• Title/Summary/Keyword: Motor paralysis

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Analyzing clinical and genetic aspects of axonal Charcot-Marie-Tooth disease

  • Kwon, Hye Mi;Choi, Byung-Ok
    • Journal of Genetic Medicine
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    • v.18 no.2
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    • pp.83-93
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is the most common hereditary motor and sensory peripheral neuropathy. CMT is usually classified into two categories based on pathology: demyelinating CMT type 1 (CMT1) and axonal CMT type 2 (CMT2) neuropathy. CMT1 can be distinguished by assessing the median motor nerve conduction velocity as greater than 38 m/s. The main clinical features of axonal CMT2 neuropathy are distal muscle weakness and loss of sensory and areflexia. In addition, they showed unusual clinical features, including delayed development, hearing loss, pyramidal signs, vocal cord paralysis, optic atrophy, and abnormal pupillary reactions. Recently, customized treatments for genetic diseases have been developed, and pregnancy diagnosis can enable the birth of a normal child when the causative gene mutation is found in CMT2. Therefore, accurate diagnosis based on genotype/phenotypic correlations is becoming more important. In this review, we describe the latest findings on the phenotypic characteristics of axonal CMT2 neuropathy. We hope that this review will be useful for clinicians in regard to the diagnosis and treatment of CMT.

Characteristics of Gait and Motor Function Recovery in Quadriplegia Patients with Cerebellar Injury (소뇌 손상에 의한 사지 마비 환자의 보행 및 운동 기능 회복 양상 연구)

  • Sang-Seok Yeo
    • PNF and Movement
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    • v.21 no.3
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    • pp.327-335
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    • 2023
  • Purpose: Cerebellar injury can be caused by a variety of factors, including trauma, stroke, and tumor. Cerebellar injury can manifest in different clinical symptoms and signs depending on the size and location of the injury. The purpose of this study was to examine and compare the recovery patterns of each motor function by tracking the motor levels of patients with cerebellar injury. Methods: This study recruited 11 patients with quadriplegia resulting from cerebellar injury. The motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) methods were used to evaluate motor levels. The motor function evaluation was performed immediately after the onset of the condition and at intervals of one month, two months, and six months after onset. Results: The MI values of the upper and lower extremities and hand function (MBC) indicated severe paralysis in the early stages of onset. Compared to the onset time, significant motor function recovery was observed after 1, 2, and 6 months (p < 0.05). In contrast, there was no significant pattern of recovery between 1, 2, and 6 months after onset (p > 0.05). FAC indicated showed significant recovery at one month compared to onset (p<0.05), and there was also a significant difference between 1 and 2 months (p < 0.05). On the other hand, there was no significant difference in FAC between 2 and 6 months (p > 0.05). Conclusion: Patients with cerebellar injury showed significant recovery in functions related to muscle strength and voluntary muscle control one month after onset and gradually recovered further over the next six months. On the other hand, gait function, which is closely related to balance, showed a relatively slow recovery pattern from the beginning of the disease to the six month follow-up.

Consideration of the Son-Bal Jeorim in oriental and western medicine (손발저림의 원인(原因)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Park, Chi Young;Lim, Lark cheol;Kim, Young Il;Hong, Kwon Eui
    • Journal of Haehwa Medicine
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    • v.13 no.1
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    • pp.47-59
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    • 2004
  • Objectives & Methods: We investigated 28 books to study etiology and pathology of Son-Bal Jeorim. Result and Conclusion 1. The eiology of Son-Bal Jeorim is same as it of Bee Jeung(痺症). 2. Generally speaking, the cause of Bee Jeung was distributed Wind(風), Coldness(寒), Wetness (濕) of meridian. Bee Jeung can be devided into SilBi(實痺) and HeoBi(虛痺). In SilBi(實痺) there are PungHanSeupBi(風寒濕痺) and YeolBi(熱痺). In HeoBi(虛痺), there are GiHyeolHeoBi(氣血虛痺), EumheoBi(陰虛痺) and YangHeoBi(陽虛痺). 3. Son-Bal Jeorim belong to peripheral neuropathy in western medicine. 4. Syndrome of acute motor paralysis with variable disturbance of sensory and autonomic function, subacute sensorymotor paralysis, syndrome of chronic sensorimotor polyneuropathy, neuropathy with mitochondrial disease, syndrome of mononeuropathy or nerve plexusopathy. 5. Peripheral neuropathy is caused by carpal tunnel syndrome, diabetic neuropathy, uremic neuropathy, hepatic neuropathy, hypothyroid neuropathy, hyperthyroid neuropathy, neuropathy due to malnutrition, neuropathy due to toxic material, neuropathy due to drug, paraneoplastic neuropathy, hereditary neuropathy, etc. 6. Cerebral apoplexy, myelopathy, peripheral circulatory disturbance, anxiety syndrome cause symptoms of peripheral neuropathy

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Development of surface electrode type electrical stimulator or supporting walk function in foot drop patients (족하수 환자에서의 보행기능 보조를 위한 표피 자극형 전기자극기 개발)

  • Lim, S.K.;Jeong, H.C.;Kim, K.G.;Jin, D.B.;Park, B.R.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.11
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    • pp.9-13
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    • 1997
  • The present study was designed to develop the functional electrical stimulation system in order to restore motor function of paralytic patients. We attempt to establish adequate stimulus parameters for the recovery of work unction in lower limb paralysis patients and to develop the electrical stimulation system, which is effective to protect foot drop in these patients. In our animal and human experiment, adequate stimulus condition for surface electrode on the lower limb were 0.2-0.3ms at the duration and 50 Hz, which contain 600Hz train pulse. This parameter has efficiently prevented the foot drop from lower limb paralysis, decreased muscle fatigue and induced powerful contraction of lower limb muscle.

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Masseter nerve-based facial palsy reconstruction

  • Park, Hojin;Jeong, Seong Su;Oh, Tae Suk
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.337-344
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    • 2020
  • Facial paralysis is a devastating disease, the treatment of which is challenging. The use of the masseteric nerve in facial reanimation has become increasingly popular and has been applied to an expanded range of clinical scenarios. However, appropriate selection of the motor nerve and reanimation method is vital for successful facial reanimation. In this literature review on facial reanimation and the masseter nerve, we summarize and compare various reanimation methods using the masseter nerve. The masseter nerve can be used for direct coaptation with the paralyzed facial nerve for temporary motor input during cross-facial nerve graft regeneration and for double innervation with the contralateral facial nerve. The masseter nerve is favorable because of its proximity to the facial nerve, limited donor site morbidity, and rapid functional recovery. Masseter nerve transfer usually leads to improved symmetry and oral commissure excursion due to robust motor input. However, the lack of a spontaneous, effortless smile is a significant concern with the use of the masseter nerve. A thorough understanding of the advantages and disadvantages of the use of the masseter nerve, along with careful patient selection, can expand its use in clinical scenarios and improve the outcomes of facial reanimation surgery.

Loss of hsp70.1 Decreases Functional Motor Recovery after Spinal Cord Injury in Mice

  • Kim, Hyun-Jeong;Jung, Ji-In;Kim, Young-Kyung;Lee, Jae-Seon;Yoon, Young-Wook;Kim, June-Sun
    • The Korean Journal of Physiology and Pharmacology
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    • v.14 no.3
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    • pp.157-161
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    • 2010
  • Heat shock proteins (HSPs) are specifically induced by various forms of stress. Hsp70.1, a member of the hsp70 family is known to play an important role in cytoprotection from stressful insults. However, the functional role of Hsp70 in motor function after spinal cord injury (SCI) is still unclear. To study the role of hsp70.1 in motor recovery following SCI, we assessed locomotor function in hsp70.1 knockout (KO) mice and their wild-type (WT) mice via the Basso, Beattie and Bresnahan (BBB) locomotor rating scale, before and after spinal hemisection at T13 level. We also examined lesion size in the spinal cord using Luxol fast blue/cresyl violet staining. One day after injury, KO and WT mice showed no significant difference in the motor function due to complete paralysis following spinal hemisection. However, when it compared to WT mice, KO mice had significantly delayed and decreased functional outcomes from 4 days up to 21 days after SCI. KO mice also showed significantly greater lesion size in the spinal cord than WT mice showed at 21 days after spinal hemisection. These results suggest that Hsp70 has a protective effect against traumatic SCI and the manipulation of the hsp70.1 gene may help improve the recovery of motor function, thereby enhancing neuroprotection after SCI.

A Clinical Study of Facial Paralysis (안명신경 손상 환자의 임상적 고찰)

  • Huh, Choon-Bok;Suh, Tae-Soo
    • Journal of Korean Physical Therapy Science
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    • v.5 no.3
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    • pp.643-650
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    • 1998
  • Facial nerve is subject to injury at any point in the course from the cerebral cortex to the motor end plate in the face, so many etiologic varieties of facial paralysis may be encountered, including trauma, viral infection and the idiopathic. Authors have studied 39 cases of facial paralysis which had experienced of treatment in our department from March, 1996 to March, 1997 at Dong San Medical Center. The results obtained are as follows : 1) The highest age incidence showed 10 cases(24.6%) in 3rd decade 2) Among the total of 39 cases, male were 21 cases(53.8%) and female were 18cases(46.2%). 3) At the involved side, left side were 19 cases(48.7%) and right side were 18 cases(46.2%). 4) The causes of facial paralysis were; idiopathic (Bell's palsy) in 19 cases(48.7%) infectious in 6 cases(15.4%) neoplastic in 6 cases(15.4%) traumatic in 5 cases(12.9%) metabolic in 2 cases(5.1%) congenital in 1 cases(2.6%) 5) In time interval between onset of symptom and treated initial date, 26 cases(66.7%) in below 10 days and 8 cases(20.5%) in 11-20 days 6) Correlation of recovery rate according to the treated duration did not differ significantly 7)Result after treatment were satisfactory

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Facial Motor Evoked Potential Techniques and Functional Prediction during Cerebello-pontine Angle Surgery (소뇌교각 수술 중에 안면운동유발전위의 검사방법과 기능적 예측인자)

  • Baek, Jae-Seung;Park, Sang-Ku;Kim, Dong-Jun;Park, Chan-Woo;Lim, Sung-Hyuk;Lee, Jang Ho;Cho, Young-Kuk
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.470-476
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    • 2018
  • Facial motor evoked potential (FMEP) by multi-pulse transcranial electrical stimulation (mpTES) can complement free-running electromyography (EMG) and direct facial nerve stimulation to predict the functional integrity of the facial nerve during cerebello-pontine angle (CPA) tumor surgery. The purpose of this paper is to examine the standardized test methods and the usefulness of FMEP as a predictor of facial nerve function and to minimize the incidence of facial paralysis as an aftereffect of surgery. TES was delivered through electrode Mz (cathode) - M3/M4 (anode), and extracranially direct distal facial muscle excitation was excluded by the absence of single pulse response (SPR) and by longer onset latency (more than 10 ms). FMEP from the orbicularis oris (o.oris) and the mentalis muscle simultaneously can improve the accuracy and success rate compared with FMEP from the o.oris alone. Using the methods described, we can effectively predict facial nerve outcomes immediately after surgery with a reduction of more than 50% of FMEP amplitude as a warning criterion. In conclusion, along with free-running EMG and direct facial nerve stimulation, FMEP is a useful method to reduce the incidence of facial paralysis as a sequela during CPA tumor surgery.

A Case of Amyotrophic Lateral Sclerosis (근위축성 측삭 경화증 1예)

  • Lee, Beom-Jun;Jeon, Jin-Hee;Lew, Jae-Hwan;Kim, Tae-Yun
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.661-665
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    • 2000
  • Amyotrophic Lateral Sclerosis(ALS) is a fatal neuromuscular disease characterized by progressive muscle weakness resulting in paralysis. ALS is characterized by both upper and lower motor neuron damage. Diagnostic tests include magnetic resonance imaging(MRI) electromyogram(EMG), muscle biopsy, and blood tests. In order for a definitive diagnosis of ALS to be made, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We recently experienced one case of ALS, The patients was diagnosed as ALS by EMG and Symptoms. We diagnosed her as Wea jeung and treated by Herbal-medication based on the differentiation of symtoms. we report change of his symptoms through both western medical treatment and oriental medical treatment.

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2 Cases of Lower Limb Monoplegia due to Brain Cortical Infarction (대뇌 피질 경색으로 인한 하지 단마비 환자 한방치험 2례)

  • Shin, Jung-Ae;Son, Dong-Hyuk;Yu, Kyung-Suk;Lee, Jin-Goo;Lee, Young-Goo
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.263-269
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    • 2001
  • Monoplegia is the paralysis of either the upper or lower limb. Monoplegia is commonly caused by an injury to the cerebral cortex; it is rarely caused by an injury to the internal capsule, brain stem, or spinal cord. Most cerebral cortex is derived from the occlusion of a brain cortex blood vessel due to thrombus or embolus. According to motor homunculus, lower limb monoplegia occurs from limited damage to the most upper part of the primary motor area(Brodmann's area 4, located in precentral gyrus). Clinically, lower limb monoplegia due to brain cortical infarction is commonly misunderstood as monoplegia due to spinal injury because the lesion is situated at the most upper part of precentral gyrus. We had many difficulties in finding lesion on brain CT, but we diagnosed two patients correctly by using an MRI, who have lower limb monoplegia due to brain cortical infarction oriental treatment.

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