• 말소리와 음성과학
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• 제16권1호
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• pp.57-65
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• 2024

정상압 수두증(normal pressure hydrocephalus, NPH)은 뇌의 뇌척수압은 정상 범위에 있지만 뇌척수액이 정상 수준보다 증가해 뇌실확장증을 유발하는 질환으로, 조음기관의 운동성과 범위가 감소해 조음교대운동(diadochokinesis, DDK)과 말명료도에 영향을 줄 수 있다. 본 연구에서는 NPH 환자 38명과 정상 노인 38명을 대상으로 /파/, /타/, /카/ 및 /파타카/에 대한 DDK 과제를 실시한 후, 정확한 산출만 측정한 DDK(accurate token-DDK)와 부정확한 산출 포함, 모든 산출시도를 측정한 DDK(all token-DDK)의 두 방법을 모두 사용해 그 결과를 비교하였다. 또한 DDK가 NPH와 정상 노인의 두 집단을 얼마나 정확하게 분류 가능한지, 그리고 DDK와 말명료도 간 상관관계는 어떠한지에 대해서도 알아보았다. 연구결과, NPH 집단과 정상 노인 집단 간에는 accurate token-DDK와 all token-DDK 모두에서 유의한 차이가 있었고, 집단 분류정확도는 accurate token-DDK의 경우 75.0%, all token-DDK의 경우 77.6%로 비교적 높았다. 그러나 NPH 집단에서 DDK 속도와 말명료도 측정값 간에는 유의한 상관관계가 없었다. 본 연구는 NPH 환자의 말운동능력을 민감하게 평가하는 데에 DDK가 유용한 방법임을 시사한다.

• 대한중풍순환신경학회지
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• 제17권1호
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• pp.45-54
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• 2016

A case of a 75-year-old Korean female with gait disturbance due to Normal pressure hydrocephalus (NPH) is presented. She was treated with acupuncture, electroacupuncture and herbal medicine - 柴苓湯(Shirhyung-Tang, Chai-ling-tang, Sairei-to) We used iNPH grading scale, and specified further the grade of gait disturbance category. After Korean medical treatment, there was notable improvement in gait disturbance on our specified scale. Cognitive impairment, tremor and rigidity were improved on each scale alongside. Korean medical treatment may be effective in treating NPH patients.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.437-440
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• 2013

The cerebrospinal fluid tap test (CSFTT) is recommended as a key step in the diagnosis of idiopathic normal pressure hydrocephalus (iNPH). While there is no generally accepted evaluation period for ascertaining a CSFTT responder, a substantial number of patients are evaluated only once within 24 hours of the test for improvement in gait. We report an iNPH patient with a favorable response to shunt surgery, who was first judged a non-responder by this standard, though subsequently was judged a responder in virtue of repetitively testing gait over 7 days. A 68-year-old man presented with progressive impairment of gait, balance, and memory. He was diagnosed as iNPH with an Evans' ratio of 0.35. At first hospitalization, change in gait was evaluated 24 hours after the CSFTT. He didn't show any significant improvement and was judged as a non-responder. However, at the second CSFTT, we repetitively tested his change in gait over seven days. Forty-eight hours after the tap, he showed significant improvement in his gait. He was then confirmed as a responder. After the operation, the gait difficulties were almost fully resolved. Further studies developing the standard procedure of the CSFTT should be considered.

• 대한한방내과학회지
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• 제26권4호
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• pp.918-925
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• 2005

The basic mechanism of normal pressure hydrocephalus(NPH) is found in an impediment to CSF absorption. In about half of the cases, the etiology remains obscure. NPH is more frequently found in elderly people. The main symptoms are gait disturbances, urinary incontinence and various degree of cognitive changes. The current treatment is ventriculo-peritoneal shunting, ideally using an adjustable valve. In about half of surgical operations, results are poor. Hyeongbangjihwang-tang(荊防地黃湯) is used to treat Soyangin(少陽人) weakness(虛弱) and edema(浮腫). It is and important Gang-Yin(降陰) medicine. A Soyangin patient diagnosed with NPH, who had undergone surgery for ventriculo-peritoneal shunting, was treated with Hyeongbangjihwang-tang. Significant improvement of clinical symptoms was seen, so it is here reported.

• 정신신체의학
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• 제23권1호
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• pp.66-69
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• 2015

정상뇌압수두증은 보행장애, 요실금 및 치매 등의 전형적인 세 가지 증상 외에도 추체외로 증상과 다양한 신경심리 증상이 동반될 수 있다. 이 사례는 불안과 정동증상으로 치료 중 보행장애와 요실금 증상을 보였던 46세 여자 환자에서 항파킨슨 약물의 사용과 기존 정신과 치료 약물의 중단에도 불구하고 증상의 호전이 없었으나, 뇌 컴퓨터 단층 촬영상 뇌실의 확장 소견이 보였고 시험적 뇌척수액 배액에 의해서 수일 내에 증상들이 극적으로 호전되어 정상뇌압수두증을 감별해야 했던 경우이다. 뚜렷한 대뇌 실질의 위축 소견이 없으나 뇌실이 확장되어 있을 경우 추체외로 증상과 신경심리 증상이 있을 경우 정상뇌압수두증의 전형적 세 가지 증상을 보이지 않는다 하더라도 정상뇌압수두증의 가능성을 고려해서 시험적 뇌척수액 배액 등의 시술이 진단과 치료에 도움이 될 수 있음을 보여주는 사례라고 생각된다.

• Korean Journal of Acupuncture
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• 제22권1호
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• pp.43-53
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• 2005

저자(著者)는 사암침(舍岩鍼)을 응용한 수두증(水頭症) 환자(患者) 치료(治療) 2례(例)를 통한 임상적 고찰을 통한 결과 다음과 같이 요약(要約)할 수 있다. 1. 수두증(水頭症)이란 다양한 원인들에 의해서 뇌척수액(腦脊髓液)(cerebrospinal fluid; CSF)의 생성(生成)과 흡수(吸收)에 장애가 생겨 뇌척수액(腦脊髓液)이 뇌실(腦室)이나 두개강내(頭蓋腔內)에 축적되어 발생하는 질병이다. 2. 본 예(例)에서는 뇌경색과 병발(竝發)한 점진적(漸進的)인 정상뇌압수두증(正常腦壓水頭症) 환자(患者)에게는 담정격(膽正格), 신정격(腎正格)을 사용하였으며, 지주막하출혈 후(後) 병발(竝發)한 정상뇌압수두증(正常腦壓水頭症) 환자(患者)에게는 비정격(脾正格), 신정격(賢正格)을 사용하였다. 3. 전자(前者)의 예(例)에서는 별다른 호전(好轉) 양상(樣相)을 경험(經驗)하지 못한 반면, 후자(後者)의 예(例)에서는 치료(治療) 2주(週)만에 양호(良好)한 임상적(臨床的) 호전(好轉)을 보였다. 4. 수두증(水頭症)의 치료(治療)에 있어서 사암침(舍岩鍼)을 포함한 더 다양(多樣)한 한방적(韓方的) 임상연구(臨床硏究)를 기대(期待)하는 바이다.

• 동의신경정신과학회지
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• 제7권1호
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• pp.1-13
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• 1996

1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.