• Title/Summary/Keyword: Sensation disorder

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Current diagnosis and treatment of vestibular neuritis: a narrative review

  • Ba, Chang Hoon;Na, Hyung Gyun;Choi, Yoon Seok
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.81-88
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    • 2022
  • Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

Stress Coping Strategies and Cognitive Characteristics of Somatic Symptom Perception in Patients with Generalized Anxiety Disorder (범불안장애 환자의 스트레스 대처방식과 신체증상 지각에 대한 인지적 특성)

  • Kim, Yong;Park, Jong-Il;Park, Tae-Won;Chung, SangKeun;Yang, Jong-Chul
    • Anxiety and mood
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    • v.13 no.2
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    • pp.100-107
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    • 2017
  • Objective : The purpose of this study was to investigate strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with generalized anxiety disorder(GAD). Methods : A total of 55 patients meeting DSM-5 criteria for GAD and 55 normal controls were recruited for participation in this study. We evaluated subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Generalized Anxiety Disorder for 7 Item (GAD-7). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In terms of SCQ, GAD patients presented significantly lower scores on seeking social support and higher scores on wishful thinking than normal controls. GAD patients had significantly greater amplification of physical sensation in SSAS and higher scores in physical, psychological interpretation subsets of SIQ than normal controls. GAD-7 scores were positively correlated with physical interpretation scores on SIQ. Conclusion : Results reveal that patients with GAD have insufficient coping strategies for stress, greater amplification of body sensations, and tendency towards a physical, psychological interpretation of somatic symptoms.

A Review on the Concept Establishment of Stagnation Syndrome (울증(鬱證)의 개념 정립에 관한 문헌고찰)

  • Kim, Sanghyun;Choi, Yujin;Jung, In Chul;Lee, Mi Young;Yang, Changsop
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.2
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    • pp.121-133
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    • 2020
  • Objectives: The purpose of this study was to identify the meanings and characteristic of the stagnation syndrome, a distinctive clinical syndrome in traditional Korean medicine (KM). Methods: The major ancient Oriental medicine literature, including Huangdi neijing (黃帝內經), Danxixinfa (丹溪心法), and Jingyuequanshu (景岳全書) were examined to identify the semantic change of the stagnation syndrome (鬱證). Also, recently published articles about the stagnation syndrome were searched from databases including MEDLINE, CENTRAL, KMBASE, KISS, NDSL, and OASIS. Results: The term of stagnation was originally used to describe not flowing and clogged situations, and the stagnation syndrome appeared as an independent syndrome in Danxixinfa. As the etiology became more sophisticated over time, emotional factors were mentioned for one of the causes of the stagnation syndrome. However, the major causes and symptoms of the stagnation syndrome were somatic factors. Various articles about stagnation were searched, and most of them used "stagnation" as the KM syndrome subtype of disease, some of them referred to the "stagnation syndrome" as an independent syndrome. The recently defined stagnation syndrome commonly shows distinctive symptoms of chest stuffiness, and an obstructing sensation in the throat. Conclusions: The semantic changes and characteristics of the stagnation syndrome were examined through searching ancient and modern literature. The meaning of the stagnation syndrome has evolved over time, and at its center, there are somatic and mental symptoms characterized by stagnation, distinguished from the depressive disorder.

CARE OF POSTTRAUMATIC PAIN SYNDROME IN THE PSYCHIATRIC DISORDER PATIENT : REPORT OF CASES (정신 장애 환자에서 외상후 통증증후군의 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.1
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    • pp.9-16
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    • 2015
  • Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

Traumatic Brain Injury-Induced Mixed Chemosensory Disorder: a Case Study on Taste and Smell Dysfunction

  • Yeong-Gwan Im;Seul Kee Kim;Chung Man Sung;Jae-Hyung Kim
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.181-185
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    • 2023
  • We present a case report of a 52-year-old male patient who suffered head trauma in a car accident and subsequently experienced taste and smell disorders. Following the accident, the patient reported difficulty detecting salty and sour tastes and diminished olfactory perception. Neurosurgical evaluation revealed subarachnoid and subdural hemorrhages, while otolaryngology investigations revealed hyposmia-a decreased sense of smell. Upon referral to the Department of Oral Medicine, a comprehensive assessment revealed a general bilateral reduction in taste sensation, particularly ageusia for salty taste. Electric taste-detection thresholds significantly exceeded the normal ranges. Integrating our findings from neurosurgery, otolaryngology, and oral medicine resulted in a diagnosis of mixed chemosensory disorder attributed to head trauma. This case highlights the intricate interplay of alterations in taste and smell following head injury, emphasizing the significance of multidisciplinary evaluations in diagnosing mixed chemosensory disorders resulting from traumatic brain injury.

Prevalence of restless legs syndrome and sleep problems in Korean children and adolescents with attention deficit hyperactivity disorder: a single institution study

  • Kwon, Soonhak;Sohn, Youngsoo;Jeong, Seong-Hoon;Chung, Un-Sun;Seo, Hyeeun
    • Clinical and Experimental Pediatrics
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    • v.57 no.7
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    • pp.317-322
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    • 2014
  • Purpose: Attention deficit hyperactivity disorder (ADHD) is a common disorder in school-aged children. Patients with restless legs syndrome (RLS) often present with ADHD symptoms and vice versa. This study was the first to attempt to identify the prevalence of RLS and sleep problems in children with ADHD in Korea. Methods: Patients diagnosed with ADHD were asked to complete a sleep questionnaire. The sleep questionnaire included items to help identify the presence of four typical symptoms that are used as diagnostic criteria for RLS. Results: A total of 56 patients, including 51 boys and 5 girls (mean age, 10.7 years old) participated. Of these, 24 complained of pain, discomfort, or an unpleasant sensation in the legs. Based on the RLS diagnostic criteria, 2 patients were diagnosed with definite RLS and 4 with probable RLS. There were no significant differences in age, medication dosage, or neuropsychological test scores between the patients with and without RLS symptoms. Conclusion: Approximately 42.9% of patients with ADHD presented with RLS symptoms and 7.1% of these were diagnosed with RLS. Patients with ADHD also experienced various other sleep disorders. Thus, appropriate assessment and treatment for sleep disorders in patients with ADHD is essential.

Small-Fiber Neuropathy (세섬유 신경병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.1-10
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    • 2003
  • Small-fiber neuropathy (SFN) is a common clinical problems. The disorder is a generalized peripheral polyneuropathy that selectively involves small-diameter myelinated and unmyelinated nerve fibers. It is often idiopathic and typically presents with painful feet in patients over the age of 60. And autoimmune mechanisms are often suspected, but rarely identified. The clinical features consisted of painful dysesthesias and postganglionic sympathetic dysfunction, as well as reduced pinprick and temperature sensation. Although affected patients complain of neuropathic pain, this condition is often difficult to diagnose because of the few objective physical signs and normal nerve conduction studies. Diagnosis of SFN is made on the basis of the clinical features, normal nerve conduction studies, and abnormal specialized tests of small fiber function. These specialized studies include assessment of epidermal nerve fiber density as well as sudomotor, quantitative sensory, and cardiovagal testing. Unless an underlying disease is identified, treatment is usually directed toward alleviation of neuropathic pain.

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Neuromodulation for Trigeminal Neuralgia

  • Chung, Moonyoung;Huh, Ryoong
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.640-651
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    • 2022
  • Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

Potential Biomarkers for an Evidence-Based Diagnosis of Burning Mouth Syndrome

  • Won Jung;Kyung-Eun Lee
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.131-136
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    • 2023
  • Burning mouth syndrome (BMS), a chronic pain disorder with an unclear etiology, is characterized by a burning sensation in the oral cavity. The absence of objective diagnostic methods for this condition complicates its diagnosis and treatment. Recently, efforts have been ongoing to find biomarkers for the diagnosis and evaluation of patients with BMS. Several studies have reported hematological changes, differences in salivary protein composition, and peripheral neuropathy in the affected oral tissues. This review summarizes the research regarding the objective changes observed in patients with BMS to identify potential diagnostic approaches.

Clinical Case Report of Restless Leg Syndrome in Ischemic Stroke Patients (뇌경색 환자에서 발생한 하지불안증후군의 한방치료 2례)

  • Park, Sang-Moo;Kang, Baek-Gyu;Han, Deok-Jin;Lee, Jung-Wook;Na, Ran-Hee;Bang, Chang-Ho;Gang, Seak-Oh;Kim, Hoi-Young;Kong, Jae-Cheol;Kim, Kang-San
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.975-981
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    • 2008
  • Restless leg syndrome(RLS) is a sensorimotor disorder characterized by a distressing urge to move the legs and triggered by rest or inactivity. It is usually accompanied with insomnia. We experienced two cases of RLS among ischemic stroke patients. They complained uncomfortable sensation in their affected leg and urge to move the leg at night. We treated them with electro-acupuncture, moxibustion and herbal medicine until retiring. As a result, the symptoms including unpleasant sensation or pain, urge to move the leg and insomnia had withdrawn. These cases suggest the possibility that we can treat RLS with oriental medicine, especially in the case which is refractory to conventional medication or shows periodic leg movements during sleep.