• Annals of Clinical Neurophysiology
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• v.11 no.2
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• pp.81-82
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• 2009

• The Journal of Internal Korean Medicine
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• v.28 no.4
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• pp.758-762
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• 2007

Objectives : This study investigated the relationship between presymtoms and stroke subtype in early state of stroke patients. Methods : From Oct. 2005 to May 2007, 623 early state stroke patients were included. Patients were hospitalized within 30 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, or Kyung Hee University Oriental Hospital. We investigated general characteristics, stroke subtype, and presymtoms (facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke(odds ratio 2.80). Small vessel occlusion had more neck stiffness than others(odds ratio 1.59). Conclusions : Facial spasm and neck stiffness would be valuable as stroke presymtoms.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.427-431
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• 1998

Diffuse esophageal spasm(DES) is a rare disease seen in 4% of all patients studied in an esophageal motility laboratory, and its diagnosis and surgical management is still controversial. Recently, we treated two patients by extended esophageal myotomy for diffuse esophageal spasm which was diagnosed by the clinical symptoms of patients, esophagoscopy, esophagography, and esophageal manometry. The successful result of treatments was proved with subsidence of previous clinical symptoms(dysphagia and chest pain), postoperative esophagography and esophageal manometry. We present the results together with the review of literatures.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.633-636
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• 2007

Coronary artery spasm immediately after the coronary artery bypass graft (CABG) surgery is rare but it can cause sudden and severe hypotension or a ventricular arrhythmia. We report a case of low cardiac output syndrome caused by a right coronary artery spasm following CABG that did not show any significant stenotic lesions on preoperative coronary angiography.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.364-367
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• 2013

Microvascular decompression is a very effective and relatively safe surgical modality in the treatment of hemifacial spasm. But rare debilitating complications have been reported such as cranial nerve dysfunctions. We have experienced a very rare case of unilateral soft palate palsy without the involvement of vocal cord following microvascular decompression. A 33-year-old female presented to our out-patient clinic with a history of left hemifacial spasm for 5 years. On postoperative 5th day, patient started to exhibit hoarsness with swallowing difficulty. Symptoms persisted despite rehabilitation. Various laboratory work up with magnetic resonance image showed no abnormal lesions. Two years after surgery patient showed complete recovery of unitaleral soft palate palsy. Various etiologies of unilateral soft palate palsy are reviewed as the treatment and prognosis differs greatly on the cause. Although rare, it is important to keep in mind that such complication could occur after microvascular decompression.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.4
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• pp.163-171
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• 2022

Objectives : The aim of this study was to report that effect of Korean medicine treatment for patient with peripheral facial nerve palsy accompanied by hemifacial spasm through hospitalization. Methods : We treated a patient with facial nerve palsy by acupuncture, electroacupuncture, herbal medicine, pharmacopuncture and cupping. The effect of treatment was evaluated using the House-Brackmann scale, the Yanagihara grading system, and the visual analogue scale(VAS). Results : During the 18 days hospitalization period, the symptoms of hemifacial spasm disappeared and the facial palsy improved. The House-Brackmann scale changed from 4 grade to 2 grade, the Yanagihara grading system changed from 19 to 47, and the VAS changed from 3 to 0. Conclusions : This case report suggests that Korean medicine could be effective for facial palsy accompanied by hemifacial spasms.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.262-268
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• 2016

Hemifacial spasm is a disease caused by involuntary facial muscles with repeated unilateral convulsive spasms. It involves contraction of multiple muscles at the same time (synkinesia). The pathogenesis appears to be the pressure on the vessel by the facial nerve. This study included hemifacial spasm patients, who received microvascular decompression surgery. Brainstem auditory evoked potential and the examination time were carefully noted when using brain surgical retractor. The facial nerve electromyography tests for the identification of artifacts and EMG waveform when the facial nerve damage, about the importance of the maintenance of anesthesia in the lateral spread response and in a somatosensory evoked potential propose a new method. Based on the above test, it will be more effective.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.340-345
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• 2009

Objective : We investigated the locations of compressing vessels in hemifacial spasm. To approach compression sites, we described and evaluated the efficacy of the infranuchal infrafloccular (INIF) approach. Methods : A retrospective review of 31 consecutive patients who underwent microvascular decompression (MVD) through INIF with a minimum follow-up of 1 year was performed. Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment. The INIF approach was used to inspect the CNS segment and the TRZ. Subdural patch graft technique was used in order to achieve watertight dural closure. The cranioplasty was performed using polymethylmethacrylate. The outcome and procedure-related morbidities were evaluated. Results : Twenty-nine patients (93%) showed complete disappearance of spasm. In two patients, the spasm was resolved gradually in 2 and 4 weeks, respectively. Late recurrence was noted in one patient (3%). The TRZ has been identified as the only compression site in 19 cases (61.3%), both the TRZ and CNS segment in 11 (35.5%) and the CNS segment only in 1 (3.2%). There was no patient having a compressing vessel in the PNS segment. Infection as a result of cerebrospinal fluid leak occurred in one patient (3%). Delayed transient facial weakness occurred in one patient. Conclusion : The TRZ and the CNS segment were more vulnerable area to the compression of vessels. We suggest that surgical avenue with the INIF approach provides early identification of this area.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.814-821
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• 2019

Objective: This case study reports on the result of Korean medicine treatment of diffuse esophageal spasm. Methods: A 46-year-old female Korean patient with diffuse esophageal spasm received electroacupuncture, herbal medicine, and moxibustion treatment for 2 weeks in hospital. Results: Decreases in the visual analog scale (VAS) (from 8.7 to 7.0), numeric rating scale (NRS) (from 7.0 to 5.5), gastrointestinal symptom rating scale (GSRS) (from 9 to 6), and gastroesophageal reflux disease-health related quality of life questionnaire (GERD-HRQL) (from 46 to 38) scores were observed after the treatment. Conclusion: Evaluation of Korean medicine treatment is worthwhile for rare diseases like diffuse esophageal spasm.

• Yonsei Medical Journal
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• v.59 no.9
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• pp.1057-1063
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• 2018

Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.