• Title/Summary/Keyword: lower limbs weakness

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근위축성 측삭 경화증 1예 (A Case of Amyotrophic Lateral Sclerosis)

  • 이범준;전진희;류재환;김태연
    • 대한한방내과학회지
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    • 제21권4호
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    • pp.661-665
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    • 2000
  • Amyotrophic Lateral Sclerosis(ALS) is a fatal neuromuscular disease characterized by progressive muscle weakness resulting in paralysis. ALS is characterized by both upper and lower motor neuron damage. Diagnostic tests include magnetic resonance imaging(MRI) electromyogram(EMG), muscle biopsy, and blood tests. In order for a definitive diagnosis of ALS to be made, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We recently experienced one case of ALS, The patients was diagnosed as ALS by EMG and Symptoms. We diagnosed her as Wea jeung and treated by Herbal-medication based on the differentiation of symtoms. we report change of his symptoms through both western medical treatment and oriental medical treatment.

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Clinical Feasibility of Wearable Robot Orthosis on Gait and Balance Ability for Stroke Rehabilitation: A Case Study

  • Shin, Young-Il;Yang, Seong-Hwa;Kim, Jin-Young
    • The Journal of Korean Physical Therapy
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    • 제27권2호
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    • pp.124-127
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    • 2015
  • Purpose: The emphasis on gait rehabilitation after stroke depends on training support through the lower limbs, balance of body mass over the changing base of support. However, muscle weakness, lack of control of lower limb, and poor balance can interfere with training after stroke. For this case study report, a wearable robot orthosis was applied to stroke patients in order to verify its actual applicability on balance and gait ability in the clinical field. Methods: Two stroke patients participated in the training using the wearable robot orthosis. Wearable robot orthosis provides patient-initiated active assistance contraction during training. Training includes weight shift training, standing up and sitting down, ground walking, and stair up and down Training was applied a total of 20 times, five times a week for 4 weeks, for 30 minutes a day. Gait ability was determined by Stance phase symmetry profile, Swing phase symmetry profile, and velocity using the GAITRite system. Balance ability was measured using the Biodex balance system. Results: Subjects 1, 2 showed improved gait and balance ability with mean individual improvement of 72.4% for velocity, 19.4% for stance phase symmetry profile, 9.6% for swing phase symmetry profile, and 13.6% for balance ability. Conclusion: Training utilizing a wearable robot orthosis can be useful for improvement of the gait and balance ability of stroke patients.

급성 횡단성 척수염으로 의심된 길랑바레증후군 환자에 대한 한방 치료 증례보고 1례 (A Case Report of a Guillain-Barre Syndrome Patient Suspected of Having Acute Transverse Myelitis Treated with Korean Medicine)

  • 안다영;김채은;김미경;선승호
    • 대한한방내과학회지
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    • 제44권6호
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    • pp.1279-1293
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    • 2023
  • A 67-year-old female patient diagnosed with acute transverse myelitis visited our hospital in February 2023. Consultation papers indicated that she was diagnosed with acute transverse myelitis and that she complained of quadriparesis and numbness in both hands and feet. However, her spine magnetic resonance imaging (MRI) did not clearly indicate that she suffered from acute transverse myelitis. She was then sent to a high-level hospital and diagnosed with Guillain-Barre Syndrome through electromyography, cerebrospinal fluid test, and spine MRI. On March 2023, she visited our hospital again, still complaining about weakness in both hands and inability to walk. She was treated with Korean medicine, including acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine such as Yanggyeoksanhwatang and Sipimijihwang-tanggami. After three months, she was discharged on cane walking. The manual muscle test (MMT) grade of her upper limbs increased from 3-/3-/3-/3- (shoulder/elbow/wrist/fingers) to 4/4/4/3+, and the MMT grade of her lower limbs increased from 2/2/2/2 (pelvis/knee/ankle/feet) to 4/4/4-/4-. Her numbness in both feet disappeared, and her numbness in both hands decreased from a numeric rating scale of 7 to 2. No adverse events were reported during treatment. This case implies the therapeutic potential of Korean medicine for Guillain-Barre Syndrome, especially for those who had delayed diagnosis and missed the opportunity to get plasma exchange.

신경계 증상을 동반한 부분적으로 자연완화된 소세포폐암 (Partial spontaneous remission of small cell lung carcinoma with neurologic symptom)

  • 윤경현;송성헌;김충현;황찬희;이준호;최재형;김선영
    • Journal of Yeungnam Medical Science
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    • 제34권2호
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    • pp.275-278
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    • 2017
  • Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

중환자실 환자의 입원기간에 따른 사지 둘레 변화 및 관련요인 (Changes in Limb Circumferences among Intensive Care Unit Patients and Related Factors)

  • 신혜은;강지연
    • 중환자간호학회지
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    • 제9권2호
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    • pp.13-25
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    • 2016
  • Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes.

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태음인으로 오치(誤治)한 추골뇌저동맥부전증 태양인 환자 치험 1례 (A Case Study of a Taeyangin Patient with Vertebrobasilar Insufficient after Mistreat as Taeeumin.)

  • 강석환;전수형;나영주;김종원
    • 사상체질의학회지
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    • 제28권4호
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    • pp.338-349
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    • 2016
  • Objectives This case study was about a Taeyangin patient with transient ischemic attack(TIA) due to vertebrobasilar insufficiency(VBI). In this study, we report the progress of mistreat with Taeyangin as Taeeumin and the improvement of symptoms after rediagnosis as Taeyangin. Methods Patient's chief complain was weakness of lower limbs, dysarthria and dizziness. Patient first time took Taeeumin prescription such as Chunghyulganggi-tang, Chunsimyonja-tang and Sanyakbopaewon-tang. After occuring side effects we changed the prescription to Taeyangin herbal medicine such as Ogapijangchuk-tang gagam and Mihudeungsikjang-tang gagam. Result and Conclusion Patient suffered from diarrhea by taking Taeeumin prescription and symptom was continue. After changing of prescription to Taeyangin herbal medicine, not only chief symptom but also original symptom was improved.

근 위축성 측삭 경화증 환자 1례 보고 (A Case of Amyotrophic Lateral Sclerosis)

  • 김태정;문아지;이성근;이기상
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.77-85
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    • 2012
  • Amyotrophic lateral sclerosis(ALS) is a progressive disorder that causes degeneration of motor neurons of the brain and spinal cord. It is characterized by loss of motor neurons leading to muscle weakness, and sensation and mental function stay intact during the course of the disease. Diagnostic tests include magnetic response imaging(MRI), electromyogram(EMG), muscle biopsy, and blood tests. In order to a definitive diagnosis of ALS, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We experienced one case of ALS, the patients was diagnosed as ALS by EMG and symptoms. We diagnosed her as ShinEumHur(SEH) and treated by Choakwiyeum(左歸飮). We report the change of her symptoms through oriental medical treatment.

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여성 고령자들의 Sit-to-Walk동작 시 역학적 에너지 분석 (Mechanical Energy Analysis for the Lower Limbs during Sit-to-Walk Movement in Elderly Women)

  • 문훈기
    • 한국운동역학회지
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    • 제19권4호
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    • pp.697-705
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    • 2009
  • 본 연구의 목적은 여성고령자들에 있어 젊은 여성과 비교해 Sit-to-Walk동작 시 낙상의 간접적인 요인이 될 수 있는 역학적 에너지를 비교분석 하는 것이다. 여성고령자 그룹 10명과 젊은 여성 그룹 10명이 본 연구를 위해서 참여하였고, 적외선 카메라와 두 대의 지면반력기를 통하여 역학적 에너지를 분석한 결과는 다음과 같다. 근 파워는 각속도와 근 모멘트의 변화에 따라 고관절의 무릎 및 고관절의 신전 국면시 두 그룹 모두 낮은 음의 일률을 보였고, 특히 고령자그룹에 더 낯은 음의 일률을 보였다. 역학적 에너지 일량에 있어서도 무릎관절과 고관절은 무릎 및 고관절 신전 국면에서 두 그룹 모두 음의 일량을 보였고, 특히 고관절은 전체국면에서 고령자 그룹에 있어 더 낮은 음의 일량을 보였다. 이러한 결과는 STW동작 시 고관절 대퇴근의 약화로 인한 에너지 손실(dissipation)은 고령자들의 낙상의 위험요소를 간접적으로 보여주는 것이라 여겨진다.

산모에서 발생한 경막외 블록 후 하지 마비 -증례보고- (A Case of Paraplegia Associated with Epidural Anesthesia -A case report-)

  • 김현혜;김두환;김성훈;임정길;이청;신진우
    • The Korean Journal of Pain
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    • 제21권2호
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    • pp.159-163
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    • 2008
  • Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

요추 경막외 차단술 후 발생한 하지마비의 한의학적인 치료 효과 - 증례 보고 - (A Clinical Case of Oriental Medical Treatment for the Paraplegia after Lumbar Epidural Nerve Block)

  • 유덕선;김소연;김동은;정일민;염승룡;권영달
    • 한방재활의학과학회지
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    • 제19권4호
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    • pp.219-228
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    • 2009
  • Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.