• Title/Summary/Keyword: Neurologic examination

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Unilateral Deafness Diagnosed using the Brainstem Auditory Evoked Response Test in a Shih-tzu Dog

  • Ji, Na-Ni;Song, Joong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.103-106
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    • 2018
  • A 12-year-old castrated male Shih Tzu presented with suspected hearing loss. The patient had no history of head trauma or exposure to ototoxic drugs. The results of neurologic and physical examinations were normal. An otoscopic examination showed that both the tympanic membranes and the external ear canals had a normal appearance. However, the results of brainstem auditory evoked response tests confirmed sensorineural deafness in the right ear and indicated conduction disturbances and brainstem abnormalities in the left ear. Magnetic resonance imaging was performed to confirm the causes of the conduction disturbances and brainstem abnormalities. Inflammatory changes in the left middle ear were highly suspected to be responsible for the findings in the left ear. The results of these examinations confirmed complete hearing loss in the right ear and indicated otitis media in the left ear, which could have been the cause of the conduction disturbances.

Surgical Treatment of the Giant Cell Tumors in the Spine (척추에 발생한 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Lee, In-Ju;Chang, Han;Kwon, Soon-Yong;Rhyu, Kee-Won;Yi, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.1
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    • pp.37-43
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    • 1998
  • Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

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A Case Report of Congenital Spinal Dermal Sinus Tract (선천성 척추 피부동관 증례보고)

  • Shim, Byung-Kwan;Kim, Yong-Bae;Nam, Seung-Min;Choi, Hwan-Jun
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.827-830
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    • 2010
  • Purpose: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. Methods: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. Results: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. Conclusion: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

Idiopathic Polymyositis in a Young Mature Alaskan malamute (젊은 성숙 알라스칸 말라뮤트에서 특발성 다발성근염 증례)

  • Lee, Jae-Il;Hong, Sung-Hyeok;Son, Hwa-Young;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.244-246
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    • 2007
  • Clinical and histopathologic features of idopathic polymyositis in twenty-month-old Alaskan malamute dog are described. The clinical signs were progressive exercise intolerance with acute exacerbation of weakness, muscle atrophy, synchronous pelvic limb gait, short stiff steps and tip-toeing as like walking on eggshells. Physical and clinical examination revealed no evidence of neurologic, skeletal and secondary muscular disorders associated with other diseases. Therefore muscle biopsy was performed at the most severe muscle atrophy lesions to confirm by histopathology. Histopathologic findings documented mononuclear cell infiltration and necrosis of muscle fiber and it was diagnosed as idiopathic polymyositis. Initial treatment was focused on pain relief. Prednisone at immunosuppressive dose (2 mg/kg) was administered orally twice daily. After 3 weeks of starting treatment, the patient showed improvement of gait, appetite, exercise as well as gradually return to normal state of hematologic and serum chemistry profiles.

Evaluation Tools for Patients with Neurologic Disorders Based on the ICF Model: A Survey of Korean Physical Therapists (ICF 모델 기반 신경계 환자 물리치료 평가 도구 사용 조사)

  • Lee, Ji-ah;Woo, Yong-Keun;Won, Jong-Im;Kim, Su-jin
    • PNF and Movement
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    • v.20 no.3
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    • pp.359-370
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    • 2022
  • Purpose: Physical therapists are required to properly choose the most appropriate treatment for each patient within the framework of the International Classification of Functioning, Disability, and Health (ICF model). The aims of this study were to determine whether neurological physical therapists in clinical settings in South Korea know about the ICF model and to investigate the current trends of outcome measures (OMs) used by them. Methods: Two hundred and one physical therapists who worked with patients with neurological disorders participated in this study. The survey was conducted via e-mail and asked about commonly used OMs and the considerations for selecting OMs. Results: All physical therapists involved in this study responded completely, and 45.8% of participants learned about the ICF model, while 37.3% understood the detailed information related to the ICF model. The rest of the participants did not know or just heard about the ICF model. The most frequently used tools at the body function/structure level were the Range of Motion (98%), Manual Muscle Test (97%), Berg Balance Scale (83.1%), and Modified Ashworth Scale (70.6%) when allowing repetition. At the activity level, the 10-meter walk test (71.1%), 6-minute walk test (54.2%), and Functional Ambulatory Category (43.3%) were used, while the Activity-Specific Balance Confidence Scale (23.9%) was used at the participation level. There was a positive relationship between the number of tools used and years of work, as well as the level of understanding of the ICF model. Conclusion: The results of this study suggest that it is necessary to learn the ICF model in a clinical setting. In addition, the medical system needs to be modified to encourage physical therapists in South Korea to use proper OMs within the ICF model.

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

  • Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.96-102
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    • 2019
  • Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

  • Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.96-102
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    • 2019
  • Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.

A Rare Atypical Case of Asymptomatic and Spontaneous Intraneural Hematoma of Sural Nerve: A Case Report and Literature Review

  • Shin Hyuk Kang;Il Young Ahn;Han Koo Kim;Woo Ju Kim;Soo Hyun Woo;Seung Hyun Kang;Soon Auck Hong;Tae Hui Bae
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.208-211
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    • 2024
  • Intraneural hematoma is a rare disease that results in an impaired nerve function because of bleeding around the peripheral nerve, with only 20 cases reported. Trauma, neoplasm, and bleeding disorders are known factors for intraneural hematoma. However, here we report atypical features of asymptomatic and spontaneous intraneural hematoma which are difficult to diagnose. A 60-year-old woman visited our clinic with the complaint of a palpable mass on the right calf. She reported no medical history or trauma to the right calf and laboratory findings showed normal coagulopathy. Ultrasonography was performed, which indicated hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy and evacuation was performed without nerve injury. Histological examination revealed intraneural hematoma with a vascular wall. No neurologic symptoms were observed. In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our case report may help establish the implications of diagnosis and treatment. Also, we suggested surgical treatment is necessary even in cases that do not present symptoms because neurological symptoms and associated symptoms may occur later.

Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients (급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.98-104
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    • 2012
  • Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

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Prognostic Value of Repeated Cerebrospinal Latex Agglutination Testing in Bacterial Meningitis (세균성 뇌수막염에서 뇌척수액 Latex 응집 추적검사의 유용성)

  • Lee, Soo Jeong;Ahn, So Hyun;Cho, Su Jin;Kim, Hae Soon;Lee, Seung Joo
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.345-350
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    • 2003
  • Purpose : Bacterial meningitis is a serious infection of childhood associated with a significant morbidity and mortality. Repeated cerebrospinal fluid(CSF) examination is a useful prognostic indicator and a delayed sterilization is associated with a higher incidence of neurologic abnormalities. In this study we tried to determine the prognostic value of repeated CSF latex agglutination testing. Methods : We retrospectively evaluated 19 patients admitted to Ewha Womans University Mokdong Hospital for bacterial meningitis from January 1997 to June 2002. Bacterial meningitis was confirmed by a positive CSF culture and a positive CSF latex agglutination test. Repeated CSF examinations were done at three, seven, 14, 21 and 28 days after antibiotics therapy. Neuroradiologic studies were performed. Results : The mean age was $10.6{\pm}12.3months$(range; two to 33 months). The male to female ratio was 2.8 : 1. The causative organisms were Haemophilus influenzae type b 57.9%, Group B Streptococcus 21.1%, Streptococcus pneumoniae 15.7% and Escherichia coli 5.3%. Three days after the initiation of antibiotics therapy, repeated CSF latex agglutination tests persisted as positive in nine (47.4%) out of 19 cases, but all CSF cultures became negative. In those cases with negative latex agglutination tests three days after antibiotics therapy, neuroradiologic findings were completely normal. But, in cases with positive latex agglutination tests three days after antibiotics therapy, neuroradiologic abnormalities such as cerebral infarction, encephalomalasia occurred in 44.4%. Conclusion : Repeated CSF latex agglutination testing was valuable as a prognostic factor in bacterial meningitis. Neuroradiologic abnormalities may occur in cases with delayed clearance of CSF latex agglutination tests more often than in cases with negative latex agglutination tests three days after antibiotics therapy.