• Title/Summary/Keyword: Motor disorder

Search Result 315, Processing Time 0.026 seconds

Idiopathic Hypertrophic Spinal Pachymeningitis with an Osteolytic Lesion

  • Jee, Tae Keun;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
    • /
    • v.56 no.2
    • /
    • pp.162-165
    • /
    • 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.

A Case of Acute Disseminated Encephalomyelitis by Enterovirus 71 (Enterovirus 71에 의한 급성 파종성 뇌척수염 1례)

  • Hwang, Hui Sung;Cho, Sung Hee;Kim, Sun Mi;Jung, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Pediatric Infection and Vaccine
    • /
    • v.10 no.1
    • /
    • pp.114-122
    • /
    • 2003
  • Acute transverse myelitis is a focal inflammatory disorder of the spinal cord, resulting in motor, sensory, and autonomic dysfunction which would be the initial manifestation of acute disseminated encephalomyelitis. A 7-year-old boy developed weakness of lower extremities associated with dizziness and urinary dysfunction after upper respiratory infection. He showed gradual decreased mental status with respiratory difficulty. Spinal MRI showed diffuse spinal cord swelling from C3 to C7 levels with high signal intensity lesion on T2-weighted image, which is involved central gray matter of spinal cord from C3 to C7, proximal portion to cervicomedullary junction, and distal portion to the cornus medullaris. After the supplement of high dose intravenous methylprednisolone therapy with ventilator care, he showed gradual improvement. The brain MRI after extubation showed multifocal high signal intensity lesions in bilateral cerebral white matter on axial T2-weighted image. Immunoserologic test(neutral antibody test) for enterovirus 71 was positive. Dysfunction of the bladder lasted for 33 days. We report a case of transverse myelitis which progressed to acute disseminated encephalomyelitis by enterovirus 71 in a 7-year-old boy with related literatures.

  • PDF

A Case of Acute Idiopathic Longitudinal Myelitis Showing Rapid Improvement to Steroid Therapy (스테로이드 치료에 의해 빠르게 호전된 특발성 급성 종단성 척수염 1예)

  • Kang, Sung-Won;Cheong, Jin-Sung;Kang, Hyun-Gu;Jeong, Ju-Li;Kim, Soo-Sung;Han, Sun-Jung;Lee, Sung-Ik;Yang, Hyun-Duk;Son, Il-Hong
    • Annals of Clinical Neurophysiology
    • /
    • v.11 no.2
    • /
    • pp.64-66
    • /
    • 2009
  • Acute longitudinal myelitis is a group of disorder characterized by multifocal, long-segmented inflammation of the spinal cord, rapidly evolving paraparesis, a sensory level on the trunk, and bilateral Babinski signs. We report a case of 30-year-old man with longitudinal myelitis extending to long segment of spinal cord. After 15 days of aggressive treatment with intravenous pulsed methylprednisolone for 5 days, motor and sensory functions of the lower extremities were almost recovered.

  • PDF

A Case of Cauda Equina Syndrome in Early-Onset Chronic Inflammatory Demyelinating Polyneuropathy Clinically Similar to Charcot-Marie-Tooth Disease Type 1

  • Lee, Seung Eun;Park, Seung Won;Ha, Sam Yeol;Nam, Taek Kyun
    • Journal of Korean Neurosurgical Society
    • /
    • v.55 no.6
    • /
    • pp.370-374
    • /
    • 2014
  • To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation. He had had musculoskeletal deformities, such as hammertoes and pes cavus, since age 10. Lumbar spine magnetic resonance imaging showed diffuse thickening of the cauda equina. Electrophysiological testing showed increased distal latency, conduction blocks, temporal dispersion, and severe nerve conduction velocity slowing (3 m/s). We were not able to find genetic mutations at the PMP 22, MPZ, PRX, and EGR2 genes. The pathologic findings of the sural nerve biopsy revealed thinly myelinated nerve fibers with Schwann cells proliferation. We performed a decompressive laminectomy, intravenous IgG (IV-IgG) and oral steroid. At 1 week after surgery, most of his symptoms showed marked improvements except foot deformities. There was no relapse or aggravation of disease for 3 years. We diagnosed the case as an early-onset CIDP with cauda equine syndrome, whose initial clinical findings were similar to those of CMT1, and successfully managed with decompressive laminectomy, IV-IgG and oral steroid.

The Effects of Kinesio-Taping of Lower Limbs on Muscle Activity for Taekwondo Athletes (키네시오 테이핑이 태권도 선수의 하지 근활성도에 미치는 영향)

  • Yang, Dae-Jung;Choi, Eun-Young;Park, Dong-Soo;Park, Seung-Kyu
    • Journal of the Korean Academy of Clinical Electrophysiology
    • /
    • v.9 no.1
    • /
    • pp.35-39
    • /
    • 2011
  • Purpose : The purpose of this study was to determine changes in muscle activity due to elastic taping at the rectus femoris, biceps femoris and tibialis anterior muscles using surface electromyography analysis. Methods : In this study 10 healthy university students in the Department of Taekwondo Studies were screened and individuals with a history of previous injury or surgery to their nerve, muscle, and skeletal systems, such as paresthesia and motor disorder, were excluded. Subjects were taped over the rectus femoris, biceps femoris, and tibialis anterior and their muscle activities were analyzed using the surface electromyography method during maximal voluntary isometric contraction. Results : The results of this study were as follows: muscle activities indicated a significant increase after elastic taping than before at the rectus femoris, biceps femoris, and tibialis anterior muscle. These results lead us to the conclusion that muscle activity were influenced by elastic taping at the rectus femoris, biceps femoris, and tibialis anterior muscles. Conclusion : The results of this study show that muscle activity can be improved by elastic taping at the lower limbs. These results suggest that elastic taping of muscles in the lower extremities has the capability to increase muscle activity in the body.

Analysis of Spinal Stability Affected by Working Height, Safety Handrail and Work Experience in Using Movable Scaffold (이동식 틀비계 사용 작업 시 작업대 높이, 안전난간 유무, 숙련도에 따른 척추 안정성 분석)

  • Kim, Jung-Yong;Min, Seung-Nam;Sung, Si-Hoon
    • Journal of the Ergonomics Society of Korea
    • /
    • v.29 no.3
    • /
    • pp.347-356
    • /
    • 2010
  • The purpose of this study is to analyze the spine stability by comparing muscle activation in various scaffold working conditions. The independent working conditions were designed by two levels of working height, existence and absence of safety handrail, and the two levels of expertise. The corresponding activities of the agonist and antagonist muscles of spine were simultaneously recorded by using EMG. As results, novice worker showed increased muscle activity while doing the task on the 2nd floor, absence of handrail. And expert showed the increase of co-contraction while working on the 2nd floor without handrail. Such co-contraction was found to increase the spine stability when the working condition become risky. On the other hand, the co-contraction was prolonged, the spine muscle fatique and disc pressure could be increased, which would increase the risk of musculo-skeletal disorder. The results of co-contraction in this study indicates that the motor control system responds to maintain the stability of the spine particularly when workers cognitively recognize the danger of falling or imbalance. This study also quantitatively accounted for the biomechanical cause of LBP among workers who has to prevent themselves from falling. Therefore, if can be said that safe environment preventing falling can also prevent workers from MSDs as well. Such knowledge can be applied to design ergonomic workplace environment as well as movable scaffold.

Polarity discrimination of stator windings for 3 phase induction motors by using DC differential signals between mutual inductive voltages (유도기전력의 차동신호를 이용한 3상유도전동기 고정자 권선의 극성판별)

  • Choi, Soon-Man
    • Journal of Advanced Marine Engineering and Technology
    • /
    • v.38 no.9
    • /
    • pp.1141-1145
    • /
    • 2014
  • When the stator windings of 3 phase induction motors are in wrong condition, the mutual inductive responses between windings can be utilized for the purpose of diagnosing motors in that fault windings affect even the responses by DC excitation. Three phase induction motors are supposed to generate consistent inductive voltages at the remaining windings when exciting DC current is given to one of 3 windings, while the inconsistence of their voltages indicates the existence of disorder at electric motors. This study describes how the exciting current to one of three windings cause the other windings to create induced voltages, analyzing responses by transfer functions, and discloses whether or not the balance relation at two windings is normal in the way of measuring the differential voltage of their outputs. For experiment, common analog multi-testers is used for applying exciting current and measuring the output signal to confirm whether the proposed method is useful enough to be able to discriminate wrong polarities of windings onboard vessels including also the case of exciting current by AC.

Chattering Free Sliding Mode Control of Upper-limb Rehabilitation Robot with Handling Subject and Model Uncertainties (환자와 로봇의 모델 불확도를 고려한 상지재활로봇의 채터링 없는 슬라이딩 모드 제어)

  • Khan, Abdul Manan;Yun, Deok-Won;Han, Changsoo
    • Journal of Institute of Control, Robotics and Systems
    • /
    • v.21 no.5
    • /
    • pp.421-426
    • /
    • 2015
  • Need to develop human body's posture supervised robots, gave the push to researchers to think over dexterous design of exoskeleton robots. It requires to develop quantitative techniques to assess human motor function and generate the command to assist in compliance with complex human motion. Upper limb rehabilitation robots, are one of those robots. These robots are used for the rehabilitation of patients having movement disorder due to spinal or brain injuries. One aspect that must be fulfilled by these robots, is to cope with uncertainties due to different patients, without significantly degrading the performance. In this paper, we propose chattering free sliding mode control technique for this purpose. This control technique is not only able to handle matched uncertainties due to different patients but also for unmatched as well. Using this technique, patients feel active assistance as they deviate from the desired trajectory. Proposed methodology is implemented on seven degrees of freedom (DOF) upper limb rehabilitation robot. In this robot, shoulder and elbow joints are powered by electric motors while rest of the joints are kept passive. Due to these active joints, robot is able to move in sagittal plane only while abduction and adduction motion in shoulder joint is kept passive. Exoskeleton performance is evaluated experimentally by a neurologically intact subjects while varying the mass properties. Results show effectiveness of proposed control methodology for the given scenario even having 20 % uncertain parameters in system modeling.

A Case of Krabbe Disease with Infantile Spasm (영아 연축을 동반한 Krabbe병 1례)

  • Kim, Ja Kyoung;Kim, Dal Hyun;Kang, Bo Young;Kwon, Young Se;Hong, Young Jin;Son, Byong Kwan;Yoon, Hye Ran
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.1
    • /
    • pp.95-99
    • /
    • 2003
  • Krabbe disease is a rare autosomal recessive disorder clinically characterized by retardation in motor development, prominent spasticity, seizures, and optic atrophy. Pathologically, there are many globoid cells in the white matter, in addition to the lack of myelin and the presence of severe gliosis. Hence Krabbe disease is known as globoid cell leukodystrophy. Biochemically, the primary enzymatic deficiency in Krabbe disease is galactocerebroside beta-galactosidase. Patients with Krabbe disease can be subdivided into the early-onset type and late-onset type, according to the onset of clinical manifestations. Most patients with early-onset type die before their second birthday. We describe a girl with Krabbe disease associated with uncontrolled seizures, which was confirmed with biochemical study and MRI. The clinical findings of this patient included hyperirritability, scissoring of the legs, flexion of arm, and clenching of the fists, and generalized tonic seizures. EEG showed hypsarrhythmia, and MRI demonstrated degenerative white matter changes in bilateral periventricular white matter, posterior rim of internal capsule, basal ganglia and brain stem on T2W1 and FLAIR image. The diagnosis was based on clinical features of progressive neurologic deterioration in conjunction with low galactocerebroside beta-galactosidase activity.

A Study on Diagnosis of the Bianque's School (편작학파(扁鵲學派)의 진단(診斷)에 관한(關) 연구(硏究))

  • Kim, Seong-ho;Bang, Min-woo;Lee, Byung-wook;Kim, Ki-woo
    • Journal of Korean Medical classics
    • /
    • v.31 no.3
    • /
    • pp.33-58
    • /
    • 2018
  • Objectives : Literatures related to Bianque are studied to discover the path of development and the impact of Bianque school's pulse diagnosis system. Methods : Texts regarding Bianque were searched in history books such as Shiji and Zhanguoce, and medical texts such as the medical books of Mawangdui Han Tomb, Huangdineijng, Maijing, and Qianjinyifang to understand how the Bianque school's pulse diagnosis system was developed. Results : 1. Bianque school's pulse diagnosis system was used to inspect the distribution pattern of blood vessels and discover the location of the disease including the palpatation realm such as only hard or only fall. 2. The system of inspection was created when the diagnosis method that uses the color of the pulse by using the color of blood vessels was added to the diagnostic method of pulse condition. 3. Adding the concept of pulse to the visual information that derives from pulse condition becomes pulsation. This is a diagnostic method that falls under the realm of palpation, and it was used to discover the location of disease. 4. The qi of pulse is motor that induces pulse, and this concept is used in order to understand how normal and abnormal pulsations appear, and to treat the circulation disorder of qi and blood. 5. Cubit skin examination is a method that comprehensively take into account the upper arm skin's cold and heat, slippery and roughness, and relax and tension state. This method was used together with other diagnostic methods. As described above, it seems that the diagnostic method with blood vessels used by Bianque school seems to have developed from Bianque's special inspection ability to the stage where it uses palpation, and then to the stage of cubit skin examination which uses both palpation and inspection.