• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.376-379
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• 2001

There are many causes of trismus. Aetiology can be roughly divided into muscle spasm, mechanical interference, extracapsular ankylosis, intracapsular ankylosis. Trismus caused by mechanical interference between postero-lateral wall of zygoma-maxillary complex and coronoid process following reduction of fractured facial bone is rare. Especially on maxillary bone fracture, when we faced the trismus following removal of intermaxillary fixation, we got used to solve that problem by physical exercise. We obtained good results by coronoidectomy on patients with limited mouth opening who were referred from department of plastic surgery, St. Marys' hospital, the Catholic university of Korea. We report our experience with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.345-348
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• 2004

Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.1007-1013
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• 2006

Seizure can be categorized in various ways. Seizures are divided into those that are generalized and those affecting only part of the brain (focal seizure). Focal (partial) seizures are subdivided into simple seizures and complex seizures. Simple focal seizures may be manifested by focal motor, sensory or autonomic symptoms and consciousness is preserved. The above symptoms may be preceded, accompanied or followed by, and consciousness is impaired in, complex focal seizures. Ictal aphasia can arise from epileptiform discharge on cortical language areas. Generally next to the ictal aphasia, generalized seizures occur, but without losing consciousness, only aphasia takes place. A 61-year-old woman was admitted due to ictal aphasia and facial spasm, and she showed a little palpitation and was startled easily. We diagnosed her as Shimdamgiheo (心膽氣虛) and Damhwashimyo (痰火心擾), so we prescribed Chungsimondam-tang. It was effective on that case. so we report.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.304-307
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• 1995

1,666 patients treated by nerve block from September 1994 to August 1995 we statistically analyzed according to sex, age, diseases, and kinds of nerve blocks. Most patients were in the range from 30 to 60 year old, with a distribution of 43.9% male and 56.1% female. Diseases and ailments were as follows: low back pain 30.6%, frozen shoulder 14.0%, facial spasm 10.0%, cervical syndrome 9.7%, headache 7.3%, and hyperhidrosis 7.2%. Most common nerve blocks were stellate ganglion block 30.9%, epidural block 25.6%, trigger point injection 16.1%, and suprascapular nerve block 6.7%. Nerve blocks under fluoroscopic guide were as follows: facet joint block 28.6%, spinal root block 22.9%, thoracic sympathetic ganglion block 21.7%, and lumbar sympathetic ganglion block 15.4%.

• Journal of Acupuncture Research
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• v.36 no.4
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• pp.245-250
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• 2019

Background: This study was designed to evaluate the clinical safety of Bee Venom (BV) pharmacopuncture at craniofacial acupuncture points. Methods: This was a retrospective study of 108 patients diagnosed with peripheral facial paralysis, trigeminal neuralgia, or facial spasm who were admitted to Kyung Hee University Korean Medicine Hospital at Gangdong, from April 1st, 2017 to August 30th, 2017. Patients were allocated into either, Group 1 (the non-allergy group of patients who did not have an allergic reaction to BV) or Group 2, the group who had allergic reactions to BV. To evaluate the clinical safety of BV pharmacopuncture after each treatment, several criteria were used to measure any side effects: outcome, Common Terminology Criteria for Adverse Events scale, Mueller HL scale, treatment decision after adverse reaction, causality, measures performed for patients with adverse reactions, and efficacy assessment. Results: BV pharmacopuncture delivered in 0.1-0.2 mL at a concentration of 1:30,000 at the craniofacial acupuncture points, showed no statistically significant differences in baseline characteristics between non-allergy Group 1 and allergy Group 2. Amongst the 108 patients, 11 reported side effects after BV pharmacopuncture treatment. These adverse events included rash (n = 7), pruritus (n = 5), swelling (n = 1), vesicles (n = 1), erythema (n = 1), and hives (n = 1). All side effects resolved without sequelae. Conclusion: In this study, BV pharmacopuncture delivered at low doses at the craniofacial acupuncture points, resulted in 10% of patients experiencing non serious side effects suggesting that BV pharmacopuncture was clinically well tolerated.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.733-740
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• 2007

Objective : This study investigated the relationship between warning signs and Sasang constitution (SC) in acute stroke patients. Methods : From October in 2005 to March in 2007, 629 acute stroke patients were studied. Patients were hospitalized within 14 days after the onset ofstroke at one of 3 oriental medical hospitals in Seoul and Kyong-gi province. We assessed the type of SC of acute stroke patients by Questionnaire for Sasang Constitution Classification II (QSCC II). We investigated warning signs (motor weakness, blindness, dysarthria, sensory disturbance, finger dullness, facial & eyelid spasm, neck stiffness), general characteristics, etc. Results : This study showed a higher proportion of Tae-eum & So-eum experience upper extremity sensory disturbance but So-yangexperience lower extremity sensory disturbance. Smoker So-eumexperience 1st & 2nd finger dullness more than non-smoker So-eum. So-eum women experience motor weakness more than So-eum men. Conclusion : Besides these results, we could observe almost no relationship between warning signs and Sasang constitution (SC) in acute stroke patients. More data from prospective cohort studies will help people better understand the relationship between warning signs and Sasang constitution (SC) in acute stroke patients.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.126-146
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• 1999

In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.65-69
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• 2007

Background and Purpose : The purpose of this case-control study was to show the relationship between risk factors(past medical history, BMI, WHR, smoking, drinking), warning signs(dyscinesia, sightless, dysarthria, sensory disorder, numbness, blephalospasm, facial spasm, tension) and the incidence of stroke in korean adults. Methods : 455 stroke patients were enrolled as the case group and 180 non-stroke patients as control group from Oct. 2005 to Feb. 2006. Patients were hospitalized within 2 weeks after the onset of stroke. Obesity were defined as $BMI{\geq}25kg/m2$, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Risk factors and warning signs were obtained from personal interview. The analysis of the data was done by chi-square test. Fisher's exact test and test-sample t-test. Results : The percentage of current smokers(or current drinkers) of case group is higher significantly than that of control group. The past medical history of risk factors were found to be transient ischemic attack(p=0.0698), facial palsy(p=0.4061), hypertension(p<0.0001), hyperlipidemia(p=0.1484), DM(p<0.0001), ischemic heart disease(p=0.0093), migraine(p=0.0014) and hypochondria(p=0.2370). $WHR{\geq}0.9$ in male had a 6.696 (3.711-12.082) odds ratio, $WHR{\geq}0.8$ in female had a 1.567 (0.659-3.726) odds ratio. $BMI{\geq}25kg/m2$ had a 2.017(1.263-3.222). The dyscinesia and sensory disorder of warning signs were found to be statistical difference between case and control group. Conclusions : According to the above results, it was found that smoking, drinking, BMI, WHR, hypertension, DM, ischemic heart disease, migraine affected to the incidence of stroke.

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.816-829
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• 2007

Objectives : This study investigated warning signs and stroke presymptoms and their relationship with acute stroke patients in each stroke type. Methods : 217 patients with first-ever acute stroke within 2 weeks as the case group, 146 people without four major risk factors (hypertension, diabetes mellitus, hyperlipidemia and ischemic heart disease) as the healthy control group (Normals), and 160 people as the general control group (Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from July 2005 to March 2007 for this case-control study. We analyzed the odds ratio of each warning sign or presymptom by multivariate logistic analysis and evaluated each stroke type, as well as general characteristics such as age, sex, etc. Results : Paralysis or weakness of the face and limbs, visual field disorder or loss of vision or blurred and double vision in eyes or both eyes, and sudden difficulty in speaking or dysarthria showed significant increase respectively in each stroke type. In contrast, numbness or tingling sensation or lowering sensation of the face and limbs, numbness or dead sensation of 1st and 2nd fingers, tension at cervical lesion, blepharospasm, facial spasm, etc. had no significant relation with stroke occurrence. Conclusions : In this study we demonstrated that each presymptom have an influence on each stroke type and have different odds ratio for stroke. We believe this may contribute to interpreting the importance of warning signs or presymptoms for each type of stroke, and more prospective studies are needed.