• Phonetics and Speech Sciences
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• v.16 no.1
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• pp.57-65
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• 2024

Normal pressure hydrocephalus (NPH) is a condition wherein the cerebrospinal pressure in the brain is within the normal range, but the cerebrospinal fluid increases above the normal level, causing ventriculomegaly. In patients with NPH, the articulatory system exhibits reduced mobility and range, which may affect diadochokinesis (DDK) and speech intelligibility. In this study, we investigated the characteristics of DDK, including accurate-token DDK and all-token DDK including inaccurate tokens, in patients with NPH and healthy elderly adults (HE). We also examined the classification accuracy of DDK between the two groups. Finally, we investigated whether there was a correlation between speech intelligibility and DDKs in the NPH group. The results showed that NPH and HE groups differed significantly in both accurate-token DDK and all-token DDK, and their classification accuracy was relatively high. However, there was no correlation between speech intelligibility and DDK. The findings suggest that the DDK is a useful method for sensitively assessing speech motor performance in patients with NPH.

• The Journal of the Society of Stroke on Korean Medicine
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• v.17 no.1
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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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• v.54 no.5
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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.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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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.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.66-69
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• 2015

In addition to classical triad such as gait disturbance, urinary incontinence and dementia, parkinsonian extrapyramidal motor signs and neuropsychiatric symptoms can be observed in patients with normal pressure hydrocephalus (NPH). In our case, a 46 year old female patient showed extrapyramidal symptoms such as bradykinesia, rigidity and neuropsychiatric symptoms such as agitation, anxiety, restlessness and regressed behavior beside two(gait disturbance & urinary incontinence) symptoms of three classical triad. It was difficult to diagnose this patient as NPH from the beginning because of her relatively young age and previous psychiatric mediation history for controlling advanced anxiety and affective disorder. Antiparkinsonian agents and discontinuation of psychiatric medications did not work for this patient. Patient's brain computed tomographic finding showed enlarged ventricles. We suspected NPH and did empirical drainage of 30mL CSF. Finally, patient's pyramidal and neuropsychiatric symptoms as well as two of three classical triad of NPH were improved dramatically within several days. It is important to consider NPH as one of the differential diagnosis in patient with parkinsonian symptoms and various neuropsychiatric symptoms who did not respond to usual clinical management especially in case of ventricular enlargement in neuroimaging because of its treatable property by CSF shunt operation.

• Korean Journal of Acupuncture
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• v.22 no.1
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• pp.43-53
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• 2005

Objective : This study was designed to investigate the effect of the Sa-Am Acupuncture treatment on two patients suffering from Normal Pressure Hydrocephalus(NPH). Methods : We selected the two patients who were admitted with NPH. The patients were women with complaints of gait disturbance, dementia, incontinence, hemiparesis and dysarthria, after occurring of cerebral infarction or SAH. We treated the two patients by Sa-Am Acupuncture treatment method and herbal medication. One patient was treated during 64 days, the other was treated during 14 days. Results & conclusions : The Sa-Am Acupuncture treatment was effective on one pateint, not the other. After treatment through oriental medicine, including Sa-Am Acupuncture treatment method, one patient was improved but the other was not changed. Therefore, this application of oriental medicine and Sa-Am Acupuncture treatment are reported with a plea for further investigation.

• Journal of Oriental Neuropsychiatry
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• v.7 no.1
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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.