• 한방안이비인후피부과학회지
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• 제24권3호
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• pp.129-137
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• 2011

Objective : Foville syndrome & Foville-Millard-Gubler syndrome is a disease characterized by facial palsy, ipsilateral conjugate gaze palsy and ipsilateral internal strabismus. There has never been a clinical report of this disease in oriental medicine. Since gradual improvement has been experienced with oriental medical treatments based on facial palsy and paralytic strabismus in this case, it is worthwhile to introduce this disorder and report the case referring to clinical record. Methods : 75-year-old female patient and 45-year-old male patient suffering right facial palsy, right conjugate gaze palsy and right internal strabismus were treated with acupuncture, herbal medicine, pharmacopuncture and electroacupuncture. Result : Concurrence of right facial palsy, right conjugate gaze palsy and right internal strabismus was diagnosed with Foville syndrome or Foville-Millard-Gubler syndrome which is generally caused by the impairment of PPRF, abducens and facial nerves on the affected side and showed improvement with oriental medical treatments. Conclusion : More accurate diagnosis, more aggressive treatments and further researches are all required on this disease afterwards.

• 한방안이비인후피부과학회지
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• 제28권4호
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• pp.130-141
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• 2015

Objectives : The aim of this study is to report the effect of Korean medicine treatment on ocular motility disorders (ptosis, bilateral upward gaze palsy, adduction impairment, and strabismus) caused by thalamus, midbrain and pontine infarctions.Methods : The patient was treated by using acupuncture, hominis placenta pharmacoacupuncture, and electroacupuncture treatment. The change of ptosis was evaluated by measurement of palpebral fissure width. The change of gaze palsy and strabismus were evaluated by comparison the photographs of the extraocular movements of patient. Strabismus also was evaluated by corneal reflex test.Results : Gaze palsy and strabismus were improved. Ptosis disappeared after Korean medicine treatment.Conclusions : Korean medicine treatment should be effective for the ocular motility disorders caused by thalamus, midbrain and pontine infarctions.

• 대한한방내과학회지
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• 제27권2호
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• pp.533-537
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• 2006

The purpose of this study is to present a case of gaze palsy due to thalamic infarction improved by acupuncture and herb medicine. Monocular gaze palsies which result from a supranuclear cerebral lesion are rare clinical manifestations. The pre-frontal cortico-oculomotor pathways travel across the thalamus and mesodienphalic junction terminating directly in oculomotor complexes. The acute disinhibition of these neurons by a posterior thalamic lesion results in a sustained but transient discharge of the medial rectus and tonic activation. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat gaze palsy due to thalamic infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• 대한한방내과학회지
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• 제33권4호
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• pp.599-608
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• 2012

Objectives : To report three cases of eye movement impairment: internuclear ophthalmoplegia (INO) due to pontine infarction, traumatic abducens nerve palsy, and abducens nerve involvement in Miller-Fisher syndrome. Cases Summary : There were three cases. First, a 64-year-old woman, who was given a diagnosis of INO due to pontine infarction, had left gaze palsy of her right eye while the convergence was intact. Second, a 34-year-old man had abduction impairment of his right eye after a traffic accident. Third, a 66-year-old man, who was diagnosed with Miller-Fisher syndrome, had left gaze palsy of his left eye. Their symptoms improved substantially and their anxieties were relieved after treatment with herbal medicine and acupuncture. Conclusions : There has been no certain cure for eye movement impairment yet. In this report, we present three successful cases of patients with eye movement impairment and show that Korean medical treatment could be a solution for this incurable disease.

• Investigative Magnetic Resonance Imaging
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• 제23권2호
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• pp.167-171
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• 2019

$M\ddot{o}bius$ syndrome is a rare congenital condition, characterized by abducens and facial nerve palsy, resulting in limitation of lateral gaze movement and facial diplegia. However, to our knowledge, there have been few studies on evaluation of cranial nerves, on MR imaging in $M\ddot{o}bius$ syndrome. Herein, we describe a rare case of $M\ddot{o}bius$ syndrome representing limitation of lateral gaze, and weakness of facial expression, since the neonatal period. In this case, high-resolution MR imaging played a key role in diagnosing $M\ddot{o}bius$ syndrome, by direct visualization of corresponding cranial nerves abnormalities.

• 대한청각학회지
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• 제24권3호
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• pp.157-160
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• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• Journal of Audiology & Otology
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• 제24권3호
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• pp.157-160
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• 2020

A 38-year-old woman presented with a week's history of binocular horizontal double vision and acute vertigo with gaze-induced nystagmus. We considered a diagnosis of one of the six syndromes of the sixth cranial nerve and evaluated several causes. She had history of severe anemia, vitamin B12 deficiency, and hypertension. Magnetic resonance imaging with angiography showed stenosis of the right vertebral artery and hyperintensity on both basal ganglia. As we describe here, we should consider vertebrobasilar insufficiency as a cause for sixth cranial nerve palsy if a patient has high risk for microvascular ischemia, even in the absence of acute brain hemorrhage or infarction.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.581-583
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• 2009

Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

• 대한안과학회지
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• 제59권11호
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• pp.1087-1090
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• 2018

목적: 중뇌(midbrain) 등쪽(dorsal)의 사구수조지방종(quadrigeminal cistern lipoma)에 의한 도르래신경마비를 경험하였기에 이를 보고하고자 한다. 증례요약: 65세 남자가 2년 전부터 간헐 양안 수직 복시가 있었으나 별다른 치료 없이 지내다가 2주 전부터 항상 증상이 생겨 내원하였다. 1달 전 진단받은 당뇨 이외에 다른 전신질환의 과거력은 없었다. 시력은 우안 20/25, 좌안 20/20이었고, 상대구심동공운동장애는 없었다. 안구운동검사에서 원거리 주시에서 4프리즘디옵터(prism diopters, PD)의 좌안 상사시와 근거리에서 4PD의 외사시를 보였다. 좌안은 내전시상전(elevation in adduction)이 있었다. 머리기울임검사에서 좌측 기울임에서 6PD의 좌안 상사시가 보였고, 우측 기울임에서는 정위를 보였다. 안저검사에서 우안 외회선과 좌안 내회선이 보였다. 뇌자기공명영상(brain magnetic resonance imaging)에서 중뇌 등쪽에서 나오는 도르래신경에 인접한 사구수조지방종을 확인하였다. 복시 증상의 완화를 위해 프리즘 안경을 처방하였고, 다른 신경 증상을 동반하지 않아 뇌 병변에 대한 경과관찰을 시행하기로 하였다. 결론: 중뇌 등쪽의 사구수조지방종으로 인해 도르래신경마비를 확인하였다. 종양의 압박에 의한 도르래신경마비는 드물지만, 본 증례와 같이 비특이적인 증상을 보인 도르래신경마비 환자에서는 빠른 뇌영상검사가 원인 감별에 도움을 줄 수 있다.

• Journal of Acupuncture Research
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• 제29권3호
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• pp.139-148
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• 2012

Objectives : The purpose of this case is to report the improvement of two patients diagnosed with eight and a half syndrome after combination therapy of oriental and western medicine. Methods : We treated the patients with combination therapy of oriental and western medicine such as acupuncture, moxibustion, herbal medication, antithrombotic agents and steroid therapy. Changes of peripheral facial paralysis were evaluated using House-Brackmann facial grading system and the degree of dizziness, tenderness and pain of upper abdomen were assessed using numerous rating scale. Changes in motor grade of upper and lower extremities were evaluated using medical research council scale. Results : We have recently experienced two cases of eight and a half syndrome - a syndrome characterized by the coexistence of one and a half syndrome, a rare ophthalmoparetic syndrome characterized by a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other, and cranial nerve VII palsy. The one and a half syndrome was caused by acute cerebral infarction. Two patients in this report were improved through combination therapy of oriental and western medicine. Conclusions : We report the clinical course and treatment methods of eight and a half syndrome.