• The Korean Journal of Pain
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• v.9 no.2
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• pp.439-442
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• 1996

Continuous epidural analgesia has been used widely for chronic pain control, especially in cancer patients. As one of the complications, paraplegia developed during continuous epidural analgesia may be caused by epidural abscess, epidural hematoma, neural damage, chronic adhesive arachnoiditis, anterior spinal artery syndrome, delayed migration of extradural catheter into subdural space or subarachnoid space and preexisting disease. A 55-years-old male with lung cancer was implanted with continuous thoracic epidural catheter for pain control. Twenty days after catheterization, moderate back pain, weakness of lower extremity and urinary difficulty were developed. We suspected epidural abscess at first and made differential diagnosis with MRI which showed metastatic cancer at T2-4 spine, And compressed spinal cord was the main cause of the lower extremity paralysis.

• Journal of Sasang Constitutional Medicine
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• v.28 no.3
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• pp.300-308
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• 2016

Objectives This case study was about a Taeyangin patient with Amyotrophic Lateral Sclerosis identified as Hae-Yeok pattern. In this study, we report the significant improvement of extremity weakness of this patient after Sasang Constitutional medicine treatment.Methods The patient was identified as Taeyangin Hae-Yeok pattern and treated with Ogapijangchuk-tang and acupuncture. Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (K-ALSFRS-R) was used to assess the overall function of the patient. And the Global Assessment Scale (GAS) was used to assess the change of upper and lower extremities weakness after the treatment.Result and Conclusion The K-ALSFRS-R total score decreased from 30 points to 26 points and extremity weakness showed significant improvement in GAS after 12 days treatment. Furthermore, walking distance was much longer after treatment. In conclusion, this study shows that Sasang constitutional medicine can be effective treatment for Taeyangin patient with Amyotrophic Lateral Sclerosis.

• The Journal of Internal Korean Medicine
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• v.40 no.2
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• pp.165-172
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• 2019

Background: To suggest potential of Korean medicine treatments as a conservative management for neurogenic claudication and lower extremity weakness due to spinal stenosis. Case Summary: The patient suffered weakness, pain and numbness of the right leg and difficulty walking with diagnosis of spinal stenosis due to herniated lumbar intervertebral disc. Korean medicine treatments, including herbal medicine, acupuncture, pharmacopuncture and Chuna manual therapy were applied. The Numeric Rating Scale (NRS) of pain and numbness in the right leg decreased from 7 to 4, with an increase in strength of the right leg from 60% to 95% compared to the strength of left leg. Walking duration also increased from less than one minute to more than five minutes. Conclusion: Korean medicine treatment may be considered as an effective conservative management for symptoms of spinal stenosis.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2065-2070
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• 2020

Background: Weakness of the abdominal and mid thoracic muscles the lead to thoracic kyphosis of stroke patients. The trunk muscles activity of stroke patients is significantly related to upper extremity. Objectives: To investigate the effect of seated exercise of thoracic and abdominal muscles on upper extremity function and trunk muscles activity in stroke patients. Design: One-group pretest-posttest design. Methods: A total of 27 stroke patients were recruited. All stroke patient were given seated abdominal exercise (posterior pelvic tilt exercises) and thoracic exercise (postural-correction exercise). All exercises were conducted for 30 minutes, three times a week for four weeks. The manual function test (MFT) and electromyography (EMG) were measured, and EMG electrodes were attached to thoracic paraspinal muscles and lower rectus abdominal muscles. EMG signal is expressed as %RVC (reference voluntary contraction). Results: Experimental group showed significant increases in abdominal muscles, paraspinal muscles activity and MFT total score, items of arm motion (forward elevation of the upper extremity, lateral elevation of the upper extremity, touch the occiput with the palm) in MFT after four weeks. Conclusion: These results suggest that, in stroke patients, seated exercise of thoracic and abdominal muscles contribute to improve trunk muscles activity and upper extremity function in stroke patients.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1511-1516
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• 2020

The anomalous retro-psoas iliac artery is an extremely rare congenital iliolumbar vascular anomaly. A 51-year-old woman presented to our emergency department with worsening right lower extremity pain and weakness for 3 months. CT angiography of the right lower extremity showed no evidence of stenosis in the lower extremity arteries and the incidental finding of an anomalous right retro-psoas iliac artery. Herein, we report a rare case of anomalous retro-psoas iliac artery. Surgeons and clinicians need to be aware of this rare congenital anomaly to avoid severe complications during pelvic or orthopedic surgery.

• Journal of Korean Neurosurgical Society
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• v.37 no.2
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• pp.154-156
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• 2005

We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.139-143
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• 2018

Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

• The Journal of Internal Korean Medicine
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• v.42 no.3
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• pp.420-430
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• 2021

The survival time of breast cancer patients with lung metastasis has been prolonged as treatment methods have improved. However, there is yet no definitive therapy for the additional symptoms of lung metastasis to improve the quality of life of these patients. We report a patient who was suffering from pleural effusion due to metastasized breast cancer. She was treated with Korean medicine, including herbal medicine (Bojungikgi-tang-gami), combined with hormone therapy, for two months. We assessed her other symptoms, such as shortness of breath, generalized weakness, and lower extremity swelling, using a numeric rating scale (NRS). We also evaluated pleural effusion with chest X-rays. Shortness of breath was maintained at NRS 5, generalized weakness was slightly improved from NRS 6~7 to NRS 7~8 (10=healthy condition), and lower extremity edema was improved from NRS 3 to NRS 2 (10=highest score of discomfort). Malignant pleural effusion was maintained during the admission period. This report suggests that Korean medicine can help to maintain malignant pleural effusion and improve additional symptoms of lung metastasis.

• The Korean Journal of Pain
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• v.26 no.3
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• pp.286-290
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• 2013

Air injected into the epidural space may spread along the nerves of the paravertebral space. Depending on the location of the air, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia may occur. However, cases of motor weakness caused by air bubbles after caudal epidural injection are rare. A 44-year-old female patient received a caudal epidural injection after an air-acceptance test. Four hours later, she complained of motor weakness in the right lower extremity and numbness of the S1 dermatome. Magnetic resonance imaging showed no anomalies other than an air bubble measuring 13 mm in length and 0.337 ml in volume positioned near the right S1 root. Her symptoms completely regressed within 48 hours.