• Title/Summary/Keyword: dystonia

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Thalamic Deep Brain Stimulation for Writer's Cramp

  • Cho, Chul-Bum;Park, Hae-Kwan;Lee, Kyung-Jin;Rha, Hyoung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.52-55
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    • 2009
  • Writer's cramp is a type of idiopathic focal hand dystonia characterized by muscle cramps that accompany execution of the writing task specifically. There has been renewed interest in neurosurgical procedures for the treatment of dystonia over the past several years. In particular, deep brain stimulation (DBS) has received increasing attention as a therapeutic option for patients with dystonia. However, to date, limited reporters made investigations into DBS in relation to the Writer's cramp. In this case, unilateral Ventro-oralis complex (Vo) DBS resulted in a major improvement in patient's focal dystonic movement disorders. Her post-operative Burke-Fahn-Marsden Dystonia Rating (BFMDR) scale demonstrated 1 compared with pre-operative BFMDR scale 4. We conclude that thalamic Vo complex DBS maybe an important neurosurgical therapeutic option for Writer's cramp.

Cervical Dystonia Cases Managed by Yinyang Balancing Appliance for FCST, Functional Cerebro Spinal Therapy of TMJ (FCST의 음양균형장치를 이용한 연축성 사경증 증례보고)

  • Choe, Geun-Wook;Lee, Young-Jun
    • Journal of TMJ Balancing Medicine
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    • v.2 no.1
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    • pp.20-25
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    • 2012
  • Objectives: Therapeutic effect of Yinyang Balancing Appliance of functional cerebrospinal therapy (FCST) for meridian and neurologic yinyang balance was observed in cervical dystonia cases. Methods: Two cervical dystonia cases were managed with the Yinyang Balancing Appliance on temporomandibular joint (TMJ), combined with acupuncture. Clinical outcome measurement was based on subjective measures and clinical observations. Results: The patients showed positive changes even after the initial treatment and this effect maintained over the follow-up period. Conclusions: Although it is not clear the effect is a sustaining or temporary in its nature, a positive effect was observed and further clinical and biological research on FCST is expected.

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A Case Report of Korean Medicine Treatment for a Patient with Cervical Dystonia (경부 근긴장이상증 환자에 대한 한방치료 증례보고 1례)

  • Hyo-won Jin;Jeong-rim Bak;Jeong-rim Bak;Jong-min Yun;Byung-soon Moon
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.948-956
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    • 2023
  • The purpose of this study is to report a case of cervical dystonia and the effects of a series of traditional Korean medicine treatments applied to the patient. The patient was treated with conventional treatment and traditional Korean medicine consisting of acupuncture, moxa, chuna therapy, and herbal medicine (Hoesu-san-gami) for 48 days. Progress was measured by Tsui's score, the Toronto Western Spasmodic Torticollis Rating Scale, and the Neck Disability Index. We observed some improvements in the patient's symptoms: Tsui's score of 15 to 11, TWSTRS of 63.3 to 47.8, and NDI of 24 to 17. These findings indicate that the application of traditional Korean medicine to cervical dystonia can yield decent clinical outcomes.

Bilateral Pallidotomy for Dystonia with Glutaric Aciduria Type 1

  • Hwang, Hyung-Sik;Salles, Antonio De
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.380-383
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    • 2005
  • Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

A New Therapeutic Approach to Dystonia

  • Lee, Young-Jun
    • Journal of TMJ Balancing Medicine
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    • v.11 no.1
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    • pp.1-11
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    • 2021
  • Dystonia is a neurological disorder characterized by involuntary and uncontrollable muscle tonus abnormalities. It is a huge burden not only to the patients and their families, but also to the field of medicine, in that there has hardly been any substantial change in the concept of and approach to this intractable disorder and therefore no breakthrough to its diagnosis, evaluation and treatment. As an effort to solve the current impasse, this review briefly summarizes the current concept, etiology, diagnosis, treatment and management, and then suggests a rather new therapeutic approach to this disorder, based on the concept of neurological balance and TMJ integrative approach. These new approaches will provide a platform for the clinicians and researchers to have a leap in the concept, diagnosis and therapeutics.

A Case of Cervical dystonia Treatment Using Yin-yang Balancing Therapy of Temporomandibular Joint (턱관절음양균형요법을 이용한 연축성 사경증 치험 1례)

  • Sang Bae Lee;Young Jun Lee
    • Journal of TMJ Balancing Medicine
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    • v.12 no.1
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    • pp.15-21
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    • 2022
  • This case is witten for presenting the effect of the TMJ balancing therapy using the TMJ balancing appliance which normalizes the yin and yang balance of the brain-nervous system including the Meridian system. The balancing appliance was used in patient with cervical dystonia, and clinical outcome measurements were performed through clinical observations in specific movement and actions. The patient displayed positive changes after the treatment and the effect was well-maintained during the treatment period. For the more precise evaluation, clinical and biological studies of temporomandibular balancing therapy (TBT) are needed.

Aripiprazole-Related Oculogyric Dystonia

  • Lee, Jae-Eun;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.3
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    • pp.257-262
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    • 2013
  • Objectives : Aripiprazole is unique drug among the SGA (Second generation antipsychotics) in its pharmacology and pharmacokinetics,but is similar in clinical efficacy. Aripiprazole acts as a partial agonist at dopamine D2 receptors, activating the receptor but eliciting a reduced response compared to the natural neurotransmitter. There are some side effects of aripiprazole, the most common side effects of aripiprazole are headache, nausea, vomiting, insomnia, tremor, constipation and EPS. Difficulty in opening eyes is not defined EPS yet, but it is a rare but important side-effect symptom of aripiprazole. Methods : This article is about a case of side-effect symptom of aripiprazole, 26-year-old single female suffering from schizophrenia had difficulty in opening eyes while she was taking antipsychotics. During the hospitalization, the relaxation therapy is helpful not only to reduce tension in the eyelids but also to headache. Results : It is important that early recognition of aripiprazole-induced oculogyric dystonia can prevent life-threatening complications. Education medical staff to this easily treatable reaction will improve overall quality of health care. Conclusions : This case notifies the need for awareness of the risk of acute oculogyric dystonia in adolescent female patients receiving aripiprazole.

A Case of Nocturnal Paroxysmal Dystonia: Frontal Lobe Epilepsy and Parasomnias (FLEP) Scale, Polysomnography and Subtraction of Ictal-interictal SPECT Coregistered with MRI (SISCOM) Findings (야간발작성근육긴장이상 1예: 전두엽간질 및 사건수면척도, 수면다원검사, 발작기 및 발작간기 감산 SPECT 소견)

  • Kim, Woojun;Oh, Yun-Sang;Yoon, Bora;Kim, Yeong-In;Lee, Kwang-Soo;Kim, Joong-Seok
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.52-57
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    • 2008
  • Even though the origin and nature of nocturnal paroxysmal dystonia (NPD) remains unclear, it has been considered as a manifestation of the nocturnal frontal lobe epilepsy. We report a 17-year-old man with abnormal stereotyped movement during sleep. Video-EEG monitoring, ictal SPECT and night polysomnography did not show any evidence of epilepsy. However, the partial response to large dose of carbamazepine and the scoring according to the frontal lobe epilepsy and parasomnias (FLEP) scale suggest his events could be classified as epilepsy. Therefore we think the FLEP scale might be a useful tool for differential diagnosis in a patient presenting NPD.

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Botulinum Toxin : Basic Science and Clincal Uses in Otolaryngology (Botulinum Toxin : 기초과학과 이비인후과 영역에서의 임상적 사용)

  • 최홍식;문인석;김한수;김현직
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.164-172
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    • 2002
  • The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

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Bruxism and Oromandibular Dystonia after Brain Injury Treated with Botulinum Toxin A and Occlusal Appliance -A Case Report- (뇌손상 후 발생한 이갈이증과 근육긴장이상에 대한 보튤리눔 독소 A와 교합안정장치를 이용한 치료 증례 -증례 보고-)

  • Kim, Tae-Wan;Baek, Kwang-Woo;Song, Seung-Il
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.13-19
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    • 2010
  • Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.