• Title/Summary/Keyword: dystonia

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Outcome of Pallidal Deep Brain Stimulation in Meige Syndrome

  • Ghang, Ju-Young;Lee, Myung-Ki;Jun, Sung-Man;Ghang, Chang-Ghu
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.134-138
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    • 2010
  • Objective : Meige syndrome is the combination of blepharospasm and oromandibular dystonia. We assessed the surgical results of bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) in patients with medically refractory Meige syndrome. Methods : Eleven patients were retrospectively analyzed with follow-ups of more than 12 months. The mean follow-up period was $23.1{\pm}6.4$ months. The mean age at time of surgery was $58.0{\pm}7.8$ years. The mean duration of symptoms was $8.7 {\pm}7.6$ years. DBS electrodes were placed under local anesthesia using microelectrode recording and stimulation. After $2.4{\pm}1.3$ days of trial tests, the stimulation device was implanted under general anesthesia. Patients were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Results : BFMDRS total movement scores improved by 59.8%, 63.5%, 74.1%, 74.5%, and 85.5% during the immediate postoperative period of test stimulation, 3, 6, 12, and 24 months (n = 5) after surgery, respectively. The BFMDRS total movement scores were reduced gradually and the results reached statistical significance in the postoperative period (test period, p < 0.001; 3 months, p < 0.001; 6 months, p = 0.003; 12 months, p < 0.001; 24 months, p = 0.042). There was no statistical difference between 12 months and 24 months. BFM subscores improved by 63.3% for the eyes, 80.9% for the mouth, 68.4% for speech/swallowing, and 87.9% for the neck at 12 months after surgery. The adverse effects were insignificant. Conclusion : The bilateral GPi-DBS can be effective for the treatment of intractable Meige syndrome without significant side effects.

A proposal of injection points of botulinum toxin into temporal region for chronic migraine (만성편두통 치료를 위한 측두 부위의 보툴리눔 독소 주사 자입점 제시)

  • Kim, Young Gun;Bae, Jung Hee;Kim, Seong Taek
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.1-6
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    • 2017
  • Botulinum toxin (BoNT) injections have been used not only in the field of cosmetic surgery such as forehead and eye wrinkle treatment but also in the treatment of chronic migraine, dystonia, spasticity, temporomandibular disorders (TMD). BoNT injections are the only approved therapies to date for prophylactic treatment of chronic migraine patients. Unlike the previously known paralysis of motor neurons, the mechanism of action for migraine is to block the release of non-cholinergic neurotransmitters such as substance P, CGRP, and glutamate, which are associated with peripheral sensitization and neurogenic inflammation in the sensory nerve, it is hypothesized that the signal is blocked. This review focuses on the analgesic effects of BoNT and suggests the direction for the development of injection methods for chronic migraine patients.

Botulinum Toxin for other Head and Neck Lesions (기타 두경부 병변에서의 보툴리눔 독소의 이용)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.2
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    • pp.104-110
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    • 2012
  • The usages of botulinum toxin were most commonly for the treatment of spasmodic dysphonia in the otolaryngology field. It has been not only widely used in otolaryngology-Head Neck surgery but also plastic surgery, ophthalmology, rehabilitation medicine, and orthopedics. Now botulinum toxin is used such as blepharospasm (excessive blinking), strabismus, cosmetic, muscle spasms, upper motor neuron syndrome, severe primary axillary hyperhidrosis (excessive sweating), cervical dystonia (spasmodic torticollis), chronic migraine, bruxism, and achalasia. The indication of this drug still gradually expanding with the times. In this articles, the author will demontrate how to use the botulinum toxin for treating cricopharyngeal spasm, arytenoid dislocation, sialocele, Frey syndrome, contact granuloma, bilateral vocal fold paralysis, and mutaional falsetto instead of conventional surgical treatment.

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A Case of Tardive Tremor as A Varient of Classic Tardive Dyskinesia (지연성 진전 1례)

  • Yi, Jang Ho;Yoon, Doh Joon
    • Korean Journal of Biological Psychiatry
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    • v.2 no.1
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    • pp.140-143
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    • 1995
  • Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.

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Secondary paroxysmal dyskinesia associated with 2009 H1N1 infection

  • Hur, Yun Jung;Hwang, Taegyu
    • Clinical and Experimental Pediatrics
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    • v.56 no.1
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    • pp.42-44
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    • 2013
  • Neurological complications associated with 2009 H1N1 infection in children have been reported and recognized worldwide. The most commonly reported neurological complications are seizures and encephalopathy. Secondary movement disorders are also associated with the infection, but such cases are rarely reported. Here, we describe the case of a 14-year-old boy with paroxysmal kinesigenic dyskinesia secondary to 2009 H1N1 infection, who presented with dystonia and choreic movement triggered by sudden voluntary movement.

A Primary Sjögren's Syndrome Patient Presented with Severe General Toothache

  • Lee, Yeon-Hee;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.40 no.3
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    • pp.130-134
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    • 2015
  • $Sj{\ddot{o}}gren's$ syndrome (SS) is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. Apart from manifestations due to involvement of exocrine glands, patients with SS can present with muscular and neurological manifestations. Here, we report a rare case of a 59-year-old woman with primary SS, who presented with severe general toothache and masticatory muscle myalgia successfully treated with clonazepam. Although it was not certain that these symptoms could be originated from focal muscle dystonia or neurological changes that are associated with primary SS, our case suggested that comprehensive evaluation including neuromuscular examinations in the oral and maxillofacial area is needed in patients with SS.

Study of the oriental medical literature for 産後風(chan hou feng) (산후풍(産後風)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Min, Byung Ho;Yoo, Dong Youl
    • Journal of Haehwa Medicine
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    • v.13 no.1
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    • pp.159-168
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    • 2004
  • '産後風(chan hou feng)' is a postpartum pain-syndrome which caused by inadequate postpartum health care. Recently '産後風(chan hou feng)' contain some symptoms in relate with dystonia like sleep disorder, tiredness, depression, anxiety etc. According to The International Association for the Study of Pain(IASP) "Pain is an unpleasant sensory and emotinal experience associated with actual or potential tissue damage, or described in terms of such damage". This definition means the pain is related to emotional state as well as physical, Physical and emotional changes are common after childbirth, which can cause pain. The important point in treating its '産後風(chan hou feng)' is that the patient in the postpartum period.

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Application of Botulinum toxin in orthodontics (교정치료 영역에서 보툴리눔 독소의 적용)

  • Lee, Jong-Suk;Kim, Seong-Taek
    • The Journal of the Korean dental association
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    • v.48 no.12
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    • pp.889-892
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    • 2010
  • Botulinum toxin type A (BTX-A), a potent neurotoxin that reversibly blocks presynaptic acetylcholine release, has been applied successfully to treat facial spastic conditions such as blepharospasm, strabismus and cervical dystonia. Since the first reported application in dentistry in 1994, BTX-A has been used with great success to used in the orofacial region to help treat masticatory and facial muscle spasm, severe bruxism, facial tics, and hypertrophy of the masticatory muscles. The clinician may be aware of the many courses becoming available and aimed at dentists to start using it in the cosmetic context. This article intends to provide a basic understanding of the many functional uses of the drug in the orofacial region that may be relevant to everyday practice, especially in orthodontic field.

Spasmodic Torticollis Case Managed by Intraoral Balancing Appliance of FCST (FCST의 구강내 균형장치를 이용한 경추부 근긴장 이상증 증례보고)

  • Lee, Young Jun;Yin, Chang Shik
    • Journal of TMJ Balancing Medicine
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    • v.6 no.1
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    • pp.24-26
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    • 2016
  • To investigate the effects of the postural balance of TMJ using intraoral balancing appliance of functional cerebrospinal technique (FCST) combined acupuncture and manual medicine therapeutics in the treatment of congenital muscular torticollis. An idiopathic cervical dystonia case was managed with postural training with intraoral balancing appliance, combined with acupuncture and manual medicine therapeutics. Clinical assessment included radiography, Toronto Western Spasmodic Torticollis Rating Scale, and global clinical impression. Clinical improvement was observed over 5 months of treatment period. Clinical observational data on spasmodic torticollis provide an positive prospective for further investigation on the effect of FCST.

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A Case of Abductor Type Spasmodic Dysphonia Treated with $Botox^{circledR}$ Injection to Posterior Cricoarytenoid muscle (후윤상피열근에 $Botox^{circledR}$ 주사로 치유된 외전형 연축성 발성장애 1례)

  • 서장수;송시연;배창훈;정옥란
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.86-86
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    • 1996
  • 연축성 발성장애(spasmodic dysphonia)는 아직까지 그 원인을 정확히 밝혀내지 못하고 있는 만성적인 발성장애로 과거에는 경직성 발성장애(spastic dysphonia)로 불리던 질환이다. 연축성 발성장애는 두 종류 즉, 내전형(adductor)과 외전형(abductor)으로 나누어지며 이중 내전형이 대부분이다. 외전형 연축성 발성장애는 발성도중에 성대가 갑자기 불수의적으로 외전되면서 음성이 중단되므로 원활히 대화하기가 힘든 질환이다. 이러한 질환은 국소적 근긴장이상(fecal dystonia)의 일종이다. 현재까지 연축성 발성장애의 치료법으로 사용되고 있는 것으로는 언어치료, botulium 독소주입술, 편측반회후두신경절 단술, 반회후두신경분쇄술, 상후두신경절단술, 갑상연골성형술, implantable stimulator 등이 있다. 연축성 발성장애 환자에 $Botox^{circledR}$ 주입에 관한 보고는 주로 내전형에 대해서만 보고되고 있으며 외전형에 대하여 보고된 예는 매우 적다. (중략)

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