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A Case of Epidural Blood Patch to Treat Headache Due to Spontaneous Intracranial Hypotension -A case report- (경막외 혈액봉합술을 이용한 자연성 두개내 저압성 두통 환자의 치험 1예 -증례 보고-)

  • Park, Soo-Seog;Jang, Yeon;Cho, Eun-Chung;Jee, Seung-Eun;Song, Ho-Kyung;Jung, Sung-Woo
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.338-342
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    • 1998
  • Postural headache due to spontaneous intracranial hypotension occurs without any diagnostic lumbar puncture, myelography, cranial or spinal injury, or spinal anesthesia. The clinical characteristics of the syndrome are disappearance of the headache or a notable decrease in its severity with recumbency, the finding of meningeal enhancement and subdural fluid collection on brain MRI, the pleocytosis and the increased CSF protein concentration. We report a case of a 40-year-old woman who exhibited the signs and symptoms of postural headache due to low CSF pressure. Her headache started suddenly at the occiput and radiated to frontal head. Magnetic resonance imaging (MRI) of her brain showed enhancement of the meninges and subdural fluid collection. Intrathecal radionuclide cisternography showed the delayed appearance of the isotope in the cranium and the minimal CSF leak at the left upper thoracic region. Her headache was relieved completely after a lumbar (L2-L3) epidural injection of 12 ml of autologous blood and remained asymptomatic.

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Quantitative EEG Analysis on Emotional characteristics of Children experiencing Domestic Violence (가정폭력을 경험한 피해자녀의 감정 특성에 관한 정량화 뇌파연구)

  • Byun, Youn-Eon;Weon, Hee-Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.166-175
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    • 2017
  • This study examined children from two families exposed to domestic violence and had psychological counseling in July 2017 at KOVA, a support organization for crime victims. The subjects were exposed to family violence in excess of 10 years and was protected by the shelter with their mothers who had filed complaints with the local police. Victims of domestic violence often face difficulty in avoiding the source of aggression, and thus experience repetitive attacks. This research was conducted at the Buddhism Brain Research Facility, Seoul University, to identify and quantify the emotional characteristics of the affected children in which it is difficult to escape from their living conditions. Data was collected by BrainMaster, a 19-channel examination kit, and analyzed by NeuroGuide. As a result of analyzing the emotional characteristics of the affected children through Quantitative EEG and brain topographical map, we found an increase of slow wave and problems with abnormality of Alpha, High Beta in the left and right Frontal area asymmetry.

Evaluation of SPECT Analysis in Patients with Transient Global Amnesia

  • Choe, Bo-Young;Kim, Euy-Neyng;Chung, Yong-An;Sohn, Hyung-Sun;Kim, Sung-Hoon;Chung, Soo-Kyo;Lee, Hyoung-Koo;Suh, Tae-Suk
    • Journal of the Korean Magnetic Resonance Society
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    • v.6 no.1
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    • pp.45-53
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    • 2002
  • Objectives: This study investigated alterations in regional cerebral blood flow (rCBF) in patients with transient global amnesia (TGA) using statistical parametric mapping 99 (SPM99). Methods: Noninvasive rCBF measurements using 99mTc-ethyl cysteinate dimer (ECD) SPECT were performed on 8 patients with TGA who have ongoing symptoms and 17 age matched controls. The relative rCBF maps in patients with TGA and controls were compared. Results: In patients with TGA, significant decreased rCBF was found along the L superior temporal extending to L parietal region of the brain and L thalamus. There were areas of increased rCBF in the R temporal, R frontal region and R thalamus. Conclusion: We could demonstrate decreased perfusion in left cerebral hemisphere and increased perfusion in right cerebral hemisphere in patients with TGA using SPM99. The imbalanced change of rCBF between bilateral cerebral hemisphere in patients with TGA might suggest that imbalanced neuronal activity between the bilateral hemispheres may have strong relationship to the pathogenesis of the TGA. For quantitative SPECT analysis in TGA patients, we recommend SPM99 rather than the ROI method because of its definitive advantages.

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The Kinematic Comparison of Energy Walking and Normal Walking (에너지보행과 일반보행의 운동학적 비교)

  • Shin, Je-Min;Jin, Young-Wan
    • Korean Journal of Applied Biomechanics
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    • v.16 no.4
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    • pp.61-71
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    • 2006
  • The purpose of this study was to compare kinematic characteristics on the limbs at 3 different walking speed during the energy and the normal walking. Eight subjects performed energy walking and normal walking at the slow speed(65 beats/min), the normal speed(115beats/min), the fast speed(160 beats/min). The 3-d angle was calculated by vector projected with least squares solution with three-dimensional cinematography(Motion Analysis corporation). The range of motion was calculated on the trunk, shoulder, elbow, hip, knee joint. The results showed that stride length was no difference of the two walking pattern. The duration of support phase was also no difference of the two walking pattern. The range of motion of shoulder joint significantly increased in the sagittal and frontal planes, and the range of motion of elbow joint significantly increased as the energy walking. The range of motion of hip joint had no significant difference in the any planes in changing of walking speed. But the most remarkable difference of the two walking patterns revealed at the trunk. The range of flexion/extension angle had significant increasing $2.36^{\circ}$ at normal speed, and the range of the right/left flexion angle had significant increasing below $4^{\circ}$ at the 3 walking speed, and The range of rotation angle had significant increasing $7.35^{\circ}$, $9.22^{\circ}$, respectively at the normal and slow speed. But there was no significant difference of range of motion at the hip and knee joints between energy walking and normal walking.

Electrical Detection of Ear Acupuncture Points and Musculoskeletal Pain (경혈탐측기에 반응한 이혈(耳穴)과 신체 동통 부위와의 관계 연구)

  • Kang, Mun-Su;Park, Hyun-Chul;Kim, Lak-Hyung;Yu, Jeong-Suk;Song, Beom-Yong
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.187-193
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    • 2007
  • Objectives : The objectives of this study were to investigate the relationship between electrical detection of ear acupuncture points and musculoskeletal pain. Methods : 18 adults who have musculoskeletal pain without trauma factorsparticipated in this study. They answered the questionnaire and their ear acupuncture points were examined with electrical detectors. We analyzed the relationship between electrical detection of ear acupuncture points and musculoskeletal pain with concordance rate and validity. Results : Total concordance rates of the head region was 68.00%(questionnaire) 32.08%(investigation), that of vertebral region was 67.86%, 59.38%, that of both upper limbs was 86.67%, 39.69%, and that of both lower limbs was 50.00%, 23.46%. The true positive rate was 0.704, the true negative rate was 0.492, the false positive rate was 0.508, and the false negative rate was 0.296 in the validity test. In the head, two concordance rates of the temporal and occipital regions were relatively higher than those of the parietal and frontal regions. In the vertebral region, two concordance rates of the cervical and lumbar regions were relatively higher than those of the thoracic and sacrum regions. In the upper limb, two concordance rates of the shoulder and shoulder joints were relatively higher than those of the others. In the lower limb, concordance rates of investigation were relatively low at all areas. The right lower limb was relatively higher than the left in concordance rates of the questionnaire. Conclusions : The results suggest that electrical detection of ear acupuncture points can be used in the diagnosis and treatment of musculoskeletal pain.

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The Effect of Proprioceptive Exercise of Ankle Joint on Postural Alignment in Woman Elderly Person (발목관절의 고유수용성 운동이 여성노인의 자세정렬에 미치는 영향)

  • Bae, Young-Sook;Um, Ki-Mae;Kim, Nan-Soo
    • The Journal of Korean Physical Therapy
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    • v.21 no.3
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    • pp.53-59
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    • 2009
  • Purpose: The purpose of this study was to investigate the effects of proprioceptive exercise on the body alignment of elderly women. Method: The experimental group consisted of twenty elderly women who participated in proprioceptive exercise for 8 weeks. The subjects were measured using Global Posture System equipment for assessing their body alignment. Body alignment was measured at the ear, shoulder joint, knee joint and calcaneocuboid joint on the sagittal plane, and the left and right acromion process positions, the ASIS and the medial malleoulus on the coronal plane. The body alignment data was used to assess the changes before and after proprioceptive exercise. The data of the experimental group was compared and analyzed using the Wilcoxon singed-rank test between before and after proprioceptive exercise. The Mann-Whithney test was used to compare the experimental group and the control group. Result: The result of this study was that the body alignment of the experimental group at the ear and knee joint on the sagittal plane was significantly in alignment with the line of gravity (p<0.05) before and after proprioceptive exercise. The body alignment was statistically different (p<0.05) between the experimental group and the control group on the frontal plane and sagittal plane. Conclusion: This study showed that proprioceptive exercise does affect the body alignment in elderly women. This indicates that there is interaction that plays a crucial role for proprioceptive stimuli and the body alignment.

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Comparative Study on Initial Symptoms Using Single Photon Emission Computer Tomography in Schizophrenia (뇌 Single Photon Emission Computer Tomography 영상을 이용한 정신분열병 환자의 초기 증상 차이에 대한 연구)

  • Lee, Jin-Gu;Kim, Seong-Min;Seo, Young-Duk;Kim, Ki-Seong;Wang, Seong-Keun;Chee, Ik-Seung;Kim, Jeong-Lan
    • Korean Journal of Biological Psychiatry
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    • v.17 no.3
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    • pp.127-135
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    • 2010
  • Objectives : This study was conducted to compare between hallucination group and delusion group in patient with schizophrenia, using Brain $^{99m}Tc$-ECD PECT. Methods : Among 16 patients with less than 3 schizophrenic episodes, 8 patients whose initial symptom was hallucination were assigned to the hallucination group, and other 8 patients with initial sumptom of delusion were assinged to the hallucination group. All of the patients clinically evaluated using the PANSS and BPRS. Both groups of patients and 8 healthy subjects underwent $^{99m}Tc$-ECD PECT. Results : Score of thinking disturbance subscale of BPRS were significantly lower in the hallucination group than the delusion group. In SPECT analysis, the hallucination group showed significantly increased perfusion in some areas of the right temporal lobe, bilateral limbic lobes and left parietal lobe compared to delusion group. Both group had a reduced rCBF in some areas of the frontal lobe. Conclusion : The hallucniation group, compared with the delusion group, showed significantly increased regional cerebral blood flow in some regions. Therefore, this data suggests that different neural substrates may affect the process of auditory hallucination and delusion.

A young child of anti-NMDA receptor encephalitis presenting with epilepsia partialis continua: the first pediatric case in Korea

  • Kim, Eun-Hee;Kim, Yeo Jin;Ko, Tae-Sung;Yum, Mi-Sun;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.133-138
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    • 2016
  • Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

The Understanding of The Ideomotor Apraxia: Focusing on The Neurological Causes (관념운동실행증의 이해: 신경학적 원인을 중심으로)

  • Shin, Su-Jung;Lee, Joo-Hyun;Park, Jin-Hyuck
    • Therapeutic Science for Rehabilitation
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    • v.4 no.1
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    • pp.19-28
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    • 2015
  • Introduction : The Understanding of neurological lesion relating to apraxia will help to predict symptoms according to a lesion and to establish a proper treatment and goal. So, This study will explain causes and mechanism of a movement error of ideomotor apraxia through literature review and also will suggest the evidence using in treatment. Body : Ideomotor apraxia may occur a damage of the production part in praxis system, and is common in damage of a cortex rater than damage of a subcortex. According to study with gesture, movement of upper limbs is relate of left parietal lobe but finger movement is relate of frontal lobe. The visual and tactile stimulation through using real objects could guide into proper movement aside from memory of a skilled action. Conclusion : Praxis can occur through diverse neurological processing and various external stimulations can help praxis processing. Therefore, the treatment of ideomotor apraxia need to use this stimulations.