• Title/Summary/Keyword: Dysarthria

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Overlap syndrome of Miller-Fisher syndrome/Pharyngeal-Cervical-Brachial variant-Guillain Barre Syndrome with anti-ganglioside complex antibodies

  • Lee, Suk-yoon;Oh, Seong-il;Huh, So-Young;Shin, Kyong Jin;Kim, Jong Kuk;Yoon, Byeol-A
    • Annals of Clinical Neurophysiology
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    • v.22 no.2
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    • pp.112-116
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    • 2020
  • Guillain-Barré syndrome (GBS) and Miller Fisher syndrome (MFS) can present with overlapping features. A 56-year-old female developed ptosis and diplopia after an upper respiratory infection, and presented with facial palsy, dysarthria, brachial weakness, ataxia, and areflexia. Mild weakness of both legs appeared after a few days. Anti-ganglioside complex antibody were positive to IgG GM1/GQ1b and GQ1b/sulfatide antibodies. The present case suggests that the manifestation of overlap between MFS/PCB variants and GBS could be caused by antiganglioside complex antibodies.

A Family of Dentatorubropallidoluysian Atrophy (Dentatorubropallidoluysian Atrophy 일가족)

  • Chung, Ji-Yoon;Park, Mee-Young;Lee, Jun;Yoon, Jun-Pil;Park, Hyun-Jung
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.118-123
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    • 2006
  • Dentatorubropallidoluysian atrophy (DRPLA) is a rare neurodegenerative disorder usually inherited in an autosomal dominant pattern. DRPLA has been shown to be associated with expansion of an unstable cytosine-adenine-guanine (CAG) trinucleotide repeat in a gene on chromosome 12p. We evaluated a family with DRPLA that affected three members; A 35-year-old female presented with seven year history of gait ataxia, dysarthria and mild cognitive impairment. The MRI of the brain revealed diffuse cerebellar atrophy with an incidental lipoma in the midbrain. Her 30-year-old brother presented with progressive cerebellar ataxia that developed at the age of 20. Her grandmother and mother were reported to have developed ataxia during the late period of their life, and died at the age of 60 and 55, respectively. The demonstration of an expanded CAG repeat in the gene for DRPLA was used to confirm the diagnosis.

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A Case Study of a Taeyangin Patient with Vertebrobasilar Insufficient after Mistreat as Taeeumin. (태음인으로 오치(誤治)한 추골뇌저동맥부전증 태양인 환자 치험 1례)

  • Kang, Seok-Hwan;Jeon, Soo-Hyung;Na, Young-Ju;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.4
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    • pp.338-349
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    • 2016
  • Objectives This case study was about a Taeyangin patient with transient ischemic attack(TIA) due to vertebrobasilar insufficiency(VBI). In this study, we report the progress of mistreat with Taeyangin as Taeeumin and the improvement of symptoms after rediagnosis as Taeyangin. Methods Patient's chief complain was weakness of lower limbs, dysarthria and dizziness. Patient first time took Taeeumin prescription such as Chunghyulganggi-tang, Chunsimyonja-tang and Sanyakbopaewon-tang. After occuring side effects we changed the prescription to Taeyangin herbal medicine such as Ogapijangchuk-tang gagam and Mihudeungsikjang-tang gagam. Result and Conclusion Patient suffered from diarrhea by taking Taeeumin prescription and symptom was continue. After changing of prescription to Taeyangin herbal medicine, not only chief symptom but also original symptom was improved.

Chronic Central Post-Stroke Pain Treated with Scalp Acupuncture and Traditional Korean Medicine: A Case Report

  • Park, Jang Mi;Lee, Jae Sung;Jeong, Jae Eun;Lee, You Jung;Lee, Cham Kyul;Roh, Jeong Du;Jo, Na Young;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.277-281
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    • 2019
  • A patient with central post-stroke pain was treated for 4 weeks with scalp acupuncture and traditional Korean medicine (following a cerebral infarction in 2013). The patient presented at Chungju hospital in January 2019 with left side weakness and tingling, numbness in the left hemisphere, chronic pain and dysarthria. Initially, herbal medicine, acupuncture, pharmacupunture, indirect moxibustion, and physiotherapy were administered together with Western medicine, with no improvement in the patient's condition. On Day 5, scalp electroacupuncture (MS1, MS5, MS10, MS11) was introduced. The numbness feeling in the patient's head resolved, and the pain in his upper body decreased. Grip force difference between the left and right hand improved from 3 kg to 0-0.5 kg. Sleep disturbance was resolved after 4 weeks treatment, and his average numeric rating scale score for pain improved from an admission score of 10, to a discharge score of 5. The patient could walk unaided after treatment.

An Imported Case of Disseminated Echinococcosis in Korea

  • Shin, Dong Hoon;Jo, Hae Chan;Kim, Jeong-Han;Jun, Kang Il;Park, Wan Beom;Kim, Nam-Joong;Choi, Min-Ho;Kang, Chang Kyung;Oh, Myoung-don
    • Parasites, Hosts and Diseases
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    • v.57 no.4
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    • pp.429-434
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    • 2019
  • A complicated case of echinococcosis with multiple organ involvement is reported in a 53-year-old businessman who frequently traveled overseas, including China, Russia, and Kazakhstan from 2001 to 2007. The patient was first diagnosed with a large liver cyst during a screening abdomen ultrasonography in 2011, but he did not follow up on the lesion afterwards. Six years later, dizziness, dysarthria, and cough developed, and cystic lesions were found in the brain, liver and lungs. The clinical course was complicated when the patient went through multiple surgeries and inadequate treatment with a short duration of albendazole without a definite diagnosis. The patient visited our hospital for the first time in August 2018 due to worsening symptoms; he was finally diagnosed with echinococcosis using imaging and serologic criteria. He is now on prolonged albendazole treatment (400 mg twice a day) with gradual clinical and radiological improvement. A high index of suspicion is warranted to early diagnose echinococcosis in a patient with a travel history to endemic areas of echinococcosis.

Pontine Necrosis Related with Radiation Therapy, Complicated with Spontaneous Hemorrhage

  • Kim, Ha Min;Hong, Bo Young;Lee, Jong In;Kim, Joon Sung;Lim, Seong Hoon
    • Brain & NeuroRehabilitation
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    • v.10 no.1
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    • pp.1-6
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    • 2017
  • The brain necrosis induced by radiation therapy (RT) is an uncommon pathology of brain. A case of spontaneous hemorrhage at necrotic brain is also rare. A 52-year-old man who had nasopharyngeal carcinoma and had been treated with RT, presented with gait disturbance, dizziness, ataxia, dysarthria, and dysphagia. Magnetic resonance imaging (MRI) demonstrated progressed radiation necrosis of pons, and spontaneous hemorrhage at the site of necrosis. The hematoma was diminished by conservative treatment. However, the patient's neurologic symptoms did not recover. Two years later, spontaneous bleeding recurred at necrotic brain. His neurologic symptoms worsened. One year later, his neurologic symptoms were more progressed. He showed severe dysphagia, profound weakness and respiratory failure. This case provides the description of relapsed spontaneous hemorrhage and medullary dysfunction caused by pontine necrosis and progressed post-radiation injury, complicated with hemorrhage, and urges caution in that the necrotic brain tissue may be vulnerable to bleeding.

Influence of Nasometer Structure on Nasalance for Speech Therapy (언어치료환자를 위한 비음측정기 모듈의 구조가 비음치 산출에 미치는 영향)

  • Woo, Seong Tak;Park, Y.B.;Kim, J.Y.;Oh, D.H.;Ha, J.W.;Na, S.D.;Kim, M.N.
    • Journal of Korea Multimedia Society
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    • v.22 no.2
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    • pp.157-166
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    • 2019
  • With the development of medical technology, interest in rehabilitation devices is increasing and various devices are being studied. In particular, devices for speech disorders such as hearing impairment and cleft palate are attracting attention. In general, the nasometer is used for patients with flaccid dysarthria and velopharyngeal incompetence(VPI). However, in the case of the conventional separator type nasometer, that has an acoustic feedback problem between the oral and nasal sounds. In recent, the mask type nasometer has been developed which is insensitive to acoustic feedback. But, still not popularized. In this paper, the nasometer characteristics of the conventional separation type and mask type are analyzed. Also, We were obtained clinical acoustic data from the 6 subjects and examined the significant differences in the structure of the separation type and mask type nasometer. Through experiments, it was confirmed that the measurement was about 3~15% higher in the mask type nasometer than the conventional nasometer having a separator type. Also, We was considered the necessity of nasometer signal processing for acoustic feedback reduction and nasalance calculation optimization.

Novel compound heterozygous mutations of ATM in ataxia-telangiectasia: A case report and calculated prevalence in the Republic of Korea

  • Jang, Min Jeong;Lee, Cha Gon;Kim, Hyun Jung
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.110-114
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    • 2018
  • Ataxia-telangiectasia (AT; OMIM 208900) is a rare autosomal recessive inherited progressive neurodegenerative disorder, with onset in early childhood. AT is caused by homozygous or compound heterozygous mutations in ATM (OMIM 607585) on chromosome 11q22. The average prevalence of the disease is estimated at 1 of 100,000 children worldwide. The prevalence of AT in the Republic of Korea is suggested to be extremely low, with only a few cases genetically confirmed thus far. Herein, we report a 5-year-old Korean boy with clinical features such as progressive gait and truncal ataxia, both ankle spasticity, dysarthria, and mild intellectual disability. The patient was identified as a compound heterozygote with two novel genetic variants: a paternally derived c.5288_5289insGA p.(Tyr1763*) nonsense variant and a maternally derived c.8363A>C p.(His2788Pro) missense variant, as revealed by next-generation sequencing and confirmed by Sanger sequencing. Based on claims data from the Health Insurance Review and Assessment Service Republic of Korea, we calculated the prevalence of AT in the Republic of Korea to be about 0.9 per million individuals, which is similar to the worldwide average. Therefore, we suggest that multi-gene panel sequencing including ATM should be considered early diagnosis.

Guillain-Barre Syndrome after Minimally Invasive Lumbar Procedure: A Case Report (요추부 최소침습적 시술 후 길랑-바레 증후군: 증례보고)

  • Lee, Bong-Yeon;Yoon, Seo-Ra;Ryu, Su-Ra;Choe, Yu-Ri
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.159-163
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    • 2018
  • Guillain-Barre syndrome (GBS) after trauma and general orthopedic surgery is rare. A 74-year-old woman showed ascending paralysis symmetrically, dysarthria, dysphagia and areflexia on 14 days after minimally invasive endoscopic thermoannuloplasty on L4-5 level. Brain and lumbar magnetic resonance imaging demonstrate no abnormal findings. The electrodiagnostic study showed prolonged distal motor, sensory latencies and F-wave latencies and reduced amplitude of compound muscle action potential in nerves of upper and lower extremities. In the cerebrospinal fluid (CSF) examination, total protein and IgG were increased. We diagnosed Guillain-Barre Syndrome based on clinical features, electrodiagnostic study and CSF examination and the patient improved symptoms after immunoglobulin injection and rehabilitation. Because the occurrence of GBS after minimally invasive procedure has not been reported, we report a case of GBS after minimally invasive procedure with literature review.

Unilateral hypoglossal nerve palsy after mild COVID-19: a case report

  • Sang Jae Lee;Si-Youn Song;Hyung Gyun Na;Chang Hoon Bae;Yong-Dae Kim;Yoon Seok Choi
    • Journal of Medicine and Life Science
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    • v.20 no.2
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    • pp.103-106
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    • 2023
  • Post-acute coronavirus disease (COVID-19) syndrome is defined as persistent symptoms or delayed complications after COVID-19. Several cases of cranial nerve invasion related to COVID-19 have been reported. However, to our knowledge, no cases of solitary unilateral hypoglossal nerve paralysis after mild COVID-19 without intubation have been reported to date. Herein, we report the case of a 64-year-old man with unilateral hypoglossal nerve palsy as a complication of COVID-19. He complained of dysarthria and tongue discomfort 2 weeks after COVID-19 onset. Brain and neck computed tomography, magnetic resonance imaging, ultrasonography, and blood tests ruled out other possible causes. The patient's nerve palsy was rapidly diagnosed and improved with early rehabilitation. Understanding of the pathology of COVID-19 is still limited. Physicians should focus on patients' symptoms and their relationship to COVID-19, and investigate complications immediately. This case highlights the importance of early detection and rehabilitation of post-acute COVID-19 syndrome.