• Title/Summary/Keyword: Neurological recovery

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Primary Extramedullary Ependymoma of the Cervical Spine : Case Report and Review of the Literature

  • Son, Dong-Wuk;Song, Geun-Sung;Han, In-Ho;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.57-59
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    • 2011
  • Intradural extramedullary (IDEM) ependymomas occur very rarely and little has been reported about their clinical characteristics. The authors present a case of a 57-year-old woman with an IDEM ependymoma. She was referred for the evaluation of a 4-month history of increasing neck pain and muscular weakness of the left extremities. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an IDEM tumor with spinal cord compression. At the time of surgery, an encapsulated IDEM tumor without a dural attachment or medullary infiltration was noted, but the tumor capsule adherent to the spinal cord and root was left in place to minimize the risk of neurological sequelae. Histologic examination revealed a benign classic ependymoma. The post-operative course was uneventful and radiotherapy was performed. The patient showed an excellent clinical recovery, with no recurrence after 5 years of follow-up.

One Case of Paralytic Strabismus (마비성 사시환자 1례)

  • Lee, Kyu-jin;Kim, Hae-jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.3
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    • pp.120-125
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    • 2004
  • Strabismus is a misalignment of eye, and which devided paralytic and non-paralytic strabismus. Paralytic strabismus is generally a neurological problem, especially 3rd, 4th or 6th nerve. The abducent nerve was most common affected. Paralytic strabismus are treated based on the theory of Oriental medicine with herbal medicine bal-san(發散) and gue-pung(祛風) effects and acupuncture around the eyes and etc. Authors experienced one case of the strabismus of abducent nerve palsy, 35-year-old male, showed disorder abduction of Lt. eye, diplopia and dizziness. Disorder abduction of Lt. eye, diplopia and dizziness and cervical pain improved under the treatment of acupuncture and herbal medicine Thus further clinical study and treatment principle should be made to raise the recovery rate for paralytic strabismus and it's effectiveness of Oriental medical treatment should be informed.

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Brachial Plexus Injury as a Complication after Nerve Block or Vessel Puncture

  • Kim, Hyun Jung;Park, Sang Hyun;Shin, Hye Young;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.210-218
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    • 2014
  • Brachial plexus injury is a potential complication of a brachial plexus block or vessel puncture. It results from direct needle trauma, neurotoxicity of injection agents and hematoma formation. The neurological presentation may range from minor transient pain to severe sensory disturbance or motor loss with poor recovery. The management includes conservative treatment and surgical exploration. Especially if a hematoma forms, it should be removed promptly. Comprehensive knowledge of anatomy and adept skills are crucial to avoid nerve injuries. Whenever possible, the patient should not be heavily sedated and should be encouraged to immediately inform the doctor of any experience of numbness/paresthesia during the nerve block or vessel puncture.

L1-norm Minimization based Sparse Approximation Method of EEG for Epileptic Seizure Detection

  • Shin, Younghak;Seong, Jin-Taek
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.12 no.5
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    • pp.521-528
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    • 2019
  • Epilepsy is one of the most prevalent neurological diseases. Electroencephalogram (EEG) signals are widely used for monitoring and diagnosis tool for epileptic seizure. Typically, a huge amount of EEG signals is needed, where they are visually examined by experienced clinicians. In this study, we propose a simple automatic seizure detection framework using intracranial EEG signals. We suggest a sparse approximation based classification (SAC) scheme by solving overdetermined system. L1-norm minimization algorithms are utilized for efficient sparse signal recovery. For evaluation of the proposed scheme, the public EEG dataset obtained by five healthy subjects and five epileptic patients is utilized. The results show that the proposed fast L1-norm minimization based SAC methods achieve the 99.5% classification accuracy which is 1% improved result than the conventional L2 norm based method with negligibly increased execution time (42msec).

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

  • Leung, Yiu Yan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.5
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    • pp.233-240
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    • 2019
  • Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

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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Surgical Treatment of the Spontaneous Spinal Epidural Abscess (자발성 척추 경막외 농양의 수술적 치료)

  • Lee, Jung-Kil;Kim, Soo-Han;Kim, Eun-Seong;Kim, Tae-Sun;Jung, Shin;Kim, Jae-Hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1037-1042
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    • 2000
  • Objective : The goal of this study was to recognize the clinical feature and associated risk factors in spinal epidural abscess(SEA), and to improve the outcome accordingly. Methods : A retrospective study was performed in 14 patients with SEA who underwent surgical intervention at our hospital between 1990 and 1999. Results : After a mean follow-up period of 10.2 months(range, 1-57 months), 8 patients had no or minimal deficits, 4 patients had severe paresis or plegia and/or bowel/bladder dysfunction, and 2 patients died due to medical complications. Staphylococcus aureus was the predominant pathogen, isolated in 9 patients(64.3%). Cervical and thoracic spinal epidural abscesses showed a tendency to develop rapidly and were associated with severe neurological deficits. Conclusion : Thoracic spinal epidural abscesses were associated with a poorer prognosis than those in other regions. Therefore, it should be treated more aggressively. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

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Nonsurgical Management of Parasagittal Epidural Hematoma Report of 4 Cases (상시정맥동 주위의 뇌경막외 혈종의 비 수술적 치료 -4례 보고-)

  • Nam, Dong-Soo;Kim, Seong-Ho;Kim, Bum-Dae;Bae, Jang-Ho;Doh, Eun-Sig;Kim, Oh-Lyong;Chi, Yong-Chul;Choi, Byung-Yearn;Cho, Soo-Ho;Ihm, Jow-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.173-179
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    • 1990
  • Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and/or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.

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Retroperitoneal Extrapleural Approach for Corpectomy of the First Lumbar Vertebra : Technique and Outcome

  • Zidan, Ihab;Khedr, Wael;Fayed, Ahmed Abdelaziz;Farhoud, Ahmed
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.61-70
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    • 2019
  • Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.

Ameliorative Effects of NXP031 on MPTP-Induced Neurotoxicity (MPTP로 유도된 신경 독성에 대한 NXP031의 개선 효과)

  • Lee, Joo Hee;Song, Min Kyung;Kim, Youn-Jung
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.199-207
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    • 2021
  • Purpose: The purpose of this study was to investigate effects of NXP031, an inhibitor of oxidation by specifically binding to the complex of DNA aptamer/vitamin C, on dopaminergic neurons loss and the reaction of microglia in an animal model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced subchronic Parkinson's disease (PD). Methods: A subchronic PD mouse model was induced via an intraperitoneal (IP) injection of MPTP 30 mg/kg per day for five days. NXP031 (vitamin C/aptamer at 200 mg/4 mg/kg) and vitamin C at 200 mg/kg were administered via IP injections at one hour after performing MPTP injection. This process was performed for five days. Motor function was then evaluated with pole and rotarod tests, after which an immunohistochemical analysis was performed. Results: NXP031 administration after MPTP injection significantly improved motor functions (via both pole and rotarod tests) compared to the control (MPTP injection only) (p<.001). NXP031 alleviated the loss of dopaminergic neurons in the substantia nigra (SN) and striatum caused by MPTP injection. It was found to have a neuroprotective effect by reducing microglia activity. Conclusion: NXP031 can improve impaired motor function, showing neuroprotective effects on dopaminergic neurons in the SN and striatum of MPTP-induced subchronic Parkinson's disease mouse model. Results of this study suggest that NXP031 has potential in future treatments for PD and interventions for nerve recovery.