• Title/Summary/Keyword: Motor weakness

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A Clinical Case of Oriental Medical Treatment for the Paraplegia after Lumbar Epidural Nerve Block (요추 경막외 차단술 후 발생한 하지마비의 한의학적인 치료 효과 - 증례 보고 -)

  • Yu, Deok-Seon;Kim, So-Yeon;Kim, Dong-Eun;Jung, Il-Min;Yeom, Seung-Ryong;Kwon, Young-Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.219-228
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    • 2009
  • Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.

Clinical Study on 1 Case of Patient with Arthalgia Syndrome Diagnosed as Acute Transverse Myelitis (급성 횡단성 척수염으로 진단된 비증 환자의 치험 1례)

  • Lee, Seung-Hyun;Phil, Kam-Heun;Jo, Eun-Heui
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1663-1669
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    • 2007
  • Acute transverse myelitis(ATM) is defined as an acute intramedullary dysfunction of the spinal cord, ascendng or static involving both halves of the cord and appearing without any history of previous neurological diseases due to traumatic accident, tumor of all kind, encephalitis and of course excluding all possible viral, bacterial and fungal infection. It is mainly characterized by acute motor disorder of both limbs in respect to which spinal segments are affected as well as sensory disorder and dysuria & dyschezia. The exact cause is unknown, however it is recently suggested that immunological factors are highly involved. It has been reported by several reliable sources that it is often accompanied by immunological diseases such as systemic lupus erythematosus(SLE). As treatments non steroid anti-inflammatory drugs(NSAIDS) are primarily recommended as to steroids, limited doses are injected only with the proper prescription from the physician. Operative methods are not options as traumatic accidents and tumors are excluded as factors. To enhance muscle strength and prevent articular contracture physical therapy and passive exercise is imperative. The following patient whose chief complaints were mainly about hypoesthesia of Rt. lower limb and stiffness of phalanges of both fingers as well as to weakness of lower extermity. Therefore it has been diagnosed as arthalgia syndrome. In oriental medicine factors such as wind evil heat-evil, dampness-heat evil, cold evil cause the arthalgia syndrome. In this case the patient was diagnosed as dampness-heat evil and herbal medicine Chunglijagam-Tang and Dong-Qi acupuncture was applied to treat bladder disorder.

Patient-controlled Epidural Analgesia with Ropivacaine and Fentanyl: Experience with 2,276 Surgical Patients

  • Kim, Shin Hyung;Yoon, Kyung Bong;Yoon, Duck Mi;Kim, Chan Mi;Shin, Yang Sik
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.39-45
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    • 2013
  • Background: Good postoperative pain control is an important part of adequate postoperative care. Patient-controlled epidural analgesia (PCEA) provided better postoperative analgesia compared to other conventional analgesic methods, but several risks have been observed as well. We therefore surveyed the efficacy and safety of PCEA in this retrospective observational study. Methods: We analyzed collected data on 2,276 elective surgical patients who received PCEA with ropivacaine and fentanyl. Patients were assessed by a PCA service team in the post-anesthesia care unit (PACU), at 1-6 h, 6-24 h, and 24-48 h postoperatively for adequate pain control. The presence of PCEA-related adverse events was also assessed. Results: Numerical pain score (median [interquartile range]) were 3 [1-4], 5 [4-7], 4 [3-5], and 3 [3-5] in the PACU, at 1-6 h, 6-24 h, and 24-48 h postoperatively. Median pain scores in patients underwent major abdominal or thoracic surgery were higher than other surgical procedure in the PACU, at 1-6 h after surgery. Nausea and vomiting (20%) and numbness and motor weakness (15%) were revealed as major PCEA-related adverse events during the postoperative 48 h period. There were 329 patients (14%) for whom PCEA was ceased within 48 h following surgery. Conclusions: Our data suggest that the use of PCEA provides proper analgesia in the postoperative 48 h period after a wide variety of surgical procedures and that is associated with few serious complications. However, more careful pain management and sustainable PCEA monitoring considering the type of surgical procedure undergone is needed in patients with PCEA.

Bilateral Lesions in the Posterior Limb of Internal Capsule Attributed to Combination Therapy of Isoniazid and Rifampin (이소니아지드와 리팜핀 복합 치료에 의하여 발생한 속섬유막뒤다리의 양측성 병변)

  • Park, Min Won;Roh, Jinhong;Im, Seojun;Kim, Min Ok;Kim, Young-Soo;Kang, Jongsoo;Kim, Do-Hyung;Kwon, Oh-Young
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.354-357
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    • 2018
  • Transient isoniazid-induced brain lesions have rarely been reported. The lesions were in the dentate nucleus of cerebellum and thalamus. Meanwhile, the neurotoxicity of rifampin has not been reported evidently. We observed bilateral lesions in the internal capsule in a young woman after taking a combination of isoniazid and rifampin. She transiently suffered numbness in both hands, dysarthria, and left side motor weakness while taking the medication. Isoniazid may induce structural lesions in various brain areas including the internal capsule.

Spinal Cord Infarction after C7 Transforaminal Epidural Steroid Injection Using Dexamethasone (덱사메타손을 이용한 경추 7번 경막 외 스테로이드 주사 후 척수 경색)

  • Lee, Jong Hwa;Kim, Young Sam;Kim, Sang Beom;Lee, Kyeong Woo;Kim, Young Hwan
    • Clinical Pain
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    • v.19 no.2
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    • pp.116-119
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    • 2020
  • Cervical transforaminal epidural steroid injection (TFESI) is commonly performed to provide relief of pain caused by radiculopathy. Intra-arterial injection of particulate steroid or direct needle injury can lead to spinal artery embolism or thrombosis. Also there is a possibility of vascular spasm. To our knowledge, this is the first reported case of spinal cord infarction that occurred after TFESI with non-particulate steroid in Korea. A 47-year-old female patient underwent C7 TFESI at local pain clinic. Injected materials were dexamethasone and mepivacaine. Right after the intervention, she felt muscle weakness and decreased sensation. On physical examination, she had decreased sensation from C4 to T2 dermatome in light touch and pin-prick test. Proprioception and vibration were intact. The motor grades of upper extremities were grade 1. Cervical and thoracic spine MRI was checked. Diffusion-weighted image and apparent diffusion coefficient image showed long extension of spinal cord infarction from C2 to T1 level.

Yearly Report on CVA Patients (뇌졸중 환자에 대한 연례보고(2003년))

  • Yim, Young-Nam;Sim, Sung-Yong;Ko, Ho-Yeon;Park, Jung-Sup;Jung, Seung-Min;Lee, Si-Hyung;Kim, Dong-Woo;Jun, Chan-Yong;Park, Chong-Hyeong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.6 no.1
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    • pp.33-43
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    • 2005
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 169 patients who were admitted to Dept. of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2003 to Dec. 31, 2003. Results : Ischemic stroke(include TIA, 85.2%) was more common than hemorrhagic stroke(14.8%). The incidence in male was 46.7%, in female was 53.3% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA territory and lacunar-inf., hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus. The rate of recurrence was 30.18%. Cerebral infarction and cerebral hemorrhage was much occurred in acting. The most patients visited the hospital after 5 days. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract infection. Physical treatment from onset, in cerebral infarction was 9.14 days and in cerebral hemorrhage was 18.33 days. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2002. In most cases, western and oriental treatment and medicine were given synthetically.

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Yearly Report on CVA Patients (뇌졸중 환자에 대한 연례보고(2005년))

  • Rhee, See-hyung;Jung, Ki-yong;Yeo, Hyun-soo;Hsia, Yu-chun;Baek, Jong-woo;Choi, You-kyung;Jun, Chan-yong;Kim, Dong-woo;Park, Chong-hyeong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.8 no.1
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    • pp.1-11
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    • 2007
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 75 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2005 to Dec. 31, 2005. Results : Ischemic stroke(include TIA, 93.3%) was more common than hemorrhagic stroke(6.7%). The incidence in male was 36.0%, in female was 64.0% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in MCA-infarction and hemorrhage in putamen & thalamus. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 21.3%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly urinary tract inflamation. Conclusions : Our study on CVA patients was similar to previous studies from 1994 to 2004. In most cases, western and oriental treatment and medicine were given synthetically.

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Yearly Report on CVA Patients (뇌졸중 환자에 대한 연례보고(2004년))

  • Park, Jung-sup;Jung, Seung-min;Lee, Si-hyung;Jung, Ki-yong;Yeo, Hyun-soo;Hsia, Yu-chun;Choi, You-kyung;Jun, Chan-yong;Kim, Dong-woo;Park, Chong-hyeong
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.7 no.1
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    • pp.23-33
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    • 2006
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 102 patients who were admitted to Department of Internal Medicine, College of Oriental Medicine, Kyung-Won University with a diagnosis of stroke from Jan. 1, 2004 to Dec. 31, 2004. Results : Ischemic stroke(include TIA, 82.4%) was more common than hemorrhagic stroke(17.6%). The incidence in male was 41.2%, in female was 17.6% and the most prevalent age group is over-sixties. Cerebral infarction was most frequently noticed in lacunar-infarction and hemorrhage in putamen. Hypertention, the most preceding diseases, followed by diabetes mellitus and CVA. The rate of recurrence was 27.45%. Cerebral infarction and cerebral hemorrhage was much occurred after rising. The most patients visited the hospital within 24 Hours. The most common symptoms in admission time were motor weakness and speech disorder. The complication was mostly mental disorder. Conclusion : Our study on CVA patients was similar to previous studies from 1994 to 2003. In most cases, western and oriental treatment and medicine were given synthetically.

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Magnetic Resonance Imaging and Clinical Features of Chlorfenapyr-Induced Toxic Leukoencephalopathy: A Case Report (클로르페나피르 중독에 의한 백색질뇌증 환자의 임상양상과 자기공명영상 소견: 증례 보고)

  • Jong Hyuk Kim;Noh Hyuck Park;Ji Yeon Park;Seon-Jeong Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.985-989
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    • 2020
  • Chlorfenapyr is widely used as an insecticide, despite it being fatal to humans. However, chlorfenapyr-induced central nervous system toxicity has rarely been reported. We report the magnetic resonance imaging (MRI) findings in a rare case of chlorfenapyr-induced toxic leukoencephalopathy. A 71-year-old man who had ingested chlorfenapyr approximately two weeks prior visited our hospital and presented with bilateral lower motor weakness and voiding dysfunction that had developed two days before admission. Brain MRI revealed extensive bilateral white matter abnormalities involving the corpus callosum, internal capsule, brain stem, and bilateral middle cerebellar peduncle. Furthermore, spine MRI revealed diffuse swelling and hyperintensity on the T2-weighted images.

Clinical Analysis of Spinal Cord Tumor (척수종양의 임상적 분석)

  • Choi, Weon-Rim;Shin, Won-Han;Cho, Sung-Jin;Kim, Bum-Tae;Choi, Soon-Kwan;Byun, Bak-Jang
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.47-53
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    • 2001
  • Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.

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