• Title/Summary/Keyword: dystonia

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Maxillary complete denture with posterior zirconia occlusion and mandibular implant support fixed prostheses in completely edentulous patients with orofacial dystonia (구강안면 근긴장이상을 가진 완전 무치악 환자에서 구치부 지르코니아 교합면을 갖는 상악 총의치와 하악 임플란트 지지 고정성 보철물의 수복)

  • Jong-Min Seo;Chang-Mo Jeong;So-Hyoun Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.237-249
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    • 2023
  • Orofacial dystonia is a neuromotor disorder that causes irregular or repetitive movements of the face, lips, tongue, and jaw involuntarily, also called tic disorder. Edentulous patients with these symptoms experience functional and aesthetic problems, including difficulty using complete dentures, speech and swallowing difficulties, and orofacial pain. In this case, for a patient with orofacial dystonia who experienced complete edentulism at a relatively young age, restorative treatment was performed with a maxillary complete denture with bilateral posterior zirconia occlusal surfaces and a mandibular implant-supported fixed prosthesis, and continuous smile training was performed. The aim was to improve the aesthetics of facial muscles. As a result of the treatment, the patient was very satisfied with not only improved chewing function and aesthetics, but also regained psychological stability and was able to lead a normal daily life, so we would like to report this.

Laryngeal Dystonia and Muscle Tension Dysphonia (후두 근긴장이상증과 근긴장성 발성장애)

  • Kim, Ji Won;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.79-81
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    • 2014
  • Spasmodic dysphonia (SD) is a chronic, focal, speech-induced, action-specific dystonia, resulting strained voice. Muscle tension dysphonia (MTD) may also result in a strangled, strained voice quality, usually as a result of compensation for underlying laryngeal disease such as glottal insufficiency. Patients with SD and MTD were suffered from the severely limiting people's communication, especially via telephone and in noisy backgrounds. SD is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks, which is difficult to distinguish from MTD. In this review article, we present the characteritics and management of SD and MTD.

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Oculogyric Crisis Due to Metronidazole Toxic Encephalopathy (메트로니다졸 독성 뇌병증으로 인한 안구운동발작)

  • Lee, Sang-Woo;Kim, Hyeongseok;Heo, Deokhyun;Park, Jeong-Ho
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.322-324
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    • 2018
  • Oculogyric crisis is an acute dystonia involving ocular muscles characterized by sustained conjugate upward or lateral deviation of the eyes. Metronidazole is a commonly used antimicrobial agent in treatment of anaerobic infections. However, its long-term use can cause toxic encephalopathy particularly in patients with hepatic dysfunction. Here, we describe a case of oculogyric crisis as a presenting manifestation of metronidazole-induced encephalopathy.

Pallidal Deep Brain Stimulation in Primary Cervical Dystonia with Phasic Type : Clinical Outcome and Postoperative Course

  • Jeong, Seong-Gyu;Lee, Myung-Ki;Kang, Ju-Young;Jun, Sung-Man;Lee, Won-Ho;Ghang, Chang-Ghu
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.346-350
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    • 2009
  • Objective : The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). Methods : Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for $18.7{\pm}11.1$ months. The mean duration of the CD was $5.8{\pm}3.4$ years. The mean age at time of surgery was $54.2{\pm}10.2$ years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. Results : The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p=0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged $81.7{\pm}6.8%$ at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions : Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.

ΔFY Mutation in Human Torsina Induces Locomotor Disability and Abberant Synaptic Structures in Drosophila

  • Lee, Dae-Weon;Seo, Jong Bok;Ganetzky, Barry;Koh, Young-Ho
    • Molecules and Cells
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    • v.27 no.1
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    • pp.89-97
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    • 2009
  • We investigate the molecular and cellular etiologies that underlie the deletion of the six amino acid residues (${\Delta}F323-Y328$; ${\Delta}FY$) in human torsin A (HtorA). The most common and severe mutation involved with early-onset torsion dystonia is a glutamic acid deletion (${\Delta}E$ 302/303; ${\Delta}E$) in HtorA which induces protein aggregates in neurons and cells. Even though ${\Delta}FY$ HtorA forms no protein clusters, flies expressing ${\Delta}FY$ HtorA in neurons or muscles manifested a similar but delayed onset of adult locomotor disability compared with flies expressing ${\Delta}E$ in HtorA. In addition, flies expressing ${\Delta}FY$ HtorA had fewer aberrant ultrastructures at synapses compared with flies expressing ${\Delta}E$ HtorA. Taken together, the ${\Delta}FY$ mutation in HtorA may be responsible for behavioral and anatomical aberrations in Drosophila.

A Case Report of a patient with Paroxysmal Kinesigenic Dyskinesia (PKD), presumably induced by drug abuse , whose symptoms were improved by Oriental medical treatment. (약물남용으로 유발된 것으로 추정되는 돌발성 운동유발 이상운동증 환자 증례보고)

  • Lee, Ji-Won;Cha, Hye-Jin;Chu, Ching-Nai;Kim, Hyo-Ju;Seo, Young-Min;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.2
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    • pp.289-297
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    • 2008
  • Paroxysmal Kinesigenic Dyskinesia ( PKD ) is an unusual dyskinesia often precipitated by voluntary movements and characterized by brief episodes of choreic/ dystonic movements. Little is known of the pathophysiology of PKD, although secondary etiologies such as multiple sclerosis, ischemic stroke, birth injury , head trauma, drug abuse, etc. are known to induce the disease. We report a case of a male patient suffering from both legs dystonia for 10 years. He had a past history of drug abuse, and was diagnosed as PKD by a neurologist. We treated him with acupucture and herbal medicine and was able to observe the improvement in certain symtoms and general condition.

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Analgesic Effect of Botulinum Toxin on Neuropathic Pain after Trigeminal Nerve Injury (삼차신경 손상에 의한 신경병증성 통증에서 보툴리눔 독소의 진통 효과)

  • Kim, Young-Gun;Kim, Seong-Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.171-178
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    • 2012
  • Botulinum toxin type A (BoNT-A) has been applied successfully to treat chronic migraine, dystonia, spasticity and temporomandubular disorders(TMDs) as well as frontal wrinkle and glabella wrinkle. Recently it has been reported that BoNT-A, reversibly blocks presynaptic acetylcholine release, also inhibits the release of substance P, CGRP(calcitonin gene related peptide) and glutamate related to peripheral sensitization and neurogenic inflammation in sensory nerve, In this study we reviewed animal nerve injury model such as rat and rabbit and identify the analgesic effect and mechanism of nerve injury pain after dental treatment.

Dental Treatment of a Patient with Hallervorden-Spatz Disease under General Anesthesia -A Case Report- (Hallervorden-Spatz 병 환자의 전신마취 하 치과치료 -증례보고-)

  • Lee, Yong-Ki;Seo, Kwang-Suk;Kim, Hyun-Jeong;Yum, Kwang-Won;Ahn, Byung-Deok
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.2
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    • pp.135-138
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    • 2007
  • Hallervorden-Spatz disease (HSD) is a rare autosomal recessive disorder associated with excessive iron deposition in the basal ganglia. In general, HSD is characterized by onset in first two decade of life and by the presence of extra-pyramidal dysfunction including dystonia, rigidity, choreoathetosis. Other associated features include gait and posture disturbance, intellectual decline, seizure, tremor, dysarthria. These signs and symptoms are progressive. MRI is often demonstrated hypodensity in the basal ganglia which is probably suggestive of accumulation of iron. There is no specific treatment for HSD and 45% of patients die before reaching the age of 20 years. The managements directed at specific symptoms are often helpful. Especially, some surgical procedures like pallidotomy and gastrostomy are performed under general anesthesia. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, life-threatening airway obstruction and possibility of aspiration. We report a successful anesthetic management in a patient with HSD for dental procedures.

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A Case of Glutaric Aciduria Type 1 (Glutaric Aciduria Type 1 1례)

  • Song, Joon Young;Kim, Cheol Min;Shin, Young Lim;Yoo, Han Wook
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1278-1282
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    • 2002
  • Glutaric aciduria(type 1) is characterized clinically by progressive dystonia and dyskinesia in childhood, pathologically by degeneration of caudate and putamen, biochemically by tissue deficiency of glutaryl-CoA dehydrogenase(GCDH), and is transmitted as an autosomal recessive traits. Mutations of the GCDH gene on chromosome 19 have been implicated in the causation of glutaric aciduria(type 1). Macrocephaly in infancy and crossing of percentiles for head circumference are real clues to early diagnosis. Acute neuroregression of dystonia following an initial phase of normal or almost normal development is a common mode of presentation, at times preceded by seizures. We experienced a case of glutaric aciduria(type 1) in a 13-month old girl. She was admitted due to development delay and choreoasthetoid movememt that developed after generalized tonic-clonic type seizures. She was diagnosed as having glutaric aciduria(type 1) based on brain MRI and urine organic acid analysis finding.