• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.48-53
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• 2009

Background: Bell's palsy produces a complex problem that involves not only facial motor weakness, but also psychiatric issues. However, the relationship between facial neuromotor system impairment and psychological adjustment has not been well understood. Methods: We have performed psychological evaluations in patients with acute unilateral Bell's palsy within 2 weeks after onset. Thirty patients with Bell's palsy (10 men, 20 women) were included, who were diagnosed by neurologic examination, electrophysiologic study and/or brain MRI. We measured facial motor scale of impairment (House-Brackmann, HB scale) and psychosocial adjustment [Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)] at the time of initial presentation and 1 month after diagnosis. Results: The age of the enrolled patients ranged from 16 to 80 years. The mean grade of initial and follow up HB scale were 3.87 (SD: 0.63, range 2~5) and 1.77 (SD: 1.10, range 1~5). The mean score of initial and follow up BAI, BDI were 11.93 (range; 0 to 47, SD: 9.65, very low anxiety), 14.73 (range; 0 to 41, SD: 9.21 minimal depression) and 7.5 (range; 0 to 36, SD: 8.58, very low anxiety), 9.33 (range; 0 to 30, SD: 8.19 minimal depression). There was positive correlation between improvement of HB scale and improvement of BAI and BDI score. Conclusions: Bell's palsy is associated with the psychological problems such as depression and anxiety, and the improvement of motor symptom is associated with the improvement of these psychological problems.

• Journal of Korean Neurosurgical Society
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• v.41 no.1
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• pp.7-10
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• 2007

Objective : The aim of this study was to determine the efficacy of percutaneous radiofrequency neurotomy[RFN] of ramus communicans nerve in patients suffering from severe low back pain due to osteoporotic compression fracture. Methods : Twenty two patients with lumbar osteoporotic compression fracture who had intractable back pain for less than two weeks and were performed with RFN at L1-L4 from May 2004 to December 2005 were retrospectively analyzed. Clinical outcome using visual analogue scale[VAS] pain scores and modified MacNab's grade was tabulated. Complications related to the procedure were assessed. Results : Twenty-two female patients [age from 63 to 81 years old] were included in this study. The mean VAS score prior to RFN was 7.8, it improved to 2.6 within postoperative time of 48 hours, and the mean VAS score after 3 months was 2.8, which was significantly decreased. Eighteen of 22 patients were graded as excellent and good according to modified MacNab's criteria at final follow up. All patients recovered uneventfully, and the neurologic examination revealed no deficits. Two patients showing poor results worsened in symptom. Percutaneous was performed eventually resulting in symptom improvement. There were no significant complications related to the procedure such as sensory dysesthesia, numbness or permanent motor weakness. Conclusion : RFN is safe and effective in treating the painful osteoporotic compression fracture. in patients with intractable back pain due to lumbar osteoporotic compression fracture, RFN of gray ramus communicans nerve should be considered as a treatment option prior to vertebroplasty.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.274-280
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• 1999

A variety of mechanism may generate pain resulting from injury to the central and peripheral nervous system. None of these mechanism is disease-specific, and several different pain mechanism may be simultaneously present in anyone patient, independent of diagnosis. Diagnosis of neuropathic pain is often easily made from information gathered on neurologic examination and from patient history. Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of therapeutic options, the mainstay of which is pharmacotherapy. Selection of an appropriate rharmacologic agent is by trial and error since individual responses to different agents, doses, and serum levels are highly variable. An adequate trial for each agent tried is key to pharmacologic treatment of neuropathic pain. Tricyclic antidepressants are first-line agents, although other drugs, including anticonvulsants, local anesthetic antiarrhythmics, clonidine, opiates, and certain topical agents, also offer pain relief in some patient populations. The novel antidepressants venlafaxine and nefazodone are potentially useful new drugs that are better tolerated than tricyclic antidepressants. Also Gabapentine seems an interesting and promising drug for the treatment of neuropathic pain.

• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.248-260
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• 2020

Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.1
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• pp.1-7
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• 2008

Objectives : The os odontoideum is an uncommon abnormality which is due to non fusion of axis and odontoid process that exists as a separate ossicle apart from a hypoplastic dens. Its clinical significance lies in its potential to produce serious neurologic symptoms after cervical Chuna Manipulation Treatment. We experienced a patient diagnosed as os odontoideum which corresponds to absolute contra-indications of chuna manipulation treatment and report it. Methods : The patient was diagnosed as os odontoideum through cervical spine CT and MRI. Results and Conclusion : During cervical physical examination, we encountered L'hermitte's phenomenon from the patient and suspected one of contra-indications of chuna manipulation treatment. We could diagnose the patient as os odontoideum through cervical spine CT, MRI and prevent him from severe sequelae caused by chuna manipulation treatment.

• Pediatric Infection and Vaccine
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• v.23 no.3
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• pp.236-239
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• 2016

$Guillain-Barr{\acute{e}}$ syndrome (GBS) is caused by antecedent infectious diseases in approximately two-thirds of cases. GBS is considered an autoimmune response. Among reported preceding infections, influenza virus is relatively rare. Several reports have identified antibodies related to GBS pathogenesis. However, no case report has described the detection of influenza virus in the cerebrospinal fluid (CSF) of a patient with GBS by polymerase chain reaction (PCR). Here we report the case of a 6-year-old girl who was diagnosed with influenza A 1 week prior and was treated with oseltamivir, after which she visited our hospital for headache and bilateral leg weakness that had persisted for 1 day. We diagnosed her with GBS based on physical and neurologic examination findings, CSF analysis, nerve conduction velocity test results, spinal magnetic resonance imaging, and detection of influenza A virus in her CSF by PCR. She was treated with intravenous immunoglobulin and her symptoms slowly improved. This case report suggests that GBS may be caused by influenza virus through penetration of the CSF.

• Journal of Veterinary Clinics
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• v.35 no.4
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• pp.150-154
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• 2018

A 9-month-old, castrated, male Labrador Retriever was referred for generalized progressing cutaneous reddish mass lesions with bleeding, scale, crust, and pruritus. On the basis of histopathological findings and the results of immunochemical staining, cutaneous nonepitheliotropic B-cell lymphoma was identified. A cyclophosphamide-doxorubicin-vincristine-prednisolone (CHOP)-based chemotherapy regimen was initiated, and the patient initially showed partial response to vincristine and $\text\tiny{L}$-asparaginase, but the cutaneous lesions progressed gradually. After the first cycle of the CHOP-based protocol, lomustine was administered instead. The cutaneous lesions showed partial response to lomustine, but the treatment did not stop the progression of cutaneous lymphoma. The patient was euthanized due to neurologic signs, including reduced consciousness and seizures, 53 days after initial presentation. The postmortem histopathological examination showed systemic metastasis involving the lymph nodes, skin, kidney, ureter, liver, brain, temporal muscle, diaphragmatic muscle, conjunctiva, and oral cavity.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3271-3276
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• 2016

Background: Intracranial nonvestibular schwannomas arising from various cranial nerves excluding CN VIII are uncommon. Recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have been widely reported as effective treatment modalities for nonvestibular schwannomas. The purpose of this study was to study the long term clinical outcome for nonvestibular schwannomas treated with both X-Knife and CyberKnife (CK) radiosurgery at one institution. Materials and Methods: From 2004 to 2013, fifty-two nonvestibular schwannoma patients were included in this study, 33 patients (63%) were treated with CK, and 19 (37%) were treated with X-Knife. The majority of the tumors were jugular foramen schwannomas (38%) and trigeminal schwannomas (27%). HSRT was given for 45 patients (86%), whereas CSRT was for 6 (12%) and SRS for 1 (2%). Results: The median pretreatment volume was $9.4cm^3$ (range, $0.57-52cm^3$). With the median follow up time of 36 months (range, 3-135), the 3 and 5 year progression free survival was 94 % and 88%, respectively. Tumor size was decreased in 13 (25%), stable in 29 (56%), and increased in 10 (19%). Among the latter, 3 (30%) required additional treatment because of neurologic deterioration. No patient was found to develop any new cranial nerve deficit after SRS/SRT. Conclusions: These data confirmed that SRS/SRT provide high tumor control rates with low complications. Large volume tumors and cystic expansion after radiation should be carefully followed up with neurological examination and MRI, because it may frequently cause neurological deterioration requiring further surgery.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• The Journal of Internal Korean Medicine
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• v.39 no.5
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• pp.853-862
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• 2018

Objectives: The aim of this study was to report on the Korean medicine treatment of a case of a cerebellar infarction patient suffering from vertigo, nausea, and vomiting. Methods: We applied herbal medicine (Yangjin-tang), acupuncture, and moxibustion to the patient, who was admitted to hospital for 51 days. Clinical symptoms were assessed with a numeral rating scale (NRS) and neurologic examination. Results: After treatment, the vertigo, nausea, and vomiting symptoms were improved, and the NRS showed improvement. Conclusions: This case shows that Korean medicine treatments are effective in relieving the symptoms of cerebellar infarction patients experiencing vertigo, nausea, and vomiting.