• Title/Summary/Keyword: Tremor severity

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A Case Report of Valproic Acid-Induced Tremor by Korean Traditional Medicine (Valproic Acid 투여로 인한 약인성 떨림 환자의 한방 치료 치험 1례)

  • Jang, Hansol;Ha, Yu-bin;Jung, Seung-hyun
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1319-1330
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    • 2021
  • A 56-year-old male patient with a sudden onset of tremor and involuntary movement of right upper and lower extremities, head, and voice was diagnosed as having a drug-induced tremor, with valproic acid being the culprit drug. The patient had undergone admission treatment at an internal Korean medicine department with herbal medicine according to constitutional diagnosis, acupuncture, moxibustion, cupping, and rehabilitation. The change in the severity of tremor was assessed with the Fahn Tolosa Marine scale. After discharge, the patient took herbal medicine for two more months. After 20 days of admission and 2 months of treatment with herbal medicine, the patient's tremor improved. In this case, the patient with valproic acid-induced tremor showed improvement in symptoms after 20 days of hospitalization and further reduction of tremor and improvement of quality of life were confirmed through follow-up for 2 months.

A Case Report of Psychogenic Tremor Patient with Head Tremor (두부진전을 주증상으로 내원한 심인성 진전 환자 치험례)

  • Hwang, Eun-Young;Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.3
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    • pp.95-103
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    • 2010
  • Objectives : Abnormal movements are among the most common psychogenic symptoms, and psychogenic movement disorders(PMD) are estimated to account for 2-3% of patients in movement disorders clinics. Psychogenic tremor is the most frequent symptoms among psychogenic movement disorders. There are no treatment studies specific to PMD and lack any generally accepted treatment strategies. Methods : In this case, a 40 years old women had been suffered from head tremor for 4-5 years without any evidence for other neurological disorders and medical problems. Her symptom caused by stress events and severity of symptom had been change the level of by stress. We treated her with korean traditional herbal medicine(Chengsimyeonjatang), Qigong-based Stress Reduction Program(BQSRP), Giungoroen(wise saying and lofty opinion) and Gyeongjapyeongji(desensitizing the unease) for 2 months. Results : After treatment, the severity and frequency of the head tremors were decreased. In addition, anxiety level also decreased. Conclusions : This result suggests that our oriental medical treatments was effective on psychogenic tremor.

Thalamotomy without Microelectrode Recording

  • Jeon, Sang-Ho;Kim, Moo-Seong;Lee, Sun-Il;Jung, Yong-Tae;Sim, Jae-Hong;Burchiel, Kim J
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.105-111
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    • 2005
  • Objective: Tremor, either essential tremor or Parkinsonian tremor, has been effectively and safely treated by lesioning the ventral intermediate(Vim) nucleus of the thalamus with or without mircroelectrode recording. The authors evaluate the treatment outcome of sixteen tremor patients who had been treated with thalamotomy without microelectrode. Methods: Between September, 2001, and December, 2003, sixteen tremor patients were treated with thalamotomy without microelectrode recording. Twelve patients suffered from Parkinsonian tremor and four patients were essential tremor patients. The male to female ratio was 1.6 to 1 with median age of 59.6 years (range; 39-74 years). Under local anesthesia, a 3mm hole was made using a hand-held twist drill, and the dura mater was penetrated with a 1.2mm sharp drill beat. Radiofrequency(RF) electrode was placed in the Vim nucleus of thalamus. With intraoperative macrostimulation, RF lesion was made. Postoperative CT scan and/or MR imaging was performed to confirm the localization of the target lesioned. Preoperative and postoperative tremor was evaluated with simple tremor severity scale and the development of complications related with the procedure was closely reviewed at the immediate postoperative period and the last follow-up. Results: It produces immediate relief in up to 98.4% of the patients. There were no development of complications related with procedure, all patients discharged one or two days after surgery. Conclusion: Vim thalamotomy without microelectrode recording is a safe and effective procedure to control the tremor with minimal morbidity. Intraoperative macroelectrode stimulation safely localizes the Vim nucleus target of the thalamus for the treatment of patients with tremor.

Quantitative Assessment of Tremor in PD Using a Wearable System on Both Hands (양손에서 웨어러블 시스템을 이용한 파킨슨병의 정량적 진전 평가)

  • Lee, Hongji;Kim, Sangkyong;Kim, Hanbyul;Jeon, Hyoseon;Park, Hyeyoung;Jung, Yujin;Kim, Jeonghwan;Jeon, Beomseok;Park, Kwangsuk
    • Journal of Biomedical Engineering Research
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    • v.35 no.4
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    • pp.81-86
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    • 2014
  • One of the methods for Parkinson's disease(PD) tremor evaluation is the Clinical Tremor Rating Scale(CTRS). However, the method has some limitations that clinician ratings can vary because the scores are subjectively rated. In addition, most researches usually collected data measured on the more affected arm. In this study, we developed a portable wearable system(SNUMAP system) for measuring PD tremor. The SNUMAP system captures 3-dimensional motion using tri-accelerometer and tri-gyroscope on finger and wrist. 40 PD patients participated in resting tremor and postural tremor tasks, while wearing the system on both hands simultaneously. Estimated tremor scores from Leave-One-Out Cross Validation for regression were highly correlated to the average clinician CTRS scores for rest tremor($r^2$ = 0.87, RMSE = 0.48) and postural tremor($r^2$ = 0.82, RMSE = 0.48). Therefore, the quantitative assessment model can improve treatment of PD patients.

A Case Report of a Essential Tremor Patient Aggravated by Hwa-byung (화병에 의해 악화된 본태성 진전증 환자 치험 1례)

  • Ko, In-Sung;Ryu, Ho-Sun;Park, Se-Jin;Ahn, Hyo-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.3
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    • pp.129-142
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    • 2012
  • Objectives : The essential tremor (ET) is characterized by a tremor of the whole body, including both arms. Recent studies suggest that its psychiatric and cognitive factors are more important for treatment and management than motor symptomsymptoms. This study was performed to report the effects of Korean medicine for essential tremor aggravated by Hwa-byung. Methods : We treated a 42 year- old man with Korean medicine (acupuncture, herb-medication and moxibustion) and mental therapy. The effects of the treatment for tremor and skin symptoms were measured by VAS and Severity score (3 level). We used SCL-90-R, BDI, BAI, PSQI and instrument of oriental medical evaluation for Hwa-Byung score (IOMEHB) for a psychological condition. Results : After treatments, tremor, Hwa-byung and accompanying symptoms have improved and subsided. VAS, SCL-90-R, BDI, BAI, PSQI, and IOMEHB have decreased. Conclusions : This result suggests that Korean medical treatment and mental therapy might be effective for the essential tremor aggravated with Hwa-byung.

A Digital Device-Based Method for Quantifying Motor Impairment in Movement Disorders (디지털 디바이스를 이용한 이상운동증에서의 운동손상 정량화 방법)

  • Bae, Suhan;Yun, Daeun;Ha, Jaekyung;Gwon, Daeun;Kim, Young Goo;Ahn, Minkyu
    • Journal of Biomedical Engineering Research
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    • v.41 no.6
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    • pp.247-255
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    • 2020
  • Accurate diagnosis of movement disorders is important for providing right patient care at right time. In general, assessment of motor impairment relies on clinical ratings conducted by experienced clinicians. However, this may introduce subjective opinions into scoring the severity of motor impairment. Digital devices such as table PC and smart band with accelerometer can be used for more accurate and objective assessment and possibly helpful for clinicians to make right decision of patient's states. In this study, we introduce quantification algorithms of motor impairment which uses the digital data acquired during four clinical motor tests (Line drawing, Spiral drawing, Nose to finger and Hand flip tests). The step by step procedure of quantifying metrics (Tremor Frequency, Tremor Magnitude, Error Distance, Time, Velocity, Count and Period) are provided with flowchart. The effectiveness of the proposed algorithm is presented with the result from simulated data (normal, normal with tremor and slowness, poor with tremor, poor with tremor and slowness).

A Case of Severe Serotonin Syndrome Induced by Fluoxetine and Sertraline (Fluoxetine 및 Sertraline으로 유도된 심한 세로토닌 증후군 1예)

  • Cheon, Jin-Sook;Lee, Sang-Shin;Kim, Sung-Hi;Cho, Woong
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.167-174
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    • 2001
  • A 54-year old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

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Clinical studies of 38c.p. children in rehabilitation center (재활원의 물리치료대상 뇌성마비아의 임상적 고찰)

  • Kim, Myung-Hoon;Kim, Sang-Yeob
    • Journal of Korean Physical Therapy Science
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    • v.6 no.3
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    • pp.117-123
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    • 1999
  • The prognosis and result of treatment are influenced by associated cerebral handicaps. 38 cerebral palsied children in rehabilitation center were analized and neuromotor type severity associated defects, and their correlation were studied. The results were follows: 1. neuromotor type distribution was 65.78% of spasticity, 21.05% of athetoid, 2.63% of Ataxia, Tremor, and Rigidity, 5.26% of mixed type. 2. Mean values of I.Q, S.Q and M.Q were 84.3, 63.0 and 26.6 respectively, and percentages of strabismus, speech disturbance, shoulder abnormality, spine abnormality and hip abnormality were 26.3%, 81.5%, 5.2%, 52.6% and 15.9% respectively. 3. Significant differences were noted between each group of mild, moderate, and severe in S. Q, M. Q, and spine abnormality and between moderate and severe group in speech disturbance.

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