• Title/Summary/Keyword: neurologic disorders

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The Care of Facial Palsy after Inferior Alveolar Nerve Block Anesthesia and Temporomandibular Joint Dislocation in Diabetic Mellitus Patient -A Case Report- (당뇨환자에서 하치조신경 전달마취와 턱관절 탈구후 유발된 안면신경 마비 치험 1예 -증례보고-)

  • Lee, Chun-Ui;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.45-50
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    • 2011
  • Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.

Childhood Onset of Anti-N-Methyl-D-Aspartate Receptor Encephalitis Without Teratoma Masquerading as a Psychotic Disorder

  • Yeum, Tae-Sung;Lee, Jung;Park, Sung-Yeol;Joen, Yaelim;Kim, Bung-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.3
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    • pp.127-131
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    • 2019
  • Many neurologic disorders manifest as psychiatric symptoms. Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is an autoimmune disease of the brain characterized by numerous neurological and psychiatric features. Despite being rare, its prevalence is rapidly increasing and early management is critical in ensuring successful and sustainable recovery. Therefore, the illness should be considered as a differential diagnosis when clinically assessing patients. This report presents a case of a female child who was hospitalized for acute psychiatric manifestations, which was later confirmed as anti-NMDA receptor encephalitis. She recovered relatively successfully after combined neurological and psychiatric treatment. This report provides information on the clinical course of early onset anti-NMDA receptor encephalitis, including treatment strategy and prognosis.

Clinical profile of Asian and African strains of Zika virus in immunocompetent mice

  • Shin, Minna;Kim, Jini;Park, Jeongho;Hahn, Tae-Wook
    • Korean Journal of Veterinary Research
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    • v.61 no.2
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    • pp.12.1-12.9
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    • 2021
  • The mosquito-borne pathogen Zika virus may result in neurological disorders such as Guillain-Barré syndrome and microcephaly. The virus is classified as a member of the Flaviviridae family and its wide spread in multiple continents is a significant threat to public health. So, there is a need to develop animal models to examine the pathogenesis of the disease and to develop vaccines. To examine the clinical profile during Zika virus infection, we infected neonatal and adult wild-type mice (C57BL/6 and Balb/c) and compared the clinical signs of African-lineage strain (MR766) and Asian-lineage strain (PRVABC59, MEX2-81) of Zika virus. Consistent with previous reports, eight-week-old female Balb/c mice infected with these viral strains showed no changes in body weight, survival rate, and neurologic signs, but demonstrated increases in the weights of spleens and hearts. However, one-day-old neonates showed significantly lower survival rate and body weight with the African-lineage strain than the Asian-lineage strain. These results confirmed the pathogenic differences between Zika virus strains. We also evaluated the clinical responses in neonatal and adult mice of different strains. Our findings suggest that these are useful mouse models for characterization of Zika virus for vaccine development.

A Bibliographic Study about Comparison of Eastern-Western Medicine on Sleep Disturbances and Trend Analysis of Korean Nursing Research (수면장애에 관한 동서의학적 고찰 및 국내 간호연구 분석)

  • Chun, Sang-Hee;Chang, Chong-Mi
    • Journal of East-West Nursing Research
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    • v.15 no.1
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    • pp.43-53
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    • 2009
  • Purpose: This study is to summarize of Western-Eastern books and articles on sleep disturbances and to analyze the trends of nursing research in Korea. Methods: The Western-Eastern books and articles on sleep disturbances were comprehensively reviewed. The 70 articles published from 1981-2008 of Korean nursing research about sleep disturbances were reviewed using a structured form. Results: In Oriental medicine, the main cause of sleep disorder is unbalance of Yin and Yang, the treatments are herb therapy, acupuncture, moxibustion, psychotherapy, sleep hygiene, etc. In Western medicine, the International Classification of Sleep disorder is dyssomnia, parasomnia, mental/neurologic or other medical disorders, proposed sleep disorder and the treatments are pharmacotherapy, cure treatment of sleep hygiene, cause, behavior and perception. The number of nursing research and experimental study about sleep disorder in Korea is increasing. The most common subjects were hospitalized patients and the elderly, Of the 34 experimental studies, foot reflexology was the most commonly used as a nursing intervention. Conclusions: Nurses should concern more on patients' or clients' sleep disturbances to increase their quality of life. This literature study is useful for the access to effective nursing intervention for sleep disturbances.

The Comparison of ICSD and DSM-Ⅳ Diagnoses in Patients Referred for Sleep Disorders (정신과에 의뢰된 환자 중 수면장애에 대한 ICSD와 DSM-Ⅳ 진단 비교)

  • Lee, Bun-Hee;Kim, Leen;Suh, Kwang-Yoon
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.37-44
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    • 2001
  • Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

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Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

  • Manrriquez, Salvador L.;Robles, Kenny;Pareek, Kam;Besharati, Alireza;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.3
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    • pp.183-205
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    • 2021
  • This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.

Comparision of Hepatitis B Virus Markers in the Serum and the Cerebrospinal Fluid (혈청과 뇌척수액에서 B형 간염 바이러스 표식자 존재의 비교)

  • Suh, Sang-Dug;Kim, Seong-Min;Lee, Jun;Park, Gun-Ju;Do, Hyun-Cheal;Byun, Yeung-Ju
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.282-291
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    • 1995
  • We investigated HBV markers in serum and cerebrospinal fluid of 50 subjects with neurologic disorders or other disorders, who visited Dept. of neurology, college of medicine, Yeungnam University, from April-1 to August-31 1994 and were performed cerebrospinal fluid analysis to investigate the detection rate of HBV markers in cerebrospinal fluid and the possibility of neurologic disorders associated with HBV infection. The results were as follows. The positivity of HBsAg and HBV prevalence rate in serum were 6(12.0%) and 37(74.0%). The number of patient with HBsAg, only anti-HBV and no markers were 6(12.0%), 31(62.0%) and 13(26.0%), respectively. The positivity of HBsAg and HBV prevalence rate in cerebrospinal fluid were 3(6%) and 18(36.0%). The number of patient with HBsAg, only anti-HBV and no markers were 6(100.0%), 12(38.7%) and 0(0.0%) respectively. The number of patient with virus associated diseases(VAD) and non virus associated diseases(NVAD) were 26(52%) and 24(48%). The HBV prevalence rate in serum of VAD and NVAD groups were 88.5% and 58.3% (p<0.05). The HBV prevalence rate in CSF of VAD and NVAD groups were 53.8% and 16.7%(P<0.05). The HBV prevalence rate in serum and CSF of VAD and NVAD groups were 60.9% and 28.6%. Aa a conclusion, the HBV markers in the CSF were partially detected at the presence of the HBV markers in serum. The prevalance rate of HBV in the CSF was increased at the HBsAg positive in the serum and the serum and the CSF was significantly increased at the VAD group than the NVAD group.

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Clinical Effects of Korean Ginseng, Korean Red Ginseng, Chinese Ginseng, and American Ginseng on Blood Pressure in Mild Hypertensive Subjects

  • Choi, Dong-Jun;Jung, Woo-Sang;Park, Seong-Uk;Han, Chang-Ho;Lee, Won-Chul;Cho, Ki-Ho
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.198-208
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    • 2006
  • Background : Ginseng has traditionally been used in oriental countries to recover vital energy from Qi deficiency, and has shown various biomedical effects in the scientific literature. Recent reports suggest that ginseng could regulate blood pressure (BP), but much controversy still remains. Therefore, we intended to assess the anti-hypertensive effect of several ginseng types frequently used in clinics. We also investigated the anti-hypertensive effect on Koreans and Chinese, and by the body type according to Sasang Constitution Medicine (SCM). Methods : The study subjects were recruited from mildly hypertensive patients who exhibited pre-hypertension(120/80 to 139/89 mmHg) and stage I hypertension (140/90 to 159/99 mmHg) in Korea and China. After assigning the subjects into a Korean, a Chinese, a red, and an American ginseng group by randomization, we prescribed ginseng at a dose of 4.5 g per day for 4 weeks. To assess the anti-hypertensive effect, we compared the mean of systolic and diastolic BP between before and after ginseng medication using a 24-hour ambulatory blood pressure monitor (24 hr ABPM. We also monitored adverse effect and laboratory findings to secure the subjects' safety. In addition, all of the subjects in Korea consulted a specialist of Sasang Constitution Medicine to identify their constitutional type. Results : There were 64 subjects treated with Korean ginseng, 58 treated with Chinese ginseng, 33 treated with red ginseng, and 64 treated with American ginseng. Korean, Chinese, and American ginseng all reduced subjects' BP; Korean and Chinese ginseng showed more effect. The secondary analysis on the subjects' nationality revealed that all of the ginseng types showed more significant anti-hypertensive effect in Chinese patients than in Koreans. The third analysis on the constitutional type of SCM showed there was no significant difference in the effectiveness and the safety of ginseng among the constitutional types. Conclusions : We suggest ginseng, especially Panax ginseng without any steaming-drying process, could be useful for mild hypertension. Further, ginseng is safe regardless of subjects' constitutional type or type of ginseng within a dosage of 4.5g per day.

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Review of pediatric cerebrovascular accident in terms of insurance medicine (소아뇌졸중의 보험의학적 고찰)

  • Ahn, Gye-Hoon
    • The Journal of the Korean life insurance medical association
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    • v.29 no.2
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    • pp.29-32
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    • 2010
  • Moyamoya disease (MMD) is a progressive occlusive disease of the cerebral vasculature with particular involvement of the circle of Willis and the arteries that feed it. MMD is one of cerebrovacular accident,which is treated with sugical maeuver in pediatic neurosurgery. Moyamoya (ie, Japanese for "puff of smoke") characterizes the appearance on angiography of abnormal vascular collateral networks that develop adjacent to the stenotic vessels. The steno-occlusive areas are usually bilateral, but unilateral involvement does not exclude the diagnosis. The exact etiology of moyamoya disease is unknown. Some genetic predisposition is apparent because it is familial 10% of the time. The disease may be hereditary and multifactorial. It may occur by itself in a previously healthy individual. However, many disease states have been reported in association with moyamoya disease, including the following: 1) Immunological - Graves disease/thyrotoxicosis 2) Infections - Leptospirosis and tuberculosis 3) Hematologic disorders - Aplastic anemia, Fanconi anemia, sickle cell anemia, and lupus 4) Congenital syndromes - Apert syndrome, Down syndrome, Marfan syndrome, tuberous sclerosis, Turner syndrome, von Recklinghausen disease, and Hirschsprung disease 5) Vascular diseases - Atherosclerotic disease, coarctation of the aorta and fibromuscular dysplasia, 6)cranial trauma, radiation injury, parasellar tumors, and hypertension etc. These associations may not necessarily be causative but do warrant consideration due to impact on treatment.(Mainly neurosurgical operation.) The incidence of moyamoya disease is highest in Japan. The prevalence of MMD is 1 person per 100,000 population. The prevalence and incidence of moyamoya disease in Japan has been reported to be 3.16 cases and 0.35 case per 100,000 people, respectively. With regard to sex, the female-to-male ratio is 1.4:1. A bimodal peak of incidence is noted, with symptoms occurring either in the first decade(5-10yr) or in the third and fourth decades (30-40yr)of life. Mortality rates of moyamoya disease are approximately 10% in adults and 4.3% in children. Death is usually from hemorrhage. In aspect of life insurance, MR is 1700%, EDR is 16 per 1000 persons. Children and adults with moyamoya disease (MMD) may have different clinical presentations. The symptoms and clinical course vary widely from asymptomatic to transient events to severe neurologic deficits. Adults experience hemorrhage more commonly; cerebral ischemic events are more common in children. Children may have hemiparesis, monoparesis, sensory impairment, involuntary movements, headaches, dizziness, or seizures. Mental retardation or persistent neurologic deficits may be present. Adults may have symptoms and signs similar to those in children, but intraventricular, subarachnoid, or intracerebral hemorrhage of sudden onset is more common in adults. Recently increasing diagnosis of MMD with MRI, followed by surgical operation is noted. MMD needs to be considered as the "CI" state now in life insurance fields.

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Application of Near-Infrared Spectroscopy in Neurological Disorders: Especially in Orthostatic Intolerance (신경계 질환에서 근적외선분광분석법의 적용: 기립불내증을 중심으로)

  • Kim, Yoo Hwan;Paik, Seung-ho;Phillips V, Zephaniah;Seok, Hung Youl;Jeon, Nam-Joon;Kim, Beop-Min;Kim, Byung-Jo
    • Journal of the Korean neurological association
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    • v.35 no.1
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    • pp.8-15
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    • 2017
  • Near-infrared spectroscopy (NIRS), a noninvasive optical method, utilizes the characteristic absorption spectra of hemoglobin in the near-infrared range to provide information on cerebral hemodynamic changes in various clinical situations. NIRS monitoring have been used mainly to detect reduced perfusion of the brain during orthostatic stress for three common forms of orthostatic intolerance (OI); orthostatic hypotension, neurally mediated syncope, and postural orthostatic tachycardia syndrome. Autonomic function testing is an important diagnostic test to assess their autonomic nervous systems for patients with symptom of OI. However, these techniques cannot measure dynamic changes in cerebral blood flow. There are many experimentations about study of NIRS to reveal the pathophysiology of patients with OI. Research using NIRS in other neurologic diseases (stroke, epilepsy and migraine) are ongoing. NIRS have been experimentally used in all stages of stroke and may complement the established diagnostic and monitoring tools. NIRS also provide pathophysiological approach during rehabilitation and secondary prevention of stroke. The hemodynamic response to seizure has long been a topic for discussion in association with the neuronal damage resulting from convulsion. One critical issue when unpredictable events are to be detected is how continuous NIRS data are analyzed. Besides, NIRS studies targeting pathophysiological aspects of migraine may contribute to a deeper understanding of mechanisms relating to aura of migraine. NIRS monitoring may play an important role to trend regional hemodynamic distribution of flow in real time and also highlights the pathophysiology and management of not only patients with OI symptoms but also those with various neurologic diseases.