• Journal of Chest Surgery
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• 제13권3호
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• pp.301-305
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• 1980

Myasthenia gravis is a disorder that affects neuromuscular transmission in a way that is still poorly understood. some think that myasthenia gravis results from a reduction of available acetylcholine receptors in neuromuscular junctions, consequent to some form of autoimmune injury. Surgical interest in this disease was first aroused in 1939 when Blalock observed that some patients with thymic tumors and myasthenia gravis improved following thymectomy. This report represents two cases of myasthenia gravis. The 14-year-old girl was admitted to Korea Universtiy Hospital with chief complaintment of bilateral ptosis, diplopia, swallowing difficulty, and mastication difficulty, which were relieved by administration of edrophonium (Tensilon) chloride, given intravenously. Myasthenica gravis was confirmed and thymectomy was given. After thymectomy, symptoms were relieved but the administration of neostigmine was contijued to be needed till following 3 months. After that period, she was free from this symptoms without anticholinesterase drugs. Second case is 57 year old male who has the symptoms of diplopia, bilatreal ptosis, walking disturbance, and speech difficulty. He had thymectomy too but in thymic tissue, malignant thymoma was included. He has subjective improvement only, with no major reduction of medication requirements after thymectomy.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.43-47
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• 2004

We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

• Clinical and Experimental Pediatrics
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• 제55권9호
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• pp.354-357
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• 2012

Behçet disease (BD) is rare in childhood. We report a 9-year-old boy with neuro-Behçet disease who presented diplopia and weakness on the left side after a cerebral concussion. Brain magnetic resonance imaging (MRI) revealed hyperintensity of the right mesodiencephalic junction on T2-weighted and fluid attenuated inversion recovery images. Prednisolone administration resulted in complete remission and normalization of abnormal MRI finding. Brain MRI is a useful diagnostic tool when the neurological sign is the first symptom of subclinical BD.

• 대한상한금궤의학회지
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• 제11권1호
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• pp.153-167
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• 2019

Objective : To explore the meaning of Eumyangyeokchahunobok-byung (陰陽易差後勞復病) through two cases and finding the relationship with the DSM-5 sleep-wake disorder. Methods : Following a disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS), we analyzed cases with chronic fatigue and diplopia caused after sleep disorders. The patients were treated with the Soshiho-tang and Yijoong-tang. Results : The two herbal medicines showed remarkable improvement in the patients. The sleep disorders and the secondary pathologies were rapidly relieved within a month. Conclusions : The patterns of sleep disorders of the two patients were found to be very similar to the circadian rhythm sleep-wake disorders, as described in DSM-5. Although the etymology of the Chinese characters has not been clearly known yet, it was possible to present the original hypotheses on 更and 了due to clinical inference.

• 한방안이비인후피부과학회지
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• 제22권2호
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• pp.261-268
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• 2009

Objectives : Wallenberg's syndrome is dorsolateral medullary syndrome. The main symptoms of it are ataxia of gait, nausea, vomiting, vertigo, diplopia, numbness, dysphagia and other major symptoms. By use of Oriental medical treatment, we could improve symptoms on one patient with Wallenberg's syndrome. Methods : We conducted one patient with Wallenberg's syndrome after overwork seen at Dong-Eui University Ulsan Oriental Medical Hospital. We treated symptoms from Wallenberg's syndrome by oriental medical treatment such as herb and acupuncture. Results and Conclusion : We suggest that the oriental medical treatment by differentiation of symptoms make the patient with the Wallenberg's syndrome recovery.

• 한방안이비인후피부과학회지
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• 제17권3호
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• pp.120-125
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• 2004

Strabismus is a misalignment of eye, and which devided paralytic and non-paralytic strabismus. Paralytic strabismus is generally a neurological problem, especially 3rd, 4th or 6th nerve. The abducent nerve was most common affected. Paralytic strabismus are treated based on the theory of Oriental medicine with herbal medicine bal-san(發散) and gue-pung(祛風) effects and acupuncture around the eyes and etc. Authors experienced one case of the strabismus of abducent nerve palsy, 35-year-old male, showed disorder abduction of Lt. eye, diplopia and dizziness. Disorder abduction of Lt. eye, diplopia and dizziness and cervical pain improved under the treatment of acupuncture and herbal medicine Thus further clinical study and treatment principle should be made to raise the recovery rate for paralytic strabismus and it's effectiveness of Oriental medical treatment should be informed.

• 한방안이비인후피부과학회지
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• 제32권2호
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• pp.120-130
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• 2019

Objectives : Paralytic strabismus refers to the nerve paralysis in the muscles responsible for the movement of the eyeball for any reason, resulting in a restriction of eye movement. This study is to report a case of the paralytic Strabismus caused by midbrain infarction treated with Korean medicine. Methods : Patient received Korean medical treatment such as acupuncture & herbal medicine (Saengkankunbi-tang). Result & Conclusion : During 15 weeks of the treatment, patient's strabismus and diplopia were improved.

• 대한한방내과학회지
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• 제26권3호
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• pp.670-676
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• 2005

The purpose of this case study is to present a case of oculolmotor nerve palsy due to midbrain infarction improved by acupuncture and herb medicine. Oculomotor nerve palsy is a disorder associated with dysfunction in the third cranial nerve, which causes eye movement disorder, diplopia and ptosis. The patient, who was diagnosed with Benedikt's Syndrome(Red Nucleus Syndrome), was given oriental medical treatment. Benetikt's Syndrome has the various symptoms of weakness on one side(contralateral) and eye movement disorder, ptosis, diplopia(ipsilateral) etc., but research on Benetikt's Syndrome or midbrain infarction is scant. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat oculomotor nerve palsy(eye movement disorder, ptosis, diplopia, etc., ipsilateral) and right motor weakness(contralateral) due to midbrain infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1396-1401
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• 2000

Although direct surgical treatment of the lesion in the pons may cause severe neurologic morbidity, safe route to minimize injuries of the important structures in the pons should be considered. The authors operated four cases of intrapontine lesions via safe approach route without causing severe neurologic complications. Two cases were intrapontine tumors and other two were intrapontine hematoma. An anaplastic astrocytoma($3{\times}3{\times}3cm$) located bilaterally in the pons was approached via midline of the median sulcus, and a metastatic tumor($1.5{\times}1.5{\times}1.5cm$) located at the left posterolateral aspect in the upper pons was approached via suprafacial space. Two cases of hematoma were evacuated via median sulcus, and supra- and infrafacial spaces. Preoperatively, quadriplegia, swallowing difficulty, diplopia, speech disturbance, and nystagmus were noted in a patient with an anaplastic astrocytoma. A patient with metastatic tumor showed mild right hemiparesis, right hemisensory disturbance, diplopia, and dizziness. Two patients with hematoma in the pons were comatous, and had contracted, fixed pupils. Postoperatively, a patient with an anaplastic astrocytoma recovered and a patient with a metastatic tumor showed temporary hemifacial palsy. Mental status was fully recovered normal even though facial palsy, diplopia, severe ataxia, dizziness, and tremor persisted in both patients with pontine hematoma. Careful operation based on the anatomical knowledge of the floor of the 4th ventricle is of prime importance in appraoching to the intrapontine lesion with minimal injuries of the eloquent structures during surgery.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.23-28
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• 2009

Purpose: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium $mesh^{(R)}$, Leibinger, Germany), porous polyethylene ($Medpor^{(R)}$, Porex, USA), absorbable mesh plate(Biosorb $FX^{(R)}$ . Bionx Implants Ltd, Finland). Methods: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. Results: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. Conclusion: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.