• Title/Summary/Keyword: Neurological examination

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Understanding of Neurological Examination for Clinical Therapist (임상치료사를 위한 신경학적 검사의 이해)

  • Kim, Byung-Jo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.2
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    • pp.229-236
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    • 2007
  • Clinical therapist use neurological examination to acquire the necessary information from the patients who is neurological damaged. It is necessary to have enough neurological knowledge and clinical experience to collect useful data. Neurological disease of symptom is well correspond with anatomical location and function, therefore neurological examination is one of the powerful tool to diagnosis. These tools will be a great help to clinical therapist to evaluate the patients and helps to select most pertinent treatment approach to patients. Neurological examination can classified and evaluate with Mental Status Examination, Cranial Nerves Examination, Motor and Sensory System Examination, Reflexes, Gait and Station Evaluation, Special Maneuver. Generally, various neurological examination tools are used by therapist in clinical field. Understanding of method of Neurological examination tools and understanding of result of examination from patients's response is very important. Therefore, this research will help to understand clinical meaning by neurological examination.

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Multi-access for the Diagnosis of Missed Upper Lumbar Disc Herniation

  • Lee, Dong-Yeob;Kim, Hyung-Seok;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.144-146
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    • 2005
  • Herein, a case of missed upper lumbar disc herniation, diagnosed by thorough neurological examination, digital infrared thermographic imaging[DITI], and repeated magnetic resonance[MR] image study, is reported. A 36-year-old female presented with intractable leg pain on left anterior thigh. Although she underwent lumbar MR image at other hospital, she was misdiagnosed as acute sprain. Neurological examination suggested the possibility of upper lumbar disc herniation, which was confirmed by DITI, MRI, and selective root block. After operation, her leg pain was significantly improved. It should be considered that upper lumbar disc herniation might be misdiagnosed as an acute sprain, as in our case. A high index of suspicion based on thorough neurological examination is most important in such cases. Then, multi-access such as DITI, MR image, and selective block, base on thorough neurological examination, are warranted.

A Comparison Study of Magnetic Resonance Imaging Findings and Neurological Signs in Canine Brain Diseases

  • Kim, Min-Ju;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.5
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    • pp.178-183
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    • 2018
  • The object of this study was to compare magnetic resonance imaging (MRI) findings and neurological signs in canine brain diseases. Brain diseases can cause severe neurological deficits and may be life-threatening. The antemortem diagnosis of the brain diseases is difficult for the clinician, since definitive diagnosis is based upon histopathological confirmation. Brain diseases are often associated with specific clinical signs, signalment, progression, and location. Accurate lesion localization through neurological examination and MRI findings is helpful for developing a differential diagnosis. A retrospective study was performed to compare the neurological examination of dogs with suspected brain disease to the MRI findings. Based on this study, neurological examination is a reliable way to localize most brain lesions. Postural reaction deficits do not provide sufficient information to localize lesions. Additionally, not all brain lesions present clinical signs and inflammatory lesions may cause no detectable abnormalities on MRI. Therefore, in clinical practice, a combination of neurological examination and MRI findings recommended for accurate brain lesion localization.

How can neurological outcomes be predicted in comatose pediatric patients after out-of-hospital cardiac arrest?

  • Kim, Hyo Jeong
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.164-170
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    • 2020
  • The prognosis of patients who are comatose after resuscitation remains uncertain. The accurate prediction of neurological outcome is important for management decisions and counseling. A neurological examination is an important factor for prognostication, but widely used sedatives alter the neurological examination and delay the response recovery. Additional studies including electroencephalography, somatosensory-evoked potentials, brain imaging, and blood biomarkers are useful for evaluating the extent of brain injury. This review aimed to assess the usefulness of and provide practical prognostic strategy for pediatric postresuscitation patients. The principles of prognostication are that the assessment should be delayed until at least 72 hours after cardiac arrest and the assessment should be multimodal. Furthermore, multiple factors including unmeasured confounders in individual patients should be considered when applying the prognostication strategy.

Post-Laminectomy Kyphosis in Patients with Cervical Ossification of the Posterior Longitudinal Ligament : Does It Cause Neurological Deterioration?

  • Cho, Won-Sang;Chung, Chun-Kee;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.259-264
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    • 2008
  • Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

Preliminary study of presumptive intradural-intramedullary intervertebral disc extrusion in 20 dogs

  • Kim, Jaehwan;Kim, Hyoju;Hwang, Jeongyeon;Eom, Kidong
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.52.1-52.11
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    • 2020
  • Background: Intradural-intramedullary intervertebral disc extrusion (IIVDE) is a rare condition of intervertebral disc disease. However, the diagnosis of IIVDE is challenging because the prognosis and imaging characteristics are poorly characterized. Objectives: We aimed to describe the clinical and imaging characteristics of tentatively diagnosed IIVDE in dogs to assess the prognostic utility of neurological grade and magnetic resonance imaging (MRI) findings. Methods: Twenty dogs were included in this retrospective cohort study. Results: Nonchondrodystrophic breeds (n = 16) were more predisposed than chondrodystrophic breeds. Most dogs showed acute onset of clinical signs. Neurological examination at admission showed predominant non-ambulatory paraparesis (n = 9); paresis (n = 16) was confirmed more frequently than paralysis (n = 4). Follow-up neurological examination results were only available for 11 dogs, ten of whom showed neurological improvement and 8 showed successful outcomes at 1 month. The characteristic MRI findings include thoracic vertebra (T)2 hyperintense, T1 hypointense, intramedullary linear tracts with reduced disc volume, and cleft of the annulus fibrosus. None of the MRI measurements were significantly correlated with neurological grade at admission. Neurological grade did not differ according to the presence of parenchymal hemorrhage, parenchymal contrast enhancement, and meningeal contrast enhancement. Neurological grades at admission showed a statistical correlation with those observed at the 1-month follow-up (r = 0.814, p = 0.02). Conclusions: IIVDE is a rare form of disc extrusion commonly experienced after physical activity or trauma and most frequently affects the cranial-cervical and thoracolumbar regions of nonchondrodystrophic dog breeds. Neurological score at admission emerged as a more useful prognostic indicator than MRI findings in dogs with suspected IIVDE.

Application of Traditional Acupuncture on Canine Intervertebral Disc Disease (개에서 추간판 질환에 대한 침술치료 증례)

  • 정성목;박수원
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.49-51
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    • 2004
  • A four-year-old female Pekingese dog was presented with intermittent ambulatory hindlimb lameness and severe back pain. The course of the disease was acute and static and 5 days passed by until presentation. In neurological examination, severe back pain and slightly decreased proprioception in right hindlimb were shown. In radiographic examination, radiopacity was increased at T10-11 intervertebral disc space. According to the history taking, neurological examination and radiographic examination, it was tentatively diagnosed as intervertebral disc disease (IVDD). Conservative treatment was performed including cage rest, medication with prednisolone and traditional acupuncture. Acupoints were GV-6, GV-7, BL-18, BL-19. BL-40 and GB-34. Dry needlings rested for 20 minutes. Just after the first acupuncture treatment back pain was significantly decreased. With additional acupuncture treatment, all the clinical signs were not observed. It is considered that conservative therapy including traditional acupuncture, medication and cage rest might be the first choice of therapeutic method for Grade I or II IVDD in dogs.

Pediatric headache: a narrative review

  • Kim, Saeyoon
    • Journal of Yeungnam Medical Science
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    • v.39 no.4
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    • pp.278-284
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    • 2022
  • Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.

Morgagni-Stewart-Morel syndrome presenting with neurological symptoms: a case report

  • Bunyamin Tosunoglu;Nazlican Ergin;Nilay Kaya;Levent Ertugrul Inan
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.308-310
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    • 2023
  • Morgagni-Stewart-Morel (MSM) syndrome is characterized by the thickening of the frontal bone of the skull (hyperostosis frontalis internal), obesity, neurological symptoms, and hypertrichosis. We present the case of a 76-year-old patient who complained of confusion, extreme irritability, and headache and was diagnosed with MSM based on examination, imaging, and test results.