• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.93-102
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• 2017

Objective: We describe the case of an 84-year-old man with a midbrain infarction causing pupil sparing oculomotor nerve palsy, with ipsilateral cerebellar ataxia diagnosed as Claude's syndrome. Methods: The patient was treated with Korean medicine, including herbal medicine, acupuncture, and electro-acupuncture, during 45 days of hospitalization. Improvements in the patient's symptoms and changes in ptosis were evaluated using the Korean version of the Scale for the Assessment and Rating of Ataxia (SARA). Results: After 45 days of treatment with the Korean medicine, the patient's symptoms, including ataxia and ptosis, improved. Conclusions: This study suggests that the treatment with Korean medicine was effective in aiding the patient's recovery.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.3
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• pp.136-150
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• 2019

Objectives : The purpose of this study is to analyze and understand the trend of Korean medical treatment on ptosis. Methods : From the domestic databases KCI, KISS, OASIS, KTKP, 16 studies were selected using the keyword 'ptosis', published after 2000. Results : Selected 16 studies contain 19 cases in which mainly acupuncture and herbal medicine were practiced to treat ptosis. Treatment period varies from 12 to 134 days. When Korean medical treatment was started before 10 days from the onset, average of treatment period is about 28.6 days, but after 40 days, it increases three times longer. It takes 1.5 times longer to treat ptosis caused from central nerve than which from peripheral nerve. Conclusion : According to the results, Korean medicine can be effective treatment for ptosis which mostly depends on surgical treatment currently. tments of purpura and vasculitis up to date and some points that may have clinical significance.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1264-1273
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• 2022

Posterior communicating artery aneurysms (PcomAAs) are the second most common type of aneurysm. Large cerebral aneurysms show various neurological symptoms, especially oculomotor nerve palsy (ONP), due to PcomAAs. Recent research has shown that stent-assisted coil embolization has many side effects. We report the effectiveness of Korean medicine in the treatment of ONP due to PcomAAs after stent-assisted coil embolization. A patient with ptosis and limitation of eye movement was treated with Korean medicine, including herbal medicine (Samlyeongbaegchul-san-byeonbang [參苓白朮散變方] and Uwhangchungsim-won [牛黃淸心元]), acupuncture, electroacupuncture, cupping, and moxibustion. Clinical symptoms were observed by images of the inter-palpebral fissure and eyeball movement. After the treatment, the inter-palpebral fissure and eyeball movement were noticeably improved. These findings suggest that treatment with Korean medicine can be an effective option for the treatment of ONP due to PcomAAs after stent-assisted coil embolization.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.28-32
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• 2010

Purpose: In accordance with the increasing number of accidents caused by various reasons and recently developed fine diagnostic skills, the incidence of orbital blow-out fracture cases is increasing. As it causes complications, such as diplopia and enophthalmos, surgical reduction is commonly required. This article reports a retrospective series of 5 blow-out fracture cases that had unusual nerve injuries after reduction operations. We represents the clinical experiences about treatment process and follow-up. Methods: From January 2000 to August 2009, we treated total 705 blow-out fracture patients. Among them, there were 5 patients (0.71%) who suffered from postoperative neurologic complications. In all patients, the surgery was performed with open reduction with insertion of $Medpor^{(R)}$. Clinical symptoms and signs were a little different from each other. Results: In case 1, the diagnosis was oculomotor nerve palsy. The diagnosis of the case 2 was superior orbital fissure syndrome, case 3 was abducens nerve palsy, and case 4 was idiopathic supraorbital nerve injury. The last case 5 was diagnosed as optic neuropathy. Most of the causes were extended fracture, especially accompanied with medial and inferomedial orbital blow-out fracture. Extensive dissection and eyeball swelling, and over-retraction by assistants were also one of the causes. Immediately, we performed reexploration procedure to remove hematomas, decompress and check the incarceration. After that, we checked VEP (visual evoked potential), visual field test, electromyogram. With ophthalmologic test and followup CT, we can rule out the orbital apex syndrome. We gave $Salon^{(R)}$ (methylprednisolone, Hanlim pharmaceuticals) 500 mg twice a day for 3 days and let them bed rest. After that, we were tapering the high dose steroid with $Methylon^{(R)}$ (methylprednisolon 4 mg, Kunwha pharmaceuticals) 20 mg three times a day. Usually, it takes 1.2 months to recover from the nerve injury. Conclusion: According to the extent of nerve injury after the surgery of orbital blow-out fracture, the clinical symptoms were different. The most important point is to decide quickly whether the optic nerve injury occurred or not. Therefore, it is necess is to diagnose the nerve injury immediately, perform reexploration for decompression and use corticosteroid adequately. In other words, the early diagnosis and treatment is most important.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.340-343
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• 2017

Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient's clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.

• Journal of Korean Neurosurgical Society
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• v.66 no.4
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• pp.418-425
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• 2023

Objective : Deciphering the anatomy of posterior communicating artery (PCoA) aneurysms in relation to surrounding structures is essential to determine adjuvant surgical procedures. However, it is difficult to predict surgical structures through preoperative imaging studies. We aimed to present anatomical structures using preoperative high-resolution three-dimensional proton density-weighted turbo spin-echo magnetic resonance (PDMR) imaging with simple classification. Methods : From January 2020 to April 2022, 30 patients underwent PDMR before microsurgical clipping for unruptured PCoA aneurysms in a single tertiary institute. We retrospectively reviewed the radiographic images and operative data of these patients. The structural relationship described by PDMR and intraoperative findings were compared. Subsequently, we classified aneurysms into two groups and analyzed the rate of adjuvant surgical procedures and contact with the surrounding structures. Results : Correlations between preoperative PDMR predictions and actual intraoperative findings for PCoA aneurysm contact to the oculomotor nerve, temporal uncus, and anterior petroclinoid fold (APCF) reported a diagnostic accuracy of 0.90, 0.87, and 0.90, respectively. In 12 patients (40.0%), an aneurysm dome was located on the plane of the oculomotor triangle and was classified as the infratentorial type. Compared to the supratentorial type PCoA aneurysm, adjuvant procedures were required more frequently (66.7% vs. 22.2%, p=0.024) for infratentorial type PCoA aneurysm clipping. Conclusion : Preoperative PCoA aneurysm categorization using PDMR can be helpful for predicting surgical complexity and planning of microsurgical clipping.

• The Korean Journal of Physiology
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• v.6 no.2
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• pp.49-56
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• 1972

This experiment was designed to explore specific functional relationship between the vestibular canals and the extraocular oblique muscles by observing the isometric tension responeses of the muscles to the selected vestibular canal excitation. The vestibular excitation was simulated by either stimulation of the individual canal nerve or endolymphatic fluid displacement in each canal. Each canal nerve was subjected to square wave pulses with a monopolar wire electrode placed closely to the ampullary nerve endings for electrical stimulation, and a fine stainless cannula was introduced into the each canal toward the ampulla and a minute amount $(0.5{\sim}3.5\;microliter)$ of fluid was injected in or ejected out by means of a microsyringe connected to the cannula to produce ampullopetal or ampullofugal displacement of endolymphatic fluid. The superior oblique muscle was contracted by the excitation of homolateral canals and was relaxed by contralateral canals. On the contrary, the inferior oblique was contracted by the contralateral canals and was relaxed by the homolateral canals. Summation of excitatory and inhibitory canal effects from the bilateral vestibular system was demonstrable on the tension changes of the oblique muscles. Excitation of either dual or triple canals of the unilateral vestibular system also caused summation effect on the tension response of the oblique pair; thus multiple signals from the different ampullary receptors seems to be converged into the relevant ocular motor muclei. Since the superior and inferior obliques are known to receive their motor fibers from the contralateral trochlear nuclei and intermediate nuclei of the homolateral oculomotor complex respectively, the above experimental evidences indicate that the ocular motor nuclei for oblique muscles receive excitatory signals from the contralateral vestibular canals and inhibitory signals from the homolateral canals.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.3
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• pp.842-844
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• 2003

Miller Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia and develops after respiratory tract viral infection. Other events are GI tract infection, vaccination, digitalis intoxication, insect bite and delivery. Diagnosis of Miller Fisher syndrome can be made with clinical history taking, cardinal symptoms and normal findings of CT or MRI. We have experienced a case of Miller Fisher syndrome and treated with herbal medicine, eletro-acupuncture at paralytic external ophthalmic muscles. We enforced electro-acupuncture for 10 minutes daily. We used the PG-306 electro-acupuncture products(Suzuki Iryoki Co. Japan) and applied the low consequence wave of 1-8Hz. In 3 months, all the main symptoms disappered and the patient improved in health. Based on this experience, herbal medicine and eletro-acupuncture can be applied to the Miller Fisher syndrome.

• The Journal of Internal Korean Medicine
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• v.39 no.2
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• pp.201-208
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• 2018

Objectives: This is a case report about the effect of Korean medicine on blepharoptosis and ocular motility disorders that occur with thalamus, midbrain, and cerebellum infarctions. Methods: The patient was treated using Korean medicine such as acupuncture, moxibustion, and herbal medicine (Boyanghwano-tang-gamibang). The change of blepharoptosis was evaluated by measurement of palpebral fissure width (PFW), marginal reflex distance-1 (MRD1), and marginal reflex distance-2 (MRD2). The change inocular motility disorders was evaluated by comparison using photographs of the extraocular movements of the patient. We used the Numeric Rating Scale-11 (NRS-11) of diplopia and dizziness to evaluate the effectiveness of treatment. Results: After treatment, blepharoptosis and ocular motility disorders were improved. The NRS-11 score of dizziness decreased from 10 to 7, and diplopia disappeared after Korean medicine treatment. Conclusions: According to this study, Korean medicine can be effective for treating blepharoptosis and ocular motility disorders in thalamus, midbrain, and cerebellum infarctions.

• Annals of Clinical Neurophysiology
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• v.8 no.2
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• pp.171-173
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• 2006

Marcus Gunn jaw winking phenomenon has been thought to result from a congenitally abnormal innervation of the levator palpaebrae muscle by a branch of the trigeminal nerve. A 22-year old man presented with bilateral eyelid elevation on the chewing or eating since infancy. Neurological examination showed bilateral Marcus Gunn Jaw wingking phenomenon in this patient. We referred this patient to the department of ophthalmology and plastic surgery for levator resection or orbicularis oculi muscle flap. We report bilateral Marcus Gunn jaw winking phenomenon, although unilateral disorder is the most common form of trigemino-oculomotor synkinesis. Neurologists should be aware of this phenomenon for decision of proper management and take detailed neurologic examination for elucidating the association of other cranial nerves.