• 한방재활의학과학회지
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• 제28권1호
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• pp.161-166
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• 2018

This report describes the miniscalpel-acupuncture treatment of a 68-yr-old woman who had abnormal posture and involuntary dystonic movements of the head and neck. She suffered muscle contracture associated symptoms after she fell injured in 2014. Her neck had abnormal posture findings due to muscle tension. The spasms gradually worsened and did not respond to botulinum toxin injections. Involuntary dystonic movements may be due to peripheral post-traumatic cervical dystonia. Outcomes support cervical dystonia may be managed effectively with miniscalpel-acupuncture. Further research is recommended.

• Journal of Oral Medicine and Pain
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• 제47권3호
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• pp.152-155
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• 2022

Lingual dystonia is an uncommon focal type of oromandibular dystonia that only affects the tongue. Although the use of several treatment modalities has been attempted to reduce involuntary tongue movements, such as anticonvulsants and anticholinergics, the results do not seem promising, and the efficacy of such treatments is unpredictable among patients. This case report describes botulinum toxin injection for a patient with lingual dystonia with favorable clinical results. Botulinum toxin injection to the muscles of the tongue could be an alternative treatment option for lingual dystonia.

• Journal of Oral Medicine and Pain
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• 제34권4호
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• pp.421-427
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• 2009

구강하악 근긴장이상증(oromandibular dystonia)은 국소적인 근긴장이상증의 한 형태로, 저작근, 안면근 또는 혀 근육의 지속적이고 반복적인 근경련이 발생하여 불수의적인 개구 및 폐구, 악골의 측방 및 후퇴운동이 나타나는 것으로 정의내릴 수 있다. 구강하악 근긴장이상증에 이환된 환자의 경우, 저작, 연하 및 발음을 하는데 불편감을 가지게 되고, 그 결과 하악 운동에 지장을 초래하게 된다. 현재까지는 근긴장이상증에 대한 병태생리가 뚜렷히 입증된 바가 없어, 원인에 관련한 치료는 이루어지지 않고 있는 상태이다. 약물요법, 행동요법, 외과적 처치 등 다양한 방법이 구강하악 근긴장이상증의 치료법으로 제시되고 있으나, 성공률이 그리 높은 편은 아니며, 많은 부작용을 초래할 수 있다. 최근 들어 근긴장이상증에 이환된 근육에 보툴리눔 톡신을 이용한 치료법이 주목을 받고 있는 추세이다. 본 증례를 통해 구강하악 근긴장이상증을 중심으로 한 구강안면 운동장애에 대하여 전반적으로 고찰을 시행하고 해당 질환에서의 보툴리눔 톡신 치료법에 대하여 알아보고자 한다.

• Journal of Korean Neurosurgical Society
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• 제38권5호
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• pp.380-383
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• 2005

Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.79-81
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• 2014

Spasmodic dysphonia (SD) is a chronic, focal, speech-induced, action-specific dystonia, resulting strained voice. Muscle tension dysphonia (MTD) may also result in a strangled, strained voice quality, usually as a result of compensation for underlying laryngeal disease such as glottal insufficiency. Patients with SD and MTD were suffered from the severely limiting people's communication, especially via telephone and in noisy backgrounds. SD is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks, which is difficult to distinguish from MTD. In this review article, we present the characteritics and management of SD and MTD.

• 턱관절균형의학회지
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• 제11권1호
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• pp.1-11
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• 2021

Dystonia is a neurological disorder characterized by involuntary and uncontrollable muscle tonus abnormalities. It is a huge burden not only to the patients and their families, but also to the field of medicine, in that there has hardly been any substantial change in the concept of and approach to this intractable disorder and therefore no breakthrough to its diagnosis, evaluation and treatment. As an effort to solve the current impasse, this review briefly summarizes the current concept, etiology, diagnosis, treatment and management, and then suggests a rather new therapeutic approach to this disorder, based on the concept of neurological balance and TMJ integrative approach. These new approaches will provide a platform for the clinicians and researchers to have a leap in the concept, diagnosis and therapeutics.

• Anatomy and Cell Biology
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• 제56권3호
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• pp.398-400
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• 2023

The current case report describes an uncommon insertion of the levator scapulae (LS), which broadly attaches to multiple structures, including the serratus posterior superior, ligamentum nuchae, and the 6th and 7th spinous processes of the cervical vertebrae. The most superior portion of this aponeurosis merged with the ligamentum nuchae at the C7 level. The middle and inferior portions of the head were inserted (or fused) into the tendon of the rhomboid minor as well as the fibers of the serratus posterior superior muscle. Consequently, recognizing this anatomical variation, characterized by an additional slip of the LS attaching to the 7th vertebra and other muscular structures, is crucial not only for anatomists but also for surgeons performing procedures on the posterior neck related to cervical or shoulder pain and cervical dystonia.

• Journal of Korean Neurosurgical Society
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• 제46권1호
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• pp.52-55
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• 2009

Writer's cramp is a type of idiopathic focal hand dystonia characterized by muscle cramps that accompany execution of the writing task specifically. There has been renewed interest in neurosurgical procedures for the treatment of dystonia over the past several years. In particular, deep brain stimulation (DBS) has received increasing attention as a therapeutic option for patients with dystonia. However, to date, limited reporters made investigations into DBS in relation to the Writer's cramp. In this case, unilateral Ventro-oralis complex (Vo) DBS resulted in a major improvement in patient's focal dystonic movement disorders. Her post-operative Burke-Fahn-Marsden Dystonia Rating (BFMDR) scale demonstrated 1 compared with pre-operative BFMDR scale 4. We conclude that thalamic Vo complex DBS maybe an important neurosurgical therapeutic option for Writer's cramp.

• 대한후두음성언어의학회지
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• 제13권2호
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• pp.164-172
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• 2002

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

• 대한치과마취과학회지
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• 제10권1호
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• pp.13-19
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• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.