• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.48-50
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• 2011

Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder caused by the expansion of cytosine-thymine-guanine (CTG) repeats in the myotonic dystrophy protein kinase (DMPK) gene. Some literatures indicated that DM1 had incidental CNS lesions such as white matter lesions and diffuse gray matter atrophy. We report a patient with DM1 whose brain magnetic resonance image (MRI) showed multifocal hyperintense lesions and cystic lesion on both frontotemporoparietal lobes.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.58-60
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• 2011

Chronic graft-versus-host disease (GVHD) is a well-known complication of allogeneic bone marrow transplantation (BMT) and has heterogeneous manifestations, with multi-organ involvement. Recently, polymyositis (PM) was reported to be a rare manifestation of chronic GVHD. Here, we report a 30-year-old woman who was diagnosed with PM after allogeneic BMT.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.54-57
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• 2011

The Guillain-Barre Sydrome (GBS) is post-infectious autoimmune disease and it could be caused by auto-antibodies produced after infections. Mycoplasma pneumoniae is one of rare cause of GBS and known to be associated with antibody to galactocerebroside (GalC) which is a major neutral glycolipid constituent of myelin. We report a case of GBS with immunoglobulin M GalC antibody after M. pneumoniae infection.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.64-67
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• 2011

Shingles is a latent viral infection of the sensory ganglia. It can be accompanied by a variety of neurologic complications, including polyradiculitis and myelitis. A 66-year-old man with diabetes mellitus presented with progressive weakness, hypethesia and neuralgic pain in his right arm after herpes zoster infection in right C5 dermatome. He was diagnosed with zoster polyradiculomyelitis and treated with intravenous acyclovir and corticosteroid. It is a rare case of zoster neurologic complication in spite of oral acyclovir treatment.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.61-63
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• 2011

Postural orthostatic tachycardia syndrome (POTS) is characterized by increased heart rate with preserved blood pressure on orthostatic stress. Many patients with postural orthostatic tachycardia syndrome can be misdiagnosed as neurosis, chronic fatigue or anxiety disorder. We report a patient with POTS who presented chronic dizziness and fatigue. In approaching to a patient with orthostatic or nonspecific chronic dizziness, the postural heart rate as well as blood pressure should be checked not to miss the diagnosis.

• Annals of Clinical Neurophysiology
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• v.13 no.1
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• pp.13-20
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• 2011

Neuro-ophthalmological findings are common and occasionally prominent features in movement disorders. Accordingly, careful evaluation of the ocular motor functions may provide valuable information in early detection of the diseases and monitoring of the progression. Furthermore, accurate assessment of the abnormal ocular motor findings aids in understanding the pathophysiology and mechanisms of the movement disorders, and in their differential diagnosis. Ocular motility examination should include bedside evaluation and laboratory recording of the fixational abnormalities, saccades, smooth pursuit, the vestibulo-ocular reflex, optokinetic nystagmus, and vergence eye movements. In this review, we will discuss various ocular motor findings in ataxia and parkinsonian syndromes, and hyperkinetic movement disorders.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.1-6
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• 2012

Low back pain is a common clinical condition with heterogeneous causes and challenges to manage. High prevalence and numerous assessments result in an enormous socioeconomic burden. Clinician must conduct efficient and stepwise evaluation process to rule out serious spinal pathology, neurologic involvement, and identify risk factors for chronicity. The process can be achieved through the focused history taking and physical examination. Certain factors related to serious spinal pathology include age (>50 years), trauma, unexplained fever, recent urinary or skin infection, unrelenting night or rest pain, unexplained weight loss, osteoporosis, immunosuppression, steroid use, and widespread neurological symptoms. In non-specific low back pain, diagnostic imaging and laboratory studies are often unnecessary and can disturb an appropriate management. For the management of acute low back pain, patient education and medication such as acetaminophen, non-steroidal anti-inflammatory drugs, and muscle relaxants are recommended. For chronic low back pain, behavior therapy, back exercise, and spinal manipulation are beneficial. The evidence based approach could improve success rate of management, result in prevention of acute low back pain from being chronic intractable pain.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.12-19
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• 2012

Thermoregulatory sweat is principal mean for homeostasis of temperature. Sweat glands have eccrine gland, apocrine gland, and apoeccrine glands. Disorders of sweating are manifested by excess (hyperhidrosis) or deficit (hypohidrosis, anhidrosis) of sweat. Hyperhidrosis can be defined as excessive sweating beyond a level required to maintain normal body temperature. The sweating can be generalized or localized (axilla, palms, soles, palmar-plantar, perineal). Usually hypohidrosis or anhidrosis may be more serious than hyperhidrosis. Hyperhidrosis is usually benign, but interferes with one's daily activities. First step for diagnostic approach for sweating disorders might be dividing them into localized or generalized, and primary or secondary forms. Treatement for hyperhidrosis include topical agents, botulinum toxin A injections, systemic anticholinergics, and sympathectomy.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.41-44
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• 2012

Thenar motor neuropathy (TMN) is a compressive mononeuropathy of recurrent motor branch of median nerve. It is infrequent and may have different pathogenesis. It may be a unique entity of disease or considered a variant of carpal tunnel syndrome involving the motor branch only. We report a case of TMN induced by vigorous massage that applied strong digital pressure in the region of the base of palm and thenar muscles.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.36-40
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• 2012

Nephrogenic systemic fibrosis (NSF) is a systemic disease that affects the skin and other tissues in patients with renal insufficiency and exposure to gadolinium-containing contrast. A 55-year-old woman with end-stage renal disease on hemodialysis was consulted for progressive general weakness. After she had undergone multiple MRIs with gadolinium-containing contrast media, muscle weakness and skin lesions were developed. Her skin and muscle biopsy specimens showed CD34+ fibroblast entrapping collagen bundles. There are few reports of NSF with myopathy.