Although MIEP occurs in typical locations, it is not easy to differentiate from other conditions such as cerebral infarction, demyelinating diseases and metabolic diseases. Neurosurgeons should be aware that severe MIEP can occur during the use of metronidazole though it is not common.

• The Journal of the Korean dental association
• /
• v.49 no.6
• /
• pp.321-326
• /
• 2011

Neuropathic pain is caused by functional abnonnalities of structural lesions in the peripheral or central nervous system, and occurs without peripheral nociceptor stimulation. Trigeminal neuropathy always pose differential location difficulties as multiple diseases are capablc of producing them: they can be the result of traumatism, tumors, or diseases of the connective tissue, infectious or demyelinating diseases, or may be of idiopathic origin. There are a number of mechanisms described as causing neuropathy. They can be described as ectopic nerve activity, neuroma, ephatic trasmission, change of sodium channel expression, sympathetic activity, central sensitization, and alteration in central inhibition systems. More than I mechanism may be active to create individual clinical presentations. In order to provide better pain control, the mechanism-based approach in treating neuropathic pain should be familiar to physicians.