• Title/Summary/Keyword: Motor symptoms

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A Man Presenting with Sudden Weakness and Pain of the Right Hand, by Non-Small Cell Lung Cancer with Brain Metastases (비소세포폐암의 뇌전이로 인한 갑작스런 수부 통증 및 마비)

  • Sung, Won Jin;Hong, Bo Young;Kim, Joon Sung;Yoo, Jae Wan;Lim, Seong Hoon
    • Clinical Pain
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    • v.18 no.2
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    • pp.88-91
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    • 2019
  • Unexplained pain and weakness, i.e., without obvious predisposing factors, are often encountered by physiatrists and efforts should be made to determine the cause. A 63-year-old male presented with radiating pain in his right arm and mild weakness of the right hand. An electrodiagnostic examination revealed distal symmetric sensory polyneuropathy in the upper and lower extremities, and denervation potentials in the forearm muscles, which were inconsistent with the cervical spine MRI images and symptoms. A predisposing undiscovered disease was revealed, i.e., squamous cell carcinoma in the lung; brain metastasis affecting the left primary motor cortex was also detected. Therefore, we concluded that the pain and weakness were related to paraneoplastic syndrome and brain metastases of the hand knob. The observed denervation potentials were characterized as trans-synaptic changes in the brain metastasis. This case highlights the importance of unexplainable focal pain and weakness in the increasing prevalence of cancer.

A Case Report of Korean Medical Treatment on Atypical Parkinsonism Patient Complaining of Gait Disturbance Using 3-Demensional Gait Analysis System (3차원 보행분석기를 통해 보행장애의 호전이 확인된 비정형 파킨슨증후군 환자 한방치험 1례)

  • Hye-Min Heo;Kyeong-Hwa Lee;Kyeong-Hwa Heo;Ye-Chae Hwang;Seung-Yeon Cho;Jung-Mi Park;Chang-Nam Ko;Seong-Uk Park
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.24 no.1
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    • pp.13-24
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    • 2023
  • ■Objectives This case study is to report the effects of Korean medicine on parkinsonism patient's Gait Disturbance. ■Methods During 12 days of hospitalization, the patient was treated by acupuncture, pharmaco-acupuncture, moxibustion, herbal medicine, especially Cheongsimyeonjatang-gamibang. In order to assess the change of symptoms, we used a 3-Dimensional(3D) gait analysis system, Unified Parkinson's Disease Rating Scale(UPDRS), analysis of gait video and self-evaluation of discomfort. ■Results After treatment, The improvements of walking pattern were observed in both objective analysis results of gait analysis system and subjective video analysis. And the UPDRS score decreased, especially Part III score decreased more than minimal clinically important difference(MCID). In addition, There was improvement in self assessment of the patient. ■Conclusion This study suggests that Korean medical treatment might be effective in motor disorder of parkinsonism patient.

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Individualized Therapy to Manage Quadriplegic Spastic Cerebral Palsy with Unani Treatment Modalities

  • Fahmida Kousar;Arshiya Sultana;Shahzadi Sultana;Taseen Banu;Arfa Begum
    • CELLMED
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    • v.13 no.14
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    • pp.16.1-16.14
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    • 2023
  • Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

Dopamine Transporter Density Assessed with $[^{123}I]IPT$ SPECT Before and After Risperidone Treatment in Children with Tourette's Disorder (뚜렛 장애 아동에서 Risperidone 치료 전후 $[^{123}I]IPT$ SPECT로 측정한 기저 신경절 도파민 운반체 밀도)

  • Kim, Tae-Hoon;Ryu, Won-Gee;Park, Se-Young;Chi, Dae-Yoon;Choi, Tae-Hyun;Lee, Kyung-Yul;Cheon, Keun-Ah;Yun, Mi-Jin;Kim, Jai-Keun;Lee, Jong-Doo;Ryu, Young-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.1
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    • pp.41-51
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    • 2004
  • PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled $N-(3-iodopropen-2-yl)-2{\beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane$ ($[^{123}I]IPT$) single photon omission computed tomography (SPECT). MATERIALS and METHODS: $[^{123}I]IPT$ SPECT Imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of $[^{123}I]IPT$. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

Long-Term Results of Surgical Treatment for Sacral Chordoma (천추 척색종의 수술적 치료 후 장기 추시 결과)

  • Chung, Jae-Yoon;Lee, Jae-Joon;Seo, Hyoung-Yeon;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.148-154
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    • 2005
  • Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

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The Literatual Study on Pathologic Change Cognition to the Liver Disease (간장의 병리변화 인식에 대한 문헌적 고찰)

  • Lee Young Su;Kwack Jeong Jin;Lee Gang Nyoung;Choi Chang Won;Kim Hee Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.4
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    • pp.630-636
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    • 2002
  • After The Yellow Emperor's Canon of Internal Medicine, The text researches of pathologic change to the liver disease concluded the next, 1, The category of liver-disease(肝病) include the Symptoms of abnormality due to vital energy and blood motion, emotion and intention, muscular and reproductive function, and legions around descending liver channel. 2. In the theory that Liver-Yang energy(肝陽氣) is always overproducing, Liver-Yin blood(肝陰血) is always lacking, pathologic characteristics for liver disease is functional change of malfunction of the use of body(體用失調), So nourishing the liver and kidney is used for the principal aspects of a disease. regulating and calm the liver is used for the secondary aspects of a disease as the treatment plan, 3. If malfunctioning of the functions of dispersion and discharge(疏泄), Iiver-energy(肝氣) is becoming degected, So overproduct and overflow of ascent and exhalation of liver-yang(肝陽) is becoming blood are ascending following energy. complete usage of Yin-blood(陰血) is responsible for some kinds of mass formed by blood stasis in the early stage of pathogenesis of liver disease syndrome of the energy system as the progession of disease extravasated blood is forming. the pathologic characteristics is appeared loss of control of the vital energy and blood(體用失調) at the liver disease. 4. Sthenia-syndrome of liver(肝實證) and liver-heat syndrome(肝熱證) is appered that overproducing and overflow of dispersion(疏泄太過) and discharge is responsible for overfunctioning of liver disease or some kinds of heat syndrome such as liver fire(肝火), Sthenia of liver-yang(肝陽上亢), the syndromes of sthenic liver heat(肝實熱) are appered. deficiency of the liver(肝虛證) and cold syndrome of liver(肝寒證) is classified pathologic characteristics of cold and heat, deficiency and excess that regression of sensory, motor, mental due to lack of dispersion and discharge(疏泄不及), or intruding of the cold miasma, are degected. 5. The liver is close relation of physiologic function and internal organ such as spleen, stomach, lung, heart, kidney, gall bladder by the meridian channels, because of property of wind Zang, rapid progession is classified by phthologic charateristics.

Tethered Cord Syndrome; Surgical Indication, Technique and Outcome

  • Kang, Joon-Ki;Lee, Kwan-Sung;Jeun, Sin-Soo;Kang, Seok-Gu;Lee, Il-Woo;Yoon, Kang-Jun;Ha, Sang-Soo
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.77-82
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    • 2007
  • Objective : The authors tried to reveal some unique features of lipomeningomyelocele (LMMC), including clinical presentation, factors precipitating onset of symptoms, pathologic entities of LMMC associated with tethered cord syndrome, and surgical outcome in LMMC patients. Methods : Seventy-five patients with LMMC were enrolled in this study. Neuro-imaging and intraoperative findings allowed classification of LMMC into three Types. The patients were divided into two groups by age : A (51 patients), from birth to 3 years, and B (24 patients), from 3 to 24 years. For prevention of retethering of the cord, a mega-dural sac rebuilding procedure was performed in 15 patients. Results : During a mean postoperative follow-up period of 4 years, the surgical outcome was satisfactory in terms of improved pain and motor weakness, but disappointing with reference to the resolution of bowel and bladder dysfunction. Among these 75 patients with LMMC, preoperative deficits were improved after surgery in 29 (39%), remained stable in 28 (37%), changed slightly in 13 (17%), and worsened in 5 (7%). Patients in group A achieved better outcomes than those in group B. Depending on the type of lesion, patients with types I and II LMMC have better outcomes than those with type III LMMC. Finally, retethering of the cord with neurological deterioration occurred in 4 (5.3%) of the 75 patients, but no retethering was found in the 15 patients who were recently treated with a mega-dural sac rebuilding procedure. Conclusion : Our data continue to support the opinion that early diagnosis and optimal surgery are still essential for the treatment of patients with LMMC, since there is a high likelihood of residual neurological functions that can be preserved. Based on our surgical experience of untethering and decompression of lipomas, a mega-dural sac repair is useful to prevent retethering of the cord.

SYMPTOMS OF CHILDREN WITH RETT SYNDROME:A CASE REPORT (레트 증후군 환아의 제증상에 관한 증례보고)

  • Hwang, Jeong-Hwan;Lee, Kung-Ho;Choi, Yeong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.4
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    • pp.837-842
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    • 1998
  • Rett syndrome is a progressive neurological disorder that occurs exclusively in females. The syndrome is characterized by regression of language, motor development, and stereotypic hand movement. Autistic behavior, breathing irregularities, gait dyspraxia, scoliosis, and seizure are also accompanied. The cause of Rett syndrome is unknown, however, it is believed that the X-chromosome might playa significant role in the development of the syndrome. Patients with this syndrome have unusual oral and/or digital habits such as abnormal chewing pattern, bruxism, hypersalivation, micrognathia, high vaulted palate, tongue protrusion with lower posture of tongue, hand biting, digit-hand sucking. Dentists who are aware of distinct manifestations of Rett syndrome will be able to aid in early diagnosis and treatment of the syndrome. Prior to dental treatment for a patient with the Rett syndrome under sedation or general anesthesia, one should assess the degree of hypersalivation, apnea, severity of autism, expected life span. Early recognition of the syndrome and also dental treatment with established strict preventive guidelines for patients with the Rett syndrome may obviate the necessity of sedation or general anesthesia. Two cases with the Rett syndome were reported. Both patients had most of the above mentioned typical manifestations of the syndrome. Dental treatment for the case 1(8-year-old) including caries control, stainless steel crown, sealant application was performed under general anesthesia. The case 2 could not be undergone the dental treatment due to poor general conditions.

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'Clinical Observation on the 290 cases of Cerebrovascular Accident' (뇌졸중환자(腦卒中患者) 290례(例)에 대(對)한 임상(臨床) 고찰(考察) (III))

  • Kang, Kwan-Ho;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of Korean Medicine
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    • v.18 no.2
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    • pp.223-244
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    • 1997
  • Clinical observation was done on 290 cases of patients who were diagnosed as CVA with brain CT, TCD, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyung-Won University from 1st January to 31st December in 1996. 1. The cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, and transient ischemic attack. The most case of them was the cerebr진 infarction. 2. There is no significant difference in the frequency of strokes in male and female. And the frequency of strokes was highest in the aged over 50. 3. In cerebral infarction the most frequent lesion was the territory of middle cerebral artery, and in cerebral hemorrhage the most frequent lesion was the basal ganglia. 4. The most ordinary preceding disease was hypertension, and the next was diabetes. 5. The rate of recurrence was high in cerebral infarction. 6. The frequency of strokes seems to have no relation to the season. 7. The cerebral infarction occurred usually in resting and sleeping, and the cerebral hemorrhage in acting. 8. The course of entering hospital, most patients visited this hospital as soon as CVA occurred. And the half of patient visited this hospital within 2 days after CVA attack. 9. In the cases of patients who were unconscious at the admission, the prognosis was worse than that of the alert patients. 10. The common symptoms were motor disability and verbal disturbance. 11. The average duration of hospitalization was 27.4 days, and in case of cerebral hemorrhage the duration was prolonged. 12. The average time to start physical therapy was 13.3rd day after stroke in cerebral infarction and it was 19.9th day after stroke in cerebral hemorrhage. 13. The common complications were urinary tract infection, pneumonia, myocardial infarction and so on. 15. At the time of entering hospital, in most cases the blood pressure was high, but blood pressure was well controlled at the time of discharge. 16. Generally reported, hypercholesterolemia and hypertriglyceridemia are usually found in cerebral infarction. But in this study, they were found more frequently in cerebral hemorrhage than in infarction. 17, In the most cases, western and oriental medical treatments were given simultaneously. 18. In acute or subacute stage, the methods of smoothening the flow of KI(順氣), dispelling phlegm(祛痰), clearing away heat(淸熱) or purgation(瀉下) were frequently used. And in recovering stage, the methods of replenishing KI(補氣), tonifying the blood(補血) or tranquilization(安神) were frequently used.

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A Case Report : Hypersexuality and Obsessive-Compulsive Behaviors in a Stroke Patient with the Left Mesial Frontal Cortex and Both Basal Ganglia Lesion (좌측 정중 전두엽과 양측 기저절 경색 후 과잉성욕 증상과 강박 증상을 보인 환자 1례)

  • Kim, Se Joo;Kim, Young Shin;Choi, Nak Kyung;Lee, Byung-Chul;Lee, Man Hong
    • Korean Journal of Biological Psychiatry
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    • v.8 no.2
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    • pp.271-275
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    • 2001
  • Hyposexuality after stroke has been frequently observed, but hypersexuality as a sequela of stroke has not been commonly documented. We report a patient who exhibited hypersexuality and obsessive-compulsive behaviors after stroke in the region of the left mesial frontal cortex and both basal ganglia. At 2 months after stroke, he visited psychiatric unit due to these symptoms. His motor function was almost full recovered. He was treated with fluvoxamine and perphenazine. With two-month medication, his hypersexuality and obsessive-compulsive behavior disappeared. This case may indicate that basal ganglia-thalamocortical circuit plays an important role in the mediation of sexual behavior and obsessive-compulsive behavior. Since changes in sexual activity may not be spontaneously reported, a systemic inquiry into patient's sexual functioning after infarction in frontal lobe or basal ganglia is warranted.

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