• Journal of Korean Neurosurgical Society
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• v.47 no.3
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• pp.228-231
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• 2010

Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.279-282
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• 1996

A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper extremities were developed. On admission, his temperature was $38.3^{\circ}C$ and showed progressive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 level. Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus obtained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibiotics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.352-358
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• 2017

Frontotemporal dementia, the second most common cause of early onset dementia, is a neurodegenerative clinical syndrome characterized by progressive deficits in behavior, executive function and language. Although motor symptoms in frontotemporal dementia are represented by motor neuron disease, parkinsonism and progressive supranuclear palsy syndrome, there have been no reports of motor weakness caused by the direct involvement of central motor nervous systems in frontotemporal dementia. Moreover, no association between clinical dementia groups and complex regional pain syndrome has been reported. We diagnosed a rare case with motor weakness and complex regional pain syndrome of lower limbs due to central nervous system lesion in a patient with frontotemporal dementia by magnetic resonance imaging, electrodiagnostic study and three phase bone scan. Following steroid therapy for complex regional pain syndrome, pain was improved. Functional improvement was noted after rehabilitation therapy, including functional electrical stimulation, muscle strengthening exercise and gait training during hospitalization. This case report suggests that rehabilitation therapy for motor weakness in frontotemporal dementia could be effective for improving overall function.

• PNF and Movement
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• v.15 no.2
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• pp.167-176
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• 2017

Purpose: This study investigated the effect of core and abdominal muscle-strengthening exercises on muscle activity in the lower extremity on unexpected perturbation. Methods: Twenty subjects were randomly divided into the core exercise group (n=10) or the abdominal muscles strengthening group (n=10). The two groups performed their exercises during three sessions a week for a total of four weeks. The muscle activity in the lower muscles (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) was assessed using surface electromyography (EMG) and normalized maximal voluntary isometric contraction (MVIC) before and after the exercises. Results: An increase in the tibialis anterior activity after the core and abdominal muscles strengthening exercises was found after four weeks. A significant difference in the pre- and post-exercise was found. The gastrocnemius muscle activity increased in the core exercise group more than the abdominal muscles strengthening group. However, the difference was not significant. Conclusion: The results of this study suggest that the core and abdominal muscles strengthening exercises increased the tibialis anterior muscle activity. It is expected to help make more balance ability that affect who has abdominal muscles weakness.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.162-165
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• 2014

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.

• Physical Therapy Korea
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• v.8 no.3
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• pp.97-105
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• 2001

The purpose of this study was to investigate the effect of functional strengthening exercise on static and dynamic standing balance in a child with cerebral palsy. The subject was a 7 year old boy with diplegia whose Gross Motor Function Measure (GMFM) score was 80% along with G1 of the lower extremities in Modified Ashworth Scale. The subject was ambulatory with some degree of limitation and demonstrated muscle weakness and strength asymmetry in the lower extremities. A changing criterion design for a single-subject research was used for this study. The functional strengthening exercise consisted of lower extremity ergometer exercise and knee exercise with grading movement in standing position, each for 20 minutes, which lasted 18 sessions for 6 weeks. A knee extensor strength test on both extremities and standing balance test were conducted after each functional strengthening exercise. Two types of standing balance were tested: one leg stance test and functional reach test. One leg stance test was to evaluate static standing balance, and functional reach test was to evaluate dynamic standing balance. The results showed that the functional strengthening exercise had some positive effects on improvement of both static and dynamic standing balance, and there was a positive correlation between the knee strength and standing balance.

• Annals of Clinical Neurophysiology
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• v.10 no.2
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• pp.109-111
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• 2008

Ossification of the ligamentum flavum (OLF) usually occurs in the lower thoracic spine, and is rare in the cervical region. We report the case of a 67-year-old woman who presented a seven month's history of progressive weakness and paresthesia in her right upper extremity. MRI and CT scans of the spine revealed the presence of ossified ligamentum flavum from C3-C4. A cervical laminectomy resulted in a good post-operative improvement of muscle strength.

• Investigative Magnetic Resonance Imaging
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• v.24 no.1
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• pp.46-50
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• 2020

Radiation-induced lumbosacral plexopathy (RILSP) is an uncommon complication of pelvic radiotherapy that can result in different degrees of sensory and motor deficits. An age 59 female with cervical cancer, who had received combined chemotherapy and radiation therapy two years before, presented with bilaterally symmetric lower-extremity weakness and tingling sensation. The magnetic resonance imaging showed diffuse T2 bright signal intensity and mild enhancement along the bilateral lumbosacral plexus with no space-occupying masses. RILSP was diagnosed after the exclusion of malignant and inflammatory plexopathies.

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.84-87
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• 2008

Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

• Annals of Clinical Neurophysiology
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• v.19 no.2
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• pp.148-150
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• 2017

Peripheral neuropathy associated with hyper-IgE-emia have been rarely reported. Here we present a 72-year-old man with acute motor axonal neuropathy who had relatively poor prognosis. The serum was weakly positive for IgG GQ1b and GT1a, and serum IgE was significantly elevated. He was transferred to a rehabilitation center with Medical Research Council grade 3 lower extremity weakness on admission day 65. We would suggest that hyper-IgE-emia may increase the magnitude and rate of neural damage in this case.