• Title/Summary/Keyword: Neurological manifestations

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Therapeutic Outcomes and Prognostic Factors in Guillain-Barre Syndrome Treated with Intravenous Immunoglobulin (정주 면역글로불린을 투여 받은 길랑-바레 증후군 환자에서 치료효과와 예후에 영향을 주는 인자들에 관한 연구)

  • Lee, Jee-Young;Cho, Joong-Yang;Kim, Sung Hun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.6 no.2
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    • pp.92-97
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    • 2004
  • Background: There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenous immunoglobulin and plasmapheresis. However, there were controversies in what were significant factors and there were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This study was aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treated with intravenous immunoglobulin. Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to our hospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcome and prognosis were followed up after four weeks using the overall disability sum score. Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence of abnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestations of bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcome in patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnostic features (P<0.018) were significant in the multivariate logistic regression analysis. Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly different according to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulin and preventing complications during acute stages are essential to minimize neurological deficit and shorten the periods of recovery.

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A Case Report of Fahr Disease with Tremor (진전을 동반한 Fahr Disease 환자 치험례)

  • Kim, Tae-Yeon;Shin, Woo-Jae;Park, Yu-Jin;Moon, Joo-Ho;Shin, Seon-Mi;Kim, Gi-Tae;Go, Heung
    • The Journal of Internal Korean Medicine
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    • v.32 no.3
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    • pp.435-443
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    • 2011
  • Fahr disease (FD) is a rare neurological disorder characterized by presence of abnormal and associated cell loss in certain areas of the brain, mostly in basal ganglia, thalamus, cerebellum and subcortical areas. Approximately two-thirds of the patients are symptomatic. The most common neurological manifestations include movement disorders, cognitive impairment, cerebellar signs and speech disorders. We report one case of estimated FD through brain computed tomography (bilateral calcifications of basal ganglia, thalamus, centrum semiovale, subcortical white matter of occipital lobes, cerebellum). At the first time of treatment, he complained of tremors in his upper limbs. We diagnosed the patient as deficiency of qi (氣) and movement of phlegm-heat-wind (痰熱風動) type according to symptoms and treated by herbs and acupuncture of oriental medicine. During treatments, we evaluated how well the oriental medical treatments were working using visual analogue scale (VAS) and amplitude of hands. After the oriental medical treatments about tremor, VAS dropped from 10 to 2 and amplitude of hands from 20 mm to 2 mm, but the ratio of brain calcifications was not changed. This study suggests that oriental medical treatments can be applicable to improve FD.

Relaxation Training for psychogenic tremor patient with anger;A Case Report (분노증세를 동반한 심인성 진전 환자에 대한 이완요법과 한방치료를 실시한 1례 보고)

  • Kim, Sang-Ho;Park, So-Jung;Byun, Soo-Nim;Kim, Ji-Young;Kim, Jong-Woo;Chung, Sun-Yong;Hwang, Wei-Wan;Kim, Ji-Hyouck
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.87-96
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    • 2006
  • Psychogenic neurological conditions account for 1% to 9% of admissions at neurological unit. They are considered manifestations of underlying psychiatry disorders such as somatoform disorders and factitious disorders or malingering. Diagnosis for psychogenic tremor is difficult because mimic tremor is occurred at the secondary of the organic disorders or coexist in a patient with tremors of organic origin. A patient in this case report was diagnosed as psychogenic tremor, and she also complained the severe anger. A patient did not improved with the chemical medication for a long time. The patient received relaxation training, herbal medication and acupuncture for 20 days and showed short-term alleviation on tremor and decreased anger problem and other somatic problems.

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Moist and Mold Exposure is Associated With High Prevalence of Neurological Symptoms and MCS in a Finnish Hospital Workers Cohort

  • Hyvonen, Saija;Lohi, Jouni;Tuuminen, Tamara
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.173-177
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    • 2020
  • Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

Febrile Seizure Associated With COVID-19 in a Child: Case Report and Literature Review (소아 코로나바이러스감염증-19에서 발생한 열성 경련)

  • Yu Ri Jo;Nayoung Jung;Min Kyoung Kim ;Young Se Kwon;Dong Hyun Kim
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.147-152
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    • 2024
  • There have been several case reports of neurological manifestations in pediatrics as severe acute respiratory syndrome coronavirus-2 infection in children is being increased. We report a case of a 4-year-old boy who presented febrile seizure during follow-up in a negative pressure isolation room after confirmed coronavirus disease 2019, which has not yet been reported in Korea. He has no symptoms other than fever. The seizure was controlled after one dose of intravenous lorazepam, and there was no respiratory support during the hospitalization. He was discharged 12 days later without neurological sequelae.

Defective Self-Renewal and Differentiation of GBA-Deficient Neural Stem Cells Can Be Restored By Macrophage Colony-Stimulating Factor

  • Lee, Hyun;Bae, Jae-sung;Jin, Hee Kyung
    • Molecules and Cells
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    • v.38 no.9
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    • pp.806-813
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    • 2015
  • Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder caused by mutations in the glucocerebrosidase gene (GBA), which encodes the lysosomal enzyme glucosylceramidase (GCase). Deficiency in GCase leads to characteristic visceral pathology and lethal neurological manifestations in some patients. Investigations into neurogenesis have suggested that neurodegenerative disorders, such as GD, could be overcome or at least ameliorated by the generation of new neurons. Bone marrowderived mesenchymal stem cells (BM-MSCs) are potential candidates for use in the treatment of neurodegenerative disorders because of their ability to promote neurogenesis. Our objective was to examine the mechanism of neurogenesis by BM-MSCs in GD. We found that neural stem cells (NSCs) derived from a neuronopathic GD model exhibited decreased ability for self-renewal and neuronal differentiation. Co-culture of GBA-deficient NSCs with BM-MSCs resulted in an enhanced capacity for self-renewal, and an increased ability for differentiation into neurons or oligodendrocytes. Enhanced proliferation and neuronal differentiation of GBA-deficient NSCs was associated with elevated release of macrophage colony-stimulating factor (M-CSF) from BM-MSCs. Our findings suggest that soluble M-CSF derived from BM-MSCs can modulate GBA-deficient NSCs, resulting in their improved proliferation and neuronal differentiation.

The Usefulness of Serum Lipid Concentration as a Predictor of Convulsion in Patients with Glufosinate Ammonium Poisoning (글루포시네이트 암모늄 중독환자에서 경련 예측인자로서의 혈중 지질 농도의 유용성)

  • Lee, Hyun Do;Sun, Kyung Hoon;Kim, Seong Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.40-46
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    • 2017
  • Purpose: Glufosinate ammonium (GA; phosphinothricin) can induce neurological complications such as altered mental status, amnesia, and convulsions. This study was conducted to evaluate whether blood lipid profiles can help predict convulsions in patients with GA poisoning. Methods: This study was a retrospective review of data acquired at a tertiary academic university hospital from March 2014 to July 2016. Independent t-test, Mann-Whitney test and Analysis of covariance (ANCOVA) of demographic and laboratory findings of 50 patients with GA poisoning were performed to identify correlations of general characteristics and laboratory findings, including blood lipid profiles of GA-poisoned patients between with and without convulsions. Results: Convulsion as a GA complication showed a significant association with poison volume, age, white blood cell count, and creatine phosphokinase (CK), albumin, lactate dehydrogenase (LDH), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) content in blood according to an independent t-test and Mann-Whitney test. However, ANCOVA demonstrated significant association with LDL and triglyceride. Conclusion: Blood lipid profiles, especially serum LDL and triglyceride, were useful in predicting convulsions in patients with GA poisoning.

Brain meningioma in a patient with systemic lupus erythematosus

  • Yoo, Byung-Woo;Ahn, Sung-Soo;Pyo, Jung Yoon;Byun, Se-Jin;Song, Jason Jungsik;Park, Yong-Beom;Lee, Soo-Kon;Song, Jung-Soo;Lee, Sang-Won
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.159-161
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    • 2016
  • Brain meningioma, the most common benign brain tumor, has been reported to account for 13-26% of all intracranial tumors, with a crude incidence rate of 2.3 per 100,000 persons for all types of meningiomas. The prevalence of neuropsychiatric lupus erythematosus is 15-91% and its clinical manifestations are diverse: from mild cognitive dysfunction to serious neurological or psychiatric symptoms. Here, we report the first Korean patient with brain meningioma and systemic lupus erythematosus who had undergone surgical tumor resection.

Systematic review of the clinical and genetic aspects of Prader-Willi syndrome

  • Jin, Dong-Kyu
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.55-63
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    • 2011
  • Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder that is caused by the lack of expression of paternally inherited imprinted genes on chromosome 15q11-q13. This syndrome has a characteristic phenotype including severe neonatal hypotonia, early-onset hyperphagia, development of morbid obesity, short stature, hypogonadism, learning disabilities, behavioral problems, and psychiatric problems. PWS is an example of a genetic condition caused by genomic imprinting. It can occur via 3 main mechanisms that lead to the absence of expression of paternally inherited genes in the 15q11.2-q13 region: paternal microdeletion, maternal uniparental disomy, and an imprinting defect. Over 99% of PWS cases can be diagnosed using DNA methylation analysis. Early diagnosis of PWS is important for effective long-term management. Growth hormone (GH) treatment improves the growth, physical phenotype, and body composition of patients with PWS. In recent years, GH treatment in infants has been shown to have beneficial effects on the growth and neurological development of patients diagnosed during infancy. There is a clear need for an integrated multidisciplinary approach to facilitate early diagnosis and optimize management to improve quality of life, prevent complications, and prolong life expectancy in patients with PWS.

A Korean case of neurofibromatosis type 1 with an exonic splicing enhancer site mutation

  • Park, Sangwook;Sohn, Young Bae;Chung, In-Soon;Hong, Ji-Hee;Jung, Eun-Jung;Jeong, Seon-Yong;Jin, Hyun-Seok
    • Journal of Genetic Medicine
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    • v.11 no.1
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    • pp.40-42
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    • 2014
  • Neurofibromatosis type 1 (NF1) is an autosomal dominant disease characterized by neurological, cutaneous, and ophthalmological manifestations. A 33-year-old woman with typical symptoms of NF1 visited Ajou University Hospital. Screening of the whole-messenger RNA region of NF1 at the complementary DNA level by polymerase chain reaction-direct sequencing confirmed the presence of an NF1 mutation at the genomic level. The mutation analysis revealed an in-frame skipping of exon 46 (c.6757_6858del) caused by a point mutation (c. 6792C>A) in exon 46. In this report, we have described the first Korean case of a proband with NF1 that carries an allele with an exon 46 deletion caused by an exonic splicing enhancer site mutation, leading to the skipping of the whole of exon 46 (c.6757_6858del).