• 제목/요약/키워드: Quadriplegia

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한의치료로 호전되었던 사지마비, 운동실조, 인지저하를 호소하는 베르니케 뇌병증 환자 증례보고 1례 (A Case Report of a Patient with Wernicke's Encephalopathy Complaining of Quadriplegia, Ataxia, and Impaired Cognition Improved by Korean Medicine Treatment)

  • 심상송;이현승;안재윤;채한나;윤종민;문병순
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.777-786
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    • 2020
  • Background: This study is a report on a case of a Wernicke's encephalopathy with quadriplegia, ataxia, and impaired cognition, whose condition was improved by Korean medicine treatment. Case report: A 51-year-old man diagnosed with Wernicke's encephalopathy was treated with acupuncture, Banhabakchulchunma-tang mixed with Ondam-tang-gami (半夏白朮天麻湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Berg Balance Scale (BBS), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and a numeric rating scale (NRS). After 22 days of treatment, his clinical symptoms showed improvement. The motor function improved (MMT Rt. side Gr. 4+G/4+G, Lt. side Gr. 4G/4+G → Rt. side Gr. 5-N/4+G, Lt. side Gr. 5-N/4+G), Ataxia was relieved (BBS 3→33), cognition improved (K-MMSE 15→27), ADL scores showed improvement (FIM 58→90, MBI 40→75), and the NRS score decreased for headache (3→0). Conclusion: Korean medicine treatment could be effective in the treatment of patients with Wernicke's encephalopathy.

일산화탄소에 기인한 Delayed Neuropsychiatric Sequalae 환자에서 발생한 사지 불완전마비 증례보고 1례 (Delayed Neuropsychiatric Sequalae with Reversible Quadriplegia after Carbon Monoxide Intoxication : A Case Report)

  • 유주영;김민지;이강욱;조현경;유호룡;설인찬;김윤식
    • 대한한의학회지
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    • 제39권3호
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    • pp.73-80
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    • 2018
  • Carbon monoxide poisoning leads to hypoxia, which eventually leads to tissue ischemia. The delayed neuropsychiatric syndrome can arise in the period from 4 days to 5 weeks following carbon monoxide poisoning. This case report describes a male who suffered from delayed sequelae after self-inflicted carbon monoxide poisoning. At the time of admission, he had symptoms of quadriplegia, both upper limb ankylosis, gait disturbance, and dysuria. He was treated with acupuncture, electro-acupuncture, physical therapy, and Uwhangchungsim-won. Paraplegia improved considerably after 7 days in hospital, and paralysis of the both upper extremities improved after 14 days in hospital. He was able to walk holding on to his wheelchair after 28 days in hospital. He was hospitalized for 55 days and was discharged from the hospital in a fine condition for everyday life. This case report suggests the possibility that korean medicine for delayed neuropsychiatric syndrome.

제초제 음독 후 발생한 신경학적 후유증으로 사지마비, 인지저하를 호소한 환자의 한의치료 증례보고 1례 (A Case Report on Korean Medical Treatment for a Patient with Quadriplegia and Impaired Cognition as Neurological Sequelae after Ingestion of Herbicides)

  • 심상송;안재윤;진효원;윤종민;문병순
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.904-915
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    • 2021
  • This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G→Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.

외상성 성문하 기관 협착증의 수술 치험 1례 (Surgical Treatment of Traumatic Subglottic Stenosis; A Case Report)

  • 최필조
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.409-412
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    • 1993
  • We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

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Comparison of Trunk Control on Gross Motor Function and Topography in Children with Spastic Cerebral Palsy

  • Choi, Young-Eun;Jung, Hye-Rim;Kim, Ji-Hye
    • 대한물리의학회지
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    • 제14권4호
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    • pp.45-53
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    • 2019
  • PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.

생체역학 모델을 통한 균형능력과 상지기능의 중재: 단일대상연구 (Intervention based on Biomechanical Frame of Reference for Balance and Manual Function: a Single Subject Research)

  • 김태훈
    • 한국콘텐츠학회논문지
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    • 제9권11호
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    • pp.231-239
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    • 2009
  • 본 연구는 생체역학 모델에 기반한 상지훈련을 통해서 강직성 사지마비(spastic quadriplegia) 아동의 균형능력과 상지기능의 변화를 알아보고자 하였다. 매 회기마다 앉은 자세 및 선 자세에서 기능적 팔 뻗기 검사를 실시하였고, 초기와 마지막 회기에 아동 균형척도(Pediatric Berg Balance Scale)와 3차원 동작분석 시스템(CMS-70P, Zebris Medizintechnik Gmbh, Germany)을 사용하여 움직임을 측정하였다. 1주간 기초선 측정 후, 4주간 매 40분씩 12회기 동안 생체역학적 모델에 기반한 상지훈련을 실시한 결과, 기능적 팔 뻗기 검사에서 모든 측정값이 기초선 평균의 +2SD(standard deviation)를 벗어났다. 동작 분석 시스템 상에서 수행 시간, 최고 속도, 최고 속도 도달 시간, 움직임 단위 수가 향상되었고, 아동 균형 척도 검사결과가 향상되었다. 따라서, 생체역학 모델에 기반한 상지훈련은 상지기능 향상뿐만 아니라 균형 향상에도 긍정적 도움이 될 것으로 사료되며, 연구 결과의 일반화를 위해서 대상자와 과제를 다양화한 추후 연구가 필요할 것이다.

사지마비로 장기 침상안정 환자에서 폐결핵 발생부위 변화 1예 (A Case of Atypical Distribution of Pulmonary Tuberculosis in Bedridden Patient with Quadriplegia)

  • 황헌규;정은정;임건일;양승부;임한혁
    • Tuberculosis and Respiratory Diseases
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    • 제69권1호
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    • pp.52-55
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    • 2010
  • Pulmonary tuberculosis has intermediate prevalence in Korea. It is known that tuberculosis infection predominantly involves the upper lobes, based on the fact that multiplication of Mycobacterium tuberculosis is favored in areas with decreased pulmonary blood flow, impaired lymphatic drainage, and high oxygen tension. We report this case of a 40-year-old man who was brought to our hospital with hemoptysis and dyspnea. Prior to admission, the patient had been in a bedridden state for 15 years due to an injury of the cervical spine 4~5. A 3-Dimensional computed tomography showed predominantly longitudinal distribution of centrilobular nodules along the anterior chest wall, in the left lung. MTB-PCR and AFB culture of bronchial washing fluid revealed pulmonary tuberculosis. This case shows that long-standing supine posture and decreased motion of the anterior chest wall may change the distribution of preferential infection site of Mycobacterium tuberculosis in the lung, resulting in a ventral predominance of tuberculosis infection in the quadriplegic patient.

위증에 대한 문헌적 고찰 (The Literary study on Flaccidity-syndrome)

  • 곽중문;오민석
    • 혜화의학회지
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    • 제9권1호
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    • pp.661-689
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    • 2000
  • We came to the conculsion after considering all of information from many kinds of books on the cause, pathogenesis and treatment of Flaccidity-syndrome. The results were as follows : 1. Flaccidity-syndrome means limb-relaxation due to muscle atony that isn't able to constraction. It's begun as mild degree from extremities, in some cases ended to quadriplegia or expire. 2. Cause factor and pathogenesis of Flaccidity-syndrome is various. After Lung fluid consuption caused by heat-evil was refered in The Yellow Emperor's Canon of Internal Medicine. They were refered as cause factor that Main channel asthenia, excess of sexual intercourse, wetness-evil, heat-evil gets into the interior, asthenia of the spleen and stomach. Since Ming Dynasty, It's classified to wetness-heat evil, wetness-phlegm, deficiency of vital energy, deficiency of blood, deficiency of yin, blood stasis and indygestion, etc. 3. In the view of treatment of Flaccidity-syndrome, Yangming was selected in The Yellow Emperor's Canon of Internal Medicine, and it's been mean to clear away wetness-heat evil located at Yangming. In the method of acupuncture it was same on the base, and many skills have been used that electronic acupuncture, point-injection theraphy, acupuncture point block, catgut implantaion at acupuncture point, cutaneous acupuncture, auriculo-acupuncture and head acupuncture by the through post generation. 4. Flaccidity-syndrome was defined to weak, disuse and non-pain. Beacause it was non-pain, so medicine to expel wind-evil was prevented to use. But through post generation Flaccidity-syndrome has been treated that is able to cause pain or numness as arthralgia-syndrome. Therefore there is tendency that medicine to expel wind-evil is capable within pathological basement of Flaccidity-syndrome in recent. 5. In the view of west-medicine, Flaccidity-syndrome is diplegia or quadriplegia with sensory disorder, muscle atropy in some cases. And there are spinal disease, peripheral nerve disease, muscular disease, nerve-muscle copula disease. The symptoms are able to amyotomia, numness, sensory disorder, pain.

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소뇌 손상에 의한 사지 마비 환자의 보행 및 운동 기능 회복 양상 연구 (Characteristics of Gait and Motor Function Recovery in Quadriplegia Patients with Cerebellar Injury)

  • 여상석
    • PNF and Movement
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    • 제21권3호
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    • pp.327-335
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    • 2023
  • Purpose: Cerebellar injury can be caused by a variety of factors, including trauma, stroke, and tumor. Cerebellar injury can manifest in different clinical symptoms and signs depending on the size and location of the injury. The purpose of this study was to examine and compare the recovery patterns of each motor function by tracking the motor levels of patients with cerebellar injury. Methods: This study recruited 11 patients with quadriplegia resulting from cerebellar injury. The motricity index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) methods were used to evaluate motor levels. The motor function evaluation was performed immediately after the onset of the condition and at intervals of one month, two months, and six months after onset. Results: The MI values of the upper and lower extremities and hand function (MBC) indicated severe paralysis in the early stages of onset. Compared to the onset time, significant motor function recovery was observed after 1, 2, and 6 months (p < 0.05). In contrast, there was no significant pattern of recovery between 1, 2, and 6 months after onset (p > 0.05). FAC indicated showed significant recovery at one month compared to onset (p<0.05), and there was also a significant difference between 1 and 2 months (p < 0.05). On the other hand, there was no significant difference in FAC between 2 and 6 months (p > 0.05). Conclusion: Patients with cerebellar injury showed significant recovery in functions related to muscle strength and voluntary muscle control one month after onset and gradually recovered further over the next six months. On the other hand, gait function, which is closely related to balance, showed a relatively slow recovery pattern from the beginning of the disease to the six month follow-up.

사지부전마비를 동반한 뇌경색 환자의 욕창 치험 1례 (A Case Report of Quadriplegia Patients with Decubitus Ulcer)

  • 김기태;정진화
    • 대한한의진단학회지
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    • 제19권3호
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    • pp.185-193
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    • 2015
  • Objectives The purpose of this report is to represent decubitus ulcer(pressure sore) improved by carbon arc and oriental medicine. Methods Patients with decubitus ulcer were treated with carbon arc, acupuncture, herbal medicine and simple dressing. Laser was irradiated at ulcer site once a day for 5 hour, using cored carbon number 3000,3002. Simple dressing with wound cleansing was performed to prevent reinfection. Herbal medicine and acupuncture treatment were applied to improve patients' general condition. Ulcer sizes and aspects were carefully checked by one week. Results Sizes of the decubitus ulcer decreased. Stage of ulcer was improved from stage 3 to stage 2. These results show that carbon arc may play a role in treating the decubitus ulcer with oriental medicine.