• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.2
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• pp.171-178
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• 2007

Botulinum toxin type A (BTX-A) has a local effect at the neuromuscular junction by blocking acetylcholine release and thus causing paralysis and atrophy of the affected muscles. In dentistry, Botulinum toxin type A(BTX-A) is used for the treatment of masseteric hypertrophy, temporomandibular disorder, and severe bruxism related neurologic disorder. We hypothesized that the muscle atrophy after BTX-A injection into masseter muscle in growing rats, could affect the jaw growth. The purpose of this study was to determine the effects of the BTX-A injected into the masseter muscle on the jaw growth in rats. Rats were divided into four groups(group 1; control group, group 2; saline injection group, group 3; BTX-A injection group, group 4; baseline control group). Group 4 was sacrificed at the beginning of the experiment to provide baseline values of jaw measurements. The weight, length and width of jaw in those groups were measured every weeks. This study reported that the mandibular body length, condylar length, coronoid process length, anterior region height, coronoid process height and condylar height of the jaw in BTX-A injection group were shorter than those of the control and saline injection groups(P<0.05). In conclusion, BTX-A injected into the masseter muscle may affect the undergrowth of the jaw in rats.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.122-128
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• 2019

Background The masseter nerve is a useful donor nerve for reconstruction in patients with established facial palsy, with numerous advantages including low morbidity, a strong motor impulse, high reliability, and fast reinnervation. In this study, we assessed the results of masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Methods Ten patients with facial palsy who received treatment from January 2015 to January 2017 were enrolled in this study. Three patients received masseter nerve-only free gracilis transfer, and seven received double-innervated free gracilis transfer (masseter nerve and a cross-face nerve graft). Patients were evaluated using the Facial Assessment by Computer Evaluation software (FACEgram) to quantify oral commissure excursion and symmetry at rest and when smiling after muscle transfer. Results The mean time between surgery and initial movement was roughly 167.7 days. A statistically significant increase in excursion at rest and when smiling was seen after muscle transfer. There was a significant increase in the distance of oral commissure excursion at rest and when smiling. A statistically significant increase was observed in symmetry when smiling. Terzis' functional and aesthetic grading scores showed significant improvements postoperatively. Conclusions Masseter nerve innervation is a good option with many uses in in established facial palsy patients. For some conditions, it is the first-line treatment. Free gracilis muscle transfer using the masseter nerve has excellent results with good symmetry and an effective degree of recovery.

• The Journal of Korean Medicine
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• v.23 no.1
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• pp.100-111
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• 2002

Objectives : In order to obtain the clinical type of facial palsy sequelae and try to make the treatment protocols for each, I observed patients who visited Gunpo-Wonkwang oriental medicine center with Bell’s palsy sequelae that were treated over three months. Methods : I make the value standard of muscle paralysis, contraction, synkinesis and acquired the results as follows. Results and Conclusions : 1. The distribution of age and sex was as follows : females of 41-50 years were the most common demographic, females of 51-60 years and males of 31-40 years were the second, males of 51-60 years were the third, females of 21-30 years and males of over 60 years were the fourth, and males of 41-50 years were the fifth. 2. The distributions of period of disease were as follows : 3-6 months was the most, 12-18 months was the second, 6-12 months and over 24 months was the third, and 18-24 months was the fourth. 3. The sequelae distributions of disease were as follows. In the group of 3-6 months, 12 persons (80%) showed palsy and atrophy, 10 persons (66.6%) showed synkinetics. In the group of over 6 months, all patients showed muscle palsy, muscle atrophy and synkinetics. All groups showed lower sensitivity of muscles, but the group of 18-24 months and the group of over 24 months showed more. Tinnitus was shown by the groups of 12-18 months and 3-6 months. Facial muscle pain was shown by the group of3-6 months only, Crocodile's tear was shown by the groups of 18-24 months and over 24 months. 4. The total palsy rates of sequela patients and palsy rates by muscle for disease period were as follows. The total palsy rate was 27.94%; the palsy rates for the group of 6-12 months and the group of over 24 months was lower than the total palsy rate. The rates of the groups of 3-6, 12-18, 18-24 months were higher than the total palsy rate. The palsy rate of zygomatic minor, levator labii superior muscle was higher than the total palsy rate for all groups. 5. Synkinetics manifestation rates by disease period were as follows. Total synkinetics manifestation rate was 73.81 %; the manifestation rate of the group of 6-12 months was lower than total synkinetics manifestation rate. For the groups of 12-18, 18-24, and over 24 months it was more than the total synkinetics manifestation rate. The group of over 24 months, total synkinetics induced by orbicularis oculi muscle and orbicularis oris muscle. 6. Facial muscle atrophy rates by disease period were as follows. Total atrophy rate was 5.26%; in the groups of 6-12, 18-24, over 24 months, the atrophy rates were higher than the total atrophy rate. The groups of 3-6 and 12-18 months showed lower than the total atrophy rates, while the atrophy of the levator palpebrae superioris muscle and levator palpebrae inferioris muscle was higher than in other groups.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.133-138
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• 2005

Objectives: Narcolepsy is characterized by excessive sleepiness, cataplexy, sleep paralysis and hypnagogic hallucination. As there have been few researches on narcolepsy symptomatology in adolescents, we examined gender differences and prevalence of narcolepsy tetrad among students attending high school. Methods: Total 20,407 subjects, ages 14-19 years filled out Ullanlinna Narcolepsy Scale (UNS). Subjects whose UNS scores were equal to or more than 14 were interviewed by telephone using semi-structured questionnaire. Variables included questions to evaluate tetrad of narcolepsy. Results: UNS scores were higher in female than male ($11.1{\pm}5.2$ vs. $9.6{\pm}4.5$, p<0.001). Subjects scoring the UNS equal to or more than 14 were 4,535 (22.2% of all the participants), more frequently observed in female than in male (p<0.001). Excessive daytime sleepiness, cataplexy-like symptoms, sleep paralysis and hypnagogic hallucination in subjects of UNS ${\geq}14$ were significantly higher in female subjects than male ones. However, no significant gender difference was observed in the frequencies of severe sleep attack and cataplexy-like symptoms. Sleep paralysis was most frequently reported during sleep. There was significant correlation between sleep paralysis and hypnagogic hallucination (r=0.235, p<0.01). Conclusions: Our findings were that female adolescents complained more frequently narcolepsy symptoms than male subjects. Female adolescents might be more sensitive than male ones to physical complaints such as sleepiness or muscle weakness.

• The Korean Journal of Pain
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• v.5 no.2
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• pp.213-220
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• 1992

The sciatic nerves of anesthetized rabbits were exposed and stimulated by a nerve stimulator in order to observe the myoneural response. These rabbits were divided into three groups and respectively injected with morphine (Group 1), meperidine(Group 2) and pentazocine (Group 3). The sciatic nerves were stimulated periodically and gait changes were observed to see the myoneural activity after the injections. When the distal part of the sciatic nerves were stimulated by the nerve stimulator after the respective drug injections, the normal muscle twitch responses were observed in all the progressional stages of Group 1. However, in Group 2 and 3, the muscle twitch responses decreased gradually, finally disappearing after approximately 10 minutes in these two groups. Complete motor paralysis continued for about 60 minutes. The muscle reactions returned to normal approximately 90 minutes after injection. Specimens drug-injected tissues were severed 4 hours, 24 hours and 1 week after injection respectively. These tissue were investigated under light as well as electron microscopy. The tissue revealed rare to moderate vacuolizations scattered in the axons of the myelinated and unmyelinated nerves of some of the specimens; however, there were no significant pathologic lesions. These results provide evidence that neurophysiologically, meperidine and pentazocine have a local anesthetic-like effect such as motor paralysis, but morphine does not. In addition, the results indicated that neurohistologically, the three narcotics have no significant toxic effects on the nerve tissue.

• Journal of Korean Orthopaedic Sports Medicine
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• v.11 no.2
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• pp.92-95
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• 2012

Iliacus muscle tears are a rare injury seen after the high-energy trauma or as a result of low-energy injuries in patients with a bleeding diathesis as coagulopathy, receiving anticoagulation therapy and hemophiliac. Femoral nerve palsy due to compression from a hematoma by iliacus muscle rupture are rarely reported. Routine evaluation includes MRI to confirm and define the pathologic abnormality supplemented by EMG and nerve conduction studies to evaluate patterns and extent of femoral nerve injury. Hematologic evaluation for bleeding diathesis may preceded, if suspicion of coagulopathy is present. We report the case of a healthy 32-year-old male with iliacus rupture and concomitant femoral nerve palsy sustained by kicking motion during soccer game. After 6 months of observation with non-operative treatment regimen, satisfactory results were obtained, so we report it with a review of the literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.345-348
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• 2004

Cephalic tetanus is a rare subtype of tetanus in which trismus is a charateristic symptom. The paralysis of one or more cranial nerves can occur. The 7th cranial nerve is most frequently involved. It account for 1 to 3% of the tetanus and has a mortality of 15 to 30%. The incubation period is 1 to 14 days, and approximately two thirds of tetanus cases progress to generalized tetanus. Generally, the symptoms of cephalic tetanus can include : facial pain, trismus, dysphagia, muscle twitching spasms of the face and jaw (risus sardonicus), neck stiffness and malaise. We present a case of cephalic tetanus who 54-year male patient had trismus and dysphagia. There was no history of trauma. As there was a delay in diagnosis of cephalic tetanus, respiratory disorder and intermittent general spasm occurred. The patient was treated by injection of antibiotics, muscle relaxant, and human anti-tetanus immunoglobulin. His symptoms were disappeared, and he was discharged ambulatory.

• The Journal of Internal Korean Medicine
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• v.21 no.4
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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.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.17 no.3
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• pp.126-130
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• 2004

Oculomotor nerve palsy presents itself with sudden onset unilateral ptosis and inability to turn the eye upward, downward, or inward, which causes visual disturbances. Strabismus caused oculomotor nerve palsy refers to muscle imbalance that results in improper alignment of the visual axes of the two eyes It may be divided into paralytic and non paralytic strabismus. paralytic strabismus is primarily a neurologic problem. Characteristic clinical disturbances result from lesions of the third, fourth, and sixth cranial nerves. Lesions of the third nerve result in a paralysis of lateral or outward movement and a crossing of the visual axes. Objective: This study was designed to evaluate the effects of oriental medicine therapy on a peripheral oculomotor nerve palsy. Methods & Result: The clinical data was analyzed on a patient with oculomotor nerve palsy whose main symptoms were right side ptosis and inability to turn the eye inward. The patient was treated by the electroacupucture(4Hz frequency, intensity was adjusted so that localized muscle contractions could be seen). As the result, symptoms are improved remarkably. Conclusion: The patient showed right eye ptosis and unilateral deviation of the right eye ball in neutral position. After acupuncture treatment and electroacupuncture treatment, the ptosis and deviation of the patient's right eye was recovered six weeks after the onset. The study suggests that oriental medicine therapy is significantly effective on the treatment of peripheral oculomotor nerve palsy.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.