• Title/Summary/Keyword: Sensory disturbance

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A case of X-linked Charcot-Marie-tooth disease type 1 manifesting as recurrent alternating hemiplegia with transient cerebral white matter lesions

  • Kang, Minsung;Hwang, Sun-Jae;Shin, Jin-Hong;Kim, Dae-Seong
    • Annals of Clinical Neurophysiology
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    • v.23 no.2
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    • pp.130-133
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    • 2021
  • X-linked Charcot Marie Tooth disease type 1 (CMTX1) is a clinically heterogenous X-linked hereditary neuropathy caused by mutation of the gene encoding gap junction beta 1 protein (GJB1). Typical clinical manifestations of CMTX1 are progressive weakness or sensory disturbance due to peripheral neuropathy. However, there have been some CMTX1 cases with accompanying central nervous system (CNS) manifestations. We report the case of a genetically confirmed CMTX1 patient who presented recurrent transient CNS symptoms without any symptom or sign of peripheral nervous system involvement.

A Study of Postural Control Characteristics in Schoolchild with Intellectual Disability (초등학교 지적장애아동의 자세조절 특성)

  • Lee, Hyoung Soo
    • 재활복지
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    • v.14 no.3
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    • pp.225-256
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    • 2010
  • This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

  • Kim, Yoon-Tae;Pang, Kang-Mi;Jung, Hun-Jong;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.3
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    • pp.127-133
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    • 2013
  • Objectives: Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods: Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. Results: Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. Conclusion: Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery.

An Analysis of Health Problems Experienced by the Clients Receiving Hemodialysis (혈액투석 환자들이 경험한 건강문제 분석)

  • 신미자
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.903-916
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    • 1996
  • The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows : 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric keratosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul oder of uremia.

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Anlysis of Fatigue Perceived by the Hospitalized Children's Mother (입원 환아의 어머니가 자각하는 피로)

  • Park In-Sook;Kim Shin-Jeong;Kang Kyung-Ah;Kim Tae-Hee
    • Child Health Nursing Research
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    • v.10 no.1
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    • pp.80-88
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    • 2004
  • Purpose: The purpose of this study was to explore the fatigue of the mothers of the hospitalized children's mothers in descriptive study. Method: Two hundred eighty three mothers who take care of the hospitalized children in three University hospitals were enrolled from June, 1 to October, 30, 2003. Data were collected using a questionnaire titled 'Symptom Table on Fatigue Perception' designed by the Fatigue Research Committee of Japan, consisted of a total 30 items categorized into three sub-dimensions: the physical, the psychological and the neuro-sensory. SPSS was used for the analysis of data with 0.05 of significance. Result: 1) The mean average fatigue score of subjects was 1.94(SD:.48): the physical fatigue revealed the highest value with a mean of 2.19(SD:.57), followed by psychological fatigue with a mean score of 1.85(SD:.52), neuro-sensory fatigue with a mean of 1.79(SD:.51). 2) With the respect to the general characteristics of hospitalized children and mothers, there were statistically significant differences in the mothers' fatigue perception by the child sex(t=-2.697, p=.008), the character of child(F=9.032, p=.000), the child condition compared to pre-hospitalization(F=3.523, p=.031), with or without support in domestic households(t=-1.981, p=.049), the amount of sleeping time(t=2.704, p=.007), and with or without of night-time sleep disturbance because of the child hospitalization(t=2.082, p=.038). Conclusion: These results suggest that health care professional need to be aware of the persistent presence of the maternal fatigue related to the child hospitalization and the factors worsen the degree of the fatigue.

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The Correction of Inverted Nipple Using Modified Purse-string Suture (변형된 쌈지봉합을 이용한 함몰 유두의 교정)

  • Oh, Sang-Ha;Woo, Jong Seol;Lee, Seung Ryul;Kim, Jae Ryoung
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.687-691
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    • 2008
  • Purpose: An inverted nipple presents both cosmetic and functional problems. It is a source of repeated irritation and inflammation, and interferes with nursing. In addition, its abnormal appearance may cause psychological distress. With consideration of its underlying pathophysiologic components and severity, a number of techniques have been introduced for correction of this anomaly. The diversity of techniques indicates the lack of a good, sustainable, and durable solution for this quite common problem. We report our method as an alternative solution for correcting of the inverted nipple. Methods: From August 2003 to November 2007, 273 nipples in 147 patients were treated. 126 patients had bilateral inverted nipples. Patient age at the operation ranged from 21 to 63 years(mean age, 34 years). All nipples were congenital anomaly. 45 nipples were graded as grade I, 179 nipples as II, and 49 nipples as III. In the our study, we made some modification to the classic purse-string suture: (1) twice purse-string suture: (2) excision of diamond-shaped skin at the nipple neck: (3) buried suture of the breast parenchyma at the nipple base: (4) some timely release of retraction using Bovie's electrocautery dissection at inner surface of the nipple neck. Results: The operation time averaged 15 minutes. The mean follow-up period ranged from 3 to 48 months, with an average of 8.4 months. There were no complications associated with the surgery, such as infection, hematoma, permanent sensory disturbance, or total nipple necrosis except temporary sensory loss in 9 cases, partial nipple necrosis in 7 cases, and recurred inversion in 15 cases. All patients except recurred inversion were satisfied with their results. Conclusion: We believe that our modified purse-string suture is a reliable, simple, safe, and effective method for correcting the inverted nipple.

A Study of Bi-Jeung in the Mid-Chosun Dynasty: Based on the Seungjeongwon Ilgi (조선 중기의 비증(痺症)에 대한 연구: 승정원일기(承政院日記)를 중심으로)

  • Cho, Woo-Young;Jung, Jae-Young;Chung, Seok-Hee
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.111-118
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    • 2015
  • Objectives Through the clinical records of Seungjeongwon Ilgi, we reviewed the usage of Bi-Jeung to know the concept of the word and studied therapeutic strategies for managing Bi-Jeung. Methods We investigated the clinical records of the mid-Chosun dynasty containing the key word "Bi" from electronic database (Seungjeongwon Ilgi). Results Of 4,039 records, 249 articles thought to have medicinal value were lastly selected. We subdivided the cases into 13 categories according to time, the connection of contents and the change of associated symptoms. "Bi" was not used alone but used in combination with body parts or other symptoms. Etiological causes of "Bi" involved dampness, phlegm, fire, heat and qi disorders. We suggested that "Bi" of the mid-Chosun dynasty meant a symptom group mainly of sensory impairment and additionally pain or motor disturbance. Among the 22 herbal medicine formulas used, 15 were based on internal medical pattern identifications and 7 were symptomatic treatments. Acupuncture and moxibustion therapy were primarily applied to adjacent acupoints. In addition, External therapies were used together, such as washing therapy, plaster therapy, cupping therapy and thermotherapy. Conclusions "Bi" principally indicated sensory impairment on limbs and the main etiological cause was considered to be dampness. Herbal medicine, acupuncture, moxibustion and external therapies were used to cure Bi-Jeung.

Neuroprotective Effects and Physicochemical Characteristics of Milk Fortified with Fibroin BF-7 (BF-7 강화 우유의 뇌기능보호 효과 및 물리화학적 특성)

  • Choi, Gooi-Hun;Jo, Mi-Na;Moon, Sun-Hee;Lim, Sung-Min;Jung, A-Ram;Yoon, Yoh-Chang;Paik, Hyun-Dong
    • Food Science of Animal Resources
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    • v.28 no.4
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    • pp.431-436
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    • 2008
  • The impact of storage on the neuroprotective effects against $A\beta$-induced cell death and physicochemical characteristics of milk fortified with BF-7 were investigated. The BF-7 milk exerted protection of neuronal cells SK-N-SH from amyloid beta ($A\beta$)-induced neuronal stress. Our results showed that incubation of the cell with pretreated BF-7 milk, significantly attenuated apoptotic stress by $A\beta$, considered in cell morphology and nucleus shape. The general compositions were maintained consistently in BF-7 fortified milk (BF-7 milk). The BF-7 did not make any disturbance on pH and titratable acidity. The color change was not detected, either. Also, any microorganism had not been detected with more than 7 days storage at $4^{\circ}C$. In sensory evaluation study. the average scores of each sensory attribute were quite similar with plain milk. In conclusion, our results strongly indicate that BF-7 characteristics are quite adequate to be included in milk and BF-7 milk is still working well on neuro-protection, result in enforcing our brain and delaying neurodegeneration.

Antipsychotics for patients with pain

  • Shin, Sang Wook;Lee, Jin Seong;Abdi, Salahadin;Lee, Su Jung;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.3-11
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    • 2019
  • Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (${\alpha}$), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak $D_2$ receptor bindings with strong binding to the $5-HT_{2A}$ receptor, while typical antipsychotics block long-lasting, tight $D_2$ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.

Personal experience with microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia

  • Lee, Jung Hwan;Lee, Jae Meen;Choi, Chang Hwa
    • Journal of Yeungnam Medical Science
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    • v.38 no.3
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    • pp.202-207
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    • 2021
  • Background: Trigeminal neuralgia (TN) is a severe, paroxysmal pain in the distribution of the fifth cranial nerve. Microvascular decompression (MVD) is the most widely used surgical treatment for TN. We undertook this study to analyze the effects of and complications of MVD and to refine the surgical procedure for treating TN. Methods: A total of 88 patients underwent for TN underwent surgery at our hospital. Among them, 77 patients underwent MVD alone, and 11 underwent partial sensory rhizotomy (PSR) with or without MVD. The medical records of these patients were retrospectively analyzed for patient characteristics, clinical results, offending vessels, and complications if any. Results: The mean follow-up duration was 43.2 months (range, 3-216 months). The most common site of pain was V2+V3 territory (n=27), followed by V2 (n=25) and V3 (n=23). The most common offending vessels were the superior cerebellar artery and anterior inferior cerebellar artery in that order. The overall rate of postoperative complications was 46.1%; however, most complications were transient. There were two cases of permanent partial hearing disturbance. In the MVD alone group, the cure rate was 67.5%, and the improvement rate was 26.0%. Among 11 patients who underwent PSR with or without MVD, the cure rate was 50.0%, and the improvement rate was 30.0%. Conclusion: The clinical results of MVD were satisfactory. Although the outcomes of PSR were not as favorable as those of pure MVD in this study, PSR can be considered in cases where there is no significant vascular compressive lesion or uncertainty of the causative vessel at the surgery.