• Title/Summary/Keyword: Dystonia

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Abductor Spasmodic Dysphonia : Acoustic Evaluation - A Case Report - (외전형 경련성 발성장애 환자 음성의 음향학적 특성 - 증례보고 -)

  • Song, Yun-Kyung;Jin, Sung-Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.57-60
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    • 2010
  • Spasmodic dysphonia is a focal dystonia of the larynx and breathy voice is a typical sign of abductor spasmodic dysphonia. A group of patients with abductor spasmodic dysphonia have a number of acoustic characteristics including abnormal fundamental frequency fluctuations and abnormally long word duration. We report a abductor spasmodic dysphonia case have enlongated voice onset time voiceless consonants and breathy voice in wide band spectrogram. The patient have the acoustic characteristics only in telephone speaking at work time. We treated the patient with anticholinergic and anticonvulsant drug and supplementary voice therapy. The breathy voice and enlongated VOT were disappeared after those treatment.

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Anesthetic management in corticobasal degeneration with central sleep apnea: A case report

  • Shionoya, Yoshiki;Nakamura, Kiminari;Sunada, Katsuhisa
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.4
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    • pp.235-238
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    • 2019
  • Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of $SpO_2$ and preparations to support postoperative ventilation are necessary.

The Relation of Antipsychotic Drug Induced-Acute Dystonia and Serum Iron Level (정신과 입원환자에서 항정신병 약물에 의한 급성 근긴장 이상증과 혈청 철 농도와의 관계)

  • Lee, Dong-Jin;Park, In-Joon;Kwon, Young-Joon;Jeong, Hee-Yeon;Han, Sun-Ho
    • Korean Journal of Biological Psychiatry
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    • v.5 no.2
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    • pp.248-252
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    • 1998
  • Object : This study was performed in order to examine the correlation between acute neuroleptic-induced dystonic reactions and serum iron level. Method : Serum iron levels were measured in psychiatric inpatients who had developed acute neuroleptic-induced dystonia(N=41) and in control patients with no history of acute dystonic reactions(N=37). Serum iron levels were compared in acute dystonic inpatients before starting treatment with neuroleptics and after acute dystonic reaction. Results : The patients exhibiting acute dystonic reactions had significantly lower serum iron levels than the patients without acute dystonic reactions. Conclusion : This result supports an association between low serum iron and the occurrence of neuroleptic-induced acute dystonic reactions.

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Neurophysiological Evaluation of the Motor System Using Transcranial Magnetic Stimulation (뇌자기자극을 이용한 운동신경계의 신경생리학적 평가)

  • Shin, Hae-Won;Sohn, Young-H.
    • Annals of Clinical Neurophysiology
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    • v.13 no.1
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    • pp.1-12
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    • 2011
  • Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

Botox Injection for the Management of Spasmodic Dysphonia (연축성 발성장애(Spasmodic Dysphonia)에 대한 보톡스 주입치료)

  • Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.2
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    • pp.99-103
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    • 2012
  • Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.

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A Case of Thyroarytenoid Myoneurectomy Using LASER and Monopolar Electrical Device in Spasmodic Dysphonia (연축성 발성장애 환자에서 레이저와 단극성 전기소작기를 이용한 갑상피열근신경 절제술 1예)

  • Lee, So Jeong;Jung, Soo Yeon;Chung, Sung Min;Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.132-135
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    • 2019
  • Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.

Clinical Studies on 1 Case of Tradive Dyskinesia by Oriental Medical Treatment (약물 유발성 근 긴장 이상증 1례에 대한 임상적 고찰)

  • An, Chang-Suk;Yoo, Chang-Kil;Kim, Tae-Hui;Kwon, Ki-Rok;Choi, Sung-Mo
    • Journal of Pharmacopuncture
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    • v.5 no.2
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    • pp.71-75
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    • 2002
  • Objective : This study was performed to evaluate the treatment of acupuncture therapy including Herbal Acupuncture in Tardive Dyskinesia. Methods & Result : We treated 1 case of Tardive Dyskinesia patient with Acupuncture and herbal Acupuncture, herbal medicine. Acupuncture therapy was taken on acupoints including CV12 (Chungwan:中脘), ST40 (Pungnyung:豊隆), SP3 (Taeback:太白). As the results of this treatments, little change of tongue motion was observed, but general conditions of the patient was improved. Conclusions : Oriental medical treatments was little effective in this disease, but general conditions of the patient was improved. We think that it need the further study and clinical trial for Tardive Dyskinesia.

A case report of Hypoxic ischemic encephalopathy (저산소성 허혈성 뇌손상 환아의 치험 1례)

  • You, Han-Jung;Koh, Duck-Jae;Cho, Hyung-Jun;Lee, Jin-Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.143-160
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    • 2004
  • Objective: There were few reports on the treatment of Hypoxic ischemic encephalopathy. We treated a hypoxic ischemic encephalopathic patient after accident with Oriental medical approach, and get a significant result. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy, So we are reporting that case. Method : The acupuncture, herb medication. rehabilitation therapy was applied for treting patient's chife symptom(involuntary movement, dystonia, aphasia, dysuria, constipation) Results : 1. Generally patients with Hypoxic ischemic encephalopathy show language impairment and cognition disorder for several weeks to months. After coma stage, first they recover consciousness but have various degree of confusional mentality, visual agnosia, extrapyramidal stiffness and motor disturbance. 2. Consciousness loss in acute stage of Hypoxic ischemic encephalopathy can be considered as Mental Confusion due to Phlegm(Dammisimgyu) in veiw point of Oriental medicine. 3. After oriental medical treatment, patient's chief symptoms were improved. Conclusion: We treated a hypoxic ischemic encephalopathic patient with Oriental medical approach and patient's chief symptoms were improved. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy.

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Manual Therapy for Patient with Spasmodic Torticollis - Case Study (연축성 사경환자에 대한 도수 치료적 접근 - 사례연구)

  • Kim, Dong-Ya;Shin, Eui-Ju;Jeon, Jae-Guk
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.1
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    • pp.79-83
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    • 2013
  • Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

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Differential Diagnosis between Neurogenic and Functional Dysphonia (신경성 발성장애와 기능성 발성장애의 감별 진단)

  • Kim, So Yean;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.71-78
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    • 2017
  • Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

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