• Clinical and Experimental Pediatrics
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• 제54권1호
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• pp.40-44
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• 2011

We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI) showed acute infarction of the middle cerebral artery (MCA) territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT) showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) of white matter tract, visualization was possible.

• 동의생리병리학회지
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• 제22권1호
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• pp.246-251
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• 2008

Syringomyelia is a rare disorder that causes a cyst to form in spinal cord. This cyst, called a syrinx, can damage to the spinal cord and cause symptoms such as motor weakness, pain, sensory disturbance, etc. We experienced a case of tactile hypesthesia suspecting syringomyelia in 16 year old male patient. Syringomyelia in T2/3 level was diagnosed by magnetic resonance imaging. Hypesthesia was similar to mamokbulin in oriental medicine. And we assumed these symptoms induced by conditions called kiheo in analyzing patient's symptoms and signs. We treated the patient by acupuncture, herbal medicine improving kiheo, and other methods. In the result, the symptoms had withdrawn. This case suggested possibility to treat syringomyelia in oriental medicine, but single case is insufficient for evidence.

• The Korean Journal of Pain
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• 제20권2호
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• pp.246-250
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• 2007

We report here on a case of right side spasmodic torticollis (ST) that was refractory to botulinum toxin type A injection and medication. The patient finally underwent a selective ramisectomy with ipsilateral sternocleidomastoid muscle (SCM) resection, but the remaining symptoms slowly aggravated, and a contralateral left side SCM spasm began. As conservative therapy for reducing the spasmodic symptoms, accessory nerve block, upper cervical plexus block and stellate ganglion block were performed twice in a week. After 6 months, the spasmodic symptoms significantly decreased. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) decreased by more than 70%. After one year of serial intermittent local anesthetic blockade therapy, the patient became almost free from the original ST symptoms (TWSTRS = 1). Serial local anesthetic interventions for the ST patient may have a beneficial role on the pathological peripherocentral neural activity of the ST patient and can modulate motor-sensory integration in the patient.

• 혜화의학회지
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• 제27권2호
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• pp.21-29
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• 2018

Objectives : The purpose of this study was to report the effect of Korean medical treatment on left basal ganglia infarction. Methods : We performed acupuncture and administered herbal medicine to one patient to alleviate symptoms of hemiplegia such as motor disorder, facial palsy, and dysarthria. Manual Muscle Test(MMT), Hand Grip Test(HGT), Gait Level(GL), and Dysarthria grade were used to evaluate status of the patient. Results & Conclusions : The results of this research showed that overall symptoms of hemiplegia in the patient were improved. According to the results, the Korean medical treatment is considered to be effective on patients of left basal ganglia infarction to treat symptoms of hemiplegia. Further studies with larger sample sizes are needed to examine this issue.

• Annals of Clinical Neurophysiology
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• 제6권2호
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• pp.85-91
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• 2004

Background: Needle electromyography (EMG) and motor evoked potential (MEP) of the genioglossus (tongue) are difficult to perform in evaluations of the craniobulbar region in amyotrophic lateral sclerosis (ALS). Therefore, we investigated the yields of needle EMG and MEP recorded from the upper trapezius, since it receives innervation from the lower medulla and upper cervical cord. Methods: Needle EMG and MEP of the upper trapezius were obtained in 17 consecutive ALS patients. The needle EMG parameters recorded included abnormal spontaneous activity and motor unit action potential (MUAP) morphology. An upper motor neuron (UMN) lesion was presumed when either response to cortical stimulation was absent, or the central conduction time was delayed (>mean+2SD). Results: Of the five patients with bulbar-onset ALS, four had abnormalities in the upper trapezius and four in the tongue by needle EMG. In contrast, of the 12 patients with limb-onset ALS, 11 had abnormalities in the upper trapezius, and only five in the tongue. When MEP was performed, it was found that three of the five patients with bulbar symptoms and three of the six patients with isolated limb involvement had abnormal MEP findings. Conclusions: Electrophysiological studies of the upper trapezius are more sensitive those of the tongue in patients without bulbar symptoms. Thus, needle EMG and MEP of the upper trapezius are alternative tools for assessing bulbar and rostral neuraxial involvement in the diagnosis of ALS.

• 대한한방내과학회지
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• 제28권4호
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• pp.937-947
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• 2007

Amyotrophic lateral sclerosis (ALS) is a progressive disorder that causes degeneration of motor neurons of the brain and spinal cord. ALS is a progressive, fatal neuromuscular disease characterized by loss of motor neurons leading to muscle weakness. Sensation and mental function stay intact during the course of the disease. ALS is characterized by both upper and lower motor neuron damage. Diagnosis includes magnetic response imaging (MRI) electromyogram (EMG), muscle biopsy, and blood test. There is no cure for ALS. We recently observed three cases of ALS. The patients were diagnosis with ALS by EMG and symptoms. This report was conducted to evaluate how oriental medical treatment can affect ALS. We report the change of their symptoms through oriental medical treatment compared with taking riluzole.

• 대한예방한의학회지
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• 제16권2호
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• pp.17-30
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• 2012

Objectives : This study was to analyse the reasons for the early termination of our clinical trials that were to know the influences of Tai-chi on non-motor symptoms of Parkinson's disease. Methods : We stopped the primary study of Tai-chi to observe the changes of non-motor symptoms of Parkinson's disease. So we carried out the survey to our participants of clinical trials. We conducted the survey about the patient's characteristics of usual exercise, experience of Tai-chi, appropriate time allocation, difficulties of proceeding the program and patient's opinion for the improvement of education. And the 4 questions about the contributiveness of Tai-chi for the Parkinson's disease, usability of supplied references, difficulties and time allocation of education were using the questionaries form of 5-point scale(Likert scale). Results : The results of survey showed that the benefits of Tai-chi program for the improvement of symptoms was $3.15{\pm}0.89$ and difficulty of lecture was $3.76{\pm}1.09$. 41% of participants answered that the motions of the Tai-chi is difficult to follow and 17% of participants felt the imbalance during the motion of Tai-chi. Conclusions : Participants replied that the Tai-chi is hard for the patients of Parkinson's disease and the time for the education was too short to keep doing exercise. Thus we have plan to educate the patients of Parkinson's disease with Tai-chi program consists of easier motion by developing ourselves or searching previous studies.

• 정신신체의학
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• 제12권2호
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• pp.103-121
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• 2004

감각 및 운동 이상 증상을 동반하면서 꾀병이 의심되는 환자를 가려내는 방법에 대해서 약술하고 몇 개의 증례를 예시하였다. 꾀병을 규명하기 위해서는 우선 전환 장애, 가장성 장애를 차례로 증명하여 제외시켜야 한다. 이를 위한 방법으로는 자세한 병력 수집과 조사, 면밀한 신경학적 검사, 심리검사, 장시간의 면담 그리고 광범위한 행동 관찰이 필요하다. 그러나 증상 형성의 동기나 의도의 본질을 파악하기란 어려워서 환자의 고백에 의해 알게되는 경우도 있다. 신경 심리검사를 포함한 임상심리 검사를 통하여 꾀병의 가능성을 가려내고, 질병행동 특성을 파악하거나 기계적인 측정도구를 이용하기도 한다. 그러나 아직 객관적으로 타당한 검사 방법은 부족하다. 최근, 통증 차단제를 이용한 진성(眞性) 통증 구별법은 객관적인 검사법의 하나이다. 사고나 보상 문제가 겹친 만성 통증 환자는 꾀병의 가능성이 엿보인다 하더라도 많은 수에서 시간 경과와 환경의 영향으로 인해서 정신사회적 합병증을 동반한다. 향후 임상 심리검사법이 발달되고 행동과 의도성에 관한 뇌 기능의 연구론 통해 신체 증상이나 행위의 진실성에 대한 구별력은 더욱 향상될 것이다.

• 한국융합학회논문지
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• 제11권7호
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• pp.59-71
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• 2020

본 연구는 비전테라피가 시각 문제를 가지고 있는 ADHD 경향 아동의 증상과 시지각 기술을 향상시키는지 알아보고자 한다. 본 연구의 대상자는 ADHD 경향이 있는 아동 중 시각적인 문제를 가지고 있는 아동 10명이다. 비전테라피 전·후로 시각 기능 검사, 시지각 운동협응 검사, 시지각 기술 검사, ADHD 평가척도 검사를 실시하였다. 비전테라피는 주 2회, 6개월~1년 동안 실시되었다. 비전테라피 후에 대상자 모두 시각기능의 시력, 입체시, 버전스 범위, 폭주 근점에서 정상 범위에 도달했으며, 시각 기능과 시지각 기술이 향상되었고 ADHD 증상에 대한 점수가 낮아진 것으로 나타났다. 따라서, 비전테라피가 ADHD 경향을 가진 아동들의 증상과 시지각을 개선하고 시각문제를 해결하는데 활용될 수 있는 것으로 보인다.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.143-146
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• 2001

Background : Backpack palsy was described in military personnel with shoulder girdle and proximal upper extremity symptoms, predominantly motor in nature related to the use of heavy backpack. Currently, backpack were used for sports, transporting school books and child carriers. We evaluated clinical and electrophysiological feature of backpack palsy. Methods : We included 11 patients with brachial plexopathy as a result of wearing a heavy backpack on long distance marches. All patients were done routine blood sampling, chest X-ray, C-spine X-ray and electrophysiological studies. Results : All patients were right handed person and were not as having a thoracic outlet syndrome. Sensory changes were main initial symptoms and major persistent symptoms were motor weakness. 9 patients(81.8%) were damaged the brachial plexus on non-dominant side, 1 patient was dominant and 1 patient was bilateral involvement. 10 patients(90.9%) were damaged to upper trunk of the brachial plexus by EMG findings. The prognosis was good, 10 patients(90.9%) were complete recovery during 8 weeks, 1 patient was developed reflex sympathetic dystrophy confirmed by 3-phase bone scan. Conclusions : Depression of the clavicle and costoclavicular space probably plays a certain role in pathogenic mechanism. The non-dominant side is more frequently affected, probably due to underdevelopment of the musculature in that side.