• 제목/요약/키워드: Motor weakness

검색결과 261건 처리시간 0.02초

제 2 형 척수근위축증(SMA type II; Spinal muscular atrophy typeⅡ) 환아 1례에 대한 증례보고 (A case of spinal muscular atrophy typeⅡ)

  • 조형준;이진용;김덕곤
    • 대한한방소아과학회지
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    • 제14권1호
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    • pp.197-204
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    • 2000
  • Neuromuscular disorders are common causes of weakness and hypotonia in the infantile period and in childhood. Accurate diagnosis of specific neuromuscular disorders depends first on identification of which aspect of the peripheral neuromuscular system is affected-the motor neuron in the spinal cord, the nerve root or peripheral nerve, the neuromuscular junction, or the muscle-and then on the determination of the etiology and specific clinical entity. Spinal muscular atrophy(SMA) is the most common autosomal-recessive genetic disorder lethal to infants. The three major childhood-onset forms of SMA are now usually called type I, type II and typeⅢ. Progression of the disease is due to loss of anterior horn cells, thought to be caused by apoptosis. Diagnosis is based on the course of the illness, as well as certain changes seen on nerve and muscle biopsy and electrodiagnostic studies. More recently, our understanding of the genetics of this disorder has provided a noninvasive approach to diagnosis. We report on a 3-year-old male patient with spinal muscular atrophy type II. He had progressive muscular weakness since 18 months of age. The upper arms were slightly, and the thighs moderately atrophic. There was muscle weakness of both the upper and lower limbs, being more proximal in distribution. Electromyogram revealed a neurogenic pattern.

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Guillain-Barré syndrome associated with SARS-CoV-2 vaccination: how is it different? a systematic review and individual participant data meta-analysis

  • Yerasu Muralidhar Reddy;Jagarlapudi MK Murthy;Syed Osman;Shyam Kumar Jaiswal;Abhinay Kumar Gattu;Lalitha Pidaparthi;Santosh Kumar Boorgu;Roshan Chavan;Bharadwaj Ramakrishnan;Sreekanth Reddy Yeduguri
    • Clinical and Experimental Vaccine Research
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    • 제12권2호
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    • pp.143-155
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    • 2023
  • Purpose: An association between Guillain-Barré syndrome (GBS) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been reported. We aimed to summarize the clinical features of GBS associated with SARS-CoV-2 vaccination and determine the contrasting features from coronavirus disease-19 (COVID-19) associated GBS and GBS following other causes. Materials and Methods: We performed PubMed search for articles published between 1 December 2020 and 27 January 2022 using search terms related to "SARS-CoV-2 vaccination" and "GBS". Reference searching of the eligible studies was performed. Sociodemographic and vaccination data, clinical and laboratory features, and outcomes were extracted. We compared these findings with post-COVID-19 GBS and International GBS Outcome Study (IGOS) (GBS from other causes) cohorts. Results: We included 100 patients in the analysis. Mean age was 56.88 years, and 53% were males. Six-eight received non-replicating virus vector and 30 took messenger RNA (mRNA) vaccines. The median interval between the vaccination and the GBS onset was 11 days. Limb weakness, facial palsy, sensory symptoms, dysautonomia, and respiratory insufficiency were seen in 78.65%, 53.3%, 77.4%, 23.5%, and 25%, respectively. The commonest clinical and electrodiagnostic subtype were sensory-motor variant (68%) and acute inflammatory demyelinating polyneuropathy (61.4%), respectively. And 43.9% had poor outcome (GBS outcome score ≥3). Pain was common with virus vector than mRNA vaccine, and the latter had severe disease at presentation (Hughes grade ≥3). Sensory phenomenon and facial weakness were common in vaccination cohort than post-COVID-19 and IGOS. Conclusion: There are distinct differences between GBS associated with SARS-CoV-2 vaccination and GBS due to other causes. Facial weakness and sensory symptoms were commonly seen in the former and outcomes poor.

DMX512 프로토콜에서 자동주소를 갖는 지능형 조명 단말기 개발 (Intelligent Lighting Development having Auto-Address in DMX512 Protocol)

  • 최성철;이원호
    • 한국산학기술학회논문지
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    • 제11권4호
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    • pp.1233-1238
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    • 2010
  • 현재의 조명 산업은 반도체 LED를 이용한 R(빨강), G(초록), B(파랑)를 각각 제어 연출하여 대형화, 시스템화 되어가고 있다. 조명 산업의 통신 제어 표준인 DMX512(ANSI E1.11) 프로토콜은 기본적으로 조명 단말기를 구별할 수 있는 주소가 필요하다. 기존의 방식은 이 주소를 조명 단말기에 어떠한 형태(Dip Switch, EEPROM에 저장, PROM에 저장)로든 부여하여 서로를 구별하고, 통신으로 전송되어온 자신의 색상 데이터를 통신 선로에서 얻을 수 있었다. 또한, 통신 규약에 의하면 DMX512 통신 프로토콜의 전기적인 특성상 조명 단말기 32개 마다 스프리터(splitter)가 필요하게 된다. 즉, 512채널이 전부 연결된다면 최대 16개의 스프리터가 필요하게 된다. 본 논문은 DMX512 프로토콜에서 이러한 단점을 해결하기 위하여 모든 단말기를 직렬로 연결하여 조명제어용 Auto-Addressing 갖는 지능형 조명 단말기를 개발하였다. 각 단말기에 주소 부여에 대한 불편함을 해소하였고, 스프리터의 사용 또한 필요없게 하였다. 또한 이 개발품을 반도체 LED 조명 단말기에 적용하여, ON-OFF제어, 디밍제어, 순차제어, 무지개제어 등이 동작하는 것을 확인하였고, 이를 바탕으로 상용화하였다.

슬링(Sling) 시스템을 이용한 경부 안정화 운동 (Cervical stabilization exercise using the Sling system)

  • 권재확;조미주;박민철;김선엽
    • 대한정형도수물리치료학회지
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    • 제8권2호
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    • pp.57-71
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    • 2002
  • Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

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Functional Independence Measure를 이용한 뇌졸중(腦卒中) 환자의 임상적 관찰 (A Clinical Observation of the Stroke Patients : Using Functional Independence Measure)

  • 김민석;정승현;신길조;이원철
    • 대한한방내과학회지
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    • 제19권1호
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    • pp.97-113
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    • 1998
  • BACKGROUND The purpose of this study was to investigate disability of the patients after stroke, clinical applicability and usefulness of the FIM in evaluating the functional abilities and to assess the characteristics of the patients after stroke. And this study examined difference by predictive factors on the treatment outcome. METHOD The study was composed of 31 stroke patients who were within 1 week after stroke and had been treated in hospital more than 4 weeks. Improving rate was measured by using the Functional Independence Measure(FIM), and the correlation was analyzed between Motor FIM and Cognitive FIM. We analyzed significant meaning statistically in the mean value of FIM. RESULT 1. There was no significant meaning statistically in the mean value of FIM that was between both at admission and after 2 weeks. But there was proportional correlation between both at admission and after 4 weeks, and significant meaning statistically. 2. There was proportional correlation between both FIM and Motor FIM, and significant meaning statistically. But there was no significant meaning statistically between both FIM and Cognitive FIM. 3. There was no significant meaning statistically between both FIM and sex, age, side of weakness, stroke subtype, hypertension, hypercholesterolemia, diabetes mellitus, heart disease, starting point of rehabilitation therapy and past history of cerebral vascular accident. While dysarthria affected functional recovery in stroke patients, and significant meaning statistically. CONCLUSION 1. FIM appeared to be a valid and reliable method to measure the functional abilities of the patients after stroke. 2. Only one thing between Motor FIM and score didn't influence FIM score. 3. Dysarthria affected functional recovery in stroke patients, and it is the statistically significant factor.

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대상포진 질환에 대한 이해와 물리치료적 접근 (The Comprehension of Herpes Zoster and The Approach of Physical Therapy)

  • 한진태;최용원;이윤경;육군창;권오현
    • 대한물리의학회지
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    • 제2권2호
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    • pp.205-212
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    • 2007
  • Purpose : Herpes zoster is a common dermatologic disorder and is caused by reactivation of varicella zoster virus lying dormant in the ganglion of the dorsal root Methods : The aim of this study is to elucidate the clinical characteristics of herpes zoster and it's nature of pain, and is to review the method of physical therapy for pain control. Results : Herpes zoster is characterized by segmental rash, pain, and sensory symptoms, For most patients skin healing and pain resolution occur within 3-4 weeks, However, pain can continue after the rash has healed. Pain and paresthesia often the eruption of herpes zoster and vary from itching to stabbing. The preeruptive pain may simulate other diseases and may lead to misdiagnosis and misdirected interventions. Motor symptomatology is less well known and is most often related to central nervous system disease, although true lower motor neuron application is also thought to exist Subclinical motor involvement is relatively more common than clinical motor weakness and is easily detected by using electromyography. Higher incidences of herpes zoster were observed in female and in the elderly. Conclusion : The nature of pain associated with herpes zoster varied from a superficial itching to server stabbing or bursting, and paresthesia occurred most frequently. Therefore, the study of herpes zoster will be more research and comprehend, and the approach of physical therapy should be need positively.

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척추 경막외 출혈에 대한 수술적 치료성적 분석 (Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas)

  • 조영현;박진훈;김지훈;노성우;김창진;전상룡
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

대공부와 상위경추부 종양에 대한 수술적 치료 (Surgical Treatment of Foramen Magnum & High Cervical Spinal Cord Tumor)

  • 윤도흠;오성한;조용은;진병호;진동규;김영수
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.463-471
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    • 2001
  • Objective : The authors reviewed 51 patients of spinal cord tumor located at the craniovertebral junction and high cervical area to determine which factors influenced resectability, complications, and postoperative outcomes. Methods : Radiological examinations, clinical data, and operation notes were evaluated, and additional follow-up information was obtained from outpatient examinations. The mean follow-up period was 3.5 years Results : The most common neurological findings were motor deficit(72.5%) and sensory change(47.1%). There was no clinical finding that is considered as pathognomic. Meningioma(18 cases, 35.3%) was the most common tumor in this region. Total removal was achieved in 45 patients. There was no surgical mortality. Immediate postoperative motor weakness were encounted in 11 cases(21.6%) which improved in long term followup except two patients. Conclusions : The location and relationship of the tumor to surrounding struncture determine its resectability. Postoperative results were related to the preoperative neurological status and pathological findings.

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하시모토 갑상선염을 동반한 근위축성 측삭경화증 1예 (Amyotrophic lateral sclerosis combined with Hashimoto's thyroiditis : A case report)

  • 고영채;강성수;이영배;박현미;신동진
    • Annals of Clinical Neurophysiology
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    • 제3권1호
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    • pp.37-39
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    • 2001
  • Although the etiology and pathogenesis of amyotrophic lateral sclerosis(ALS) is unknown, increasing evidence supports a role for autoimmune mechanisms in motor neuron degeneration. The coexistence of immune disease in ALS supports that an altered immune system may contribute to disease pathogenesis. A 55-year-old woman was admitted to our department due to dysarthria and gait disturbance. On physical and neurologic examination, she showed thyroid enlargement, tongue atrophy, muscle weakness, fasciculation, and increased deep tendon reflex. The electrophysiological studies are compatible with motor neuron disease. Cytological findings of thyroid were compatible with Hashimoto's thyroiditis. Thus, we report a case of ALS combined with Hashimoto's thyroiditis. And the simultaneous presentation with ALS and Hashimoto's thyroiditis led us to consider whether this was simply a chance association or not.

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

  • 이범준;전진희;류재환;김태연
    • 대한한방내과학회지
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    • 제21권4호
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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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