• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.282-288
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• 2021

Objective : Electrooculography (EOG) records eyeball movements as changes in the potential difference between the negatively charged retina and the positively charged cornea. We aimed to investigate whether reliable EOG waveforms can be evoked by electrical stimulation of the oculomotor and abducens nerves during skull base surgery. Methods : We retrospectively reviewed the records of 18 patients who had undergone a skull base tumor surgery using EOG (11 craniotomies and seven endonasal endoscopic surgeries). Stimulation was performed at 5 Hz with a stimulus duration of 200 μs and an intensity of 0.1-5 mA using a concentric bipolar probe. Recording electrodes were placed on the upper (active) and lower (reference) eyelids, and on the outer corners of both eyes; the active electrode was placed on the contralateral side. Results : Reproducibly triggered EOG waveforms were observed in all cases. Electrical stimulation of cranial nerves (CNs) III and VI elicited positive waveforms and negative waveforms, respectively, in the horizontal recording. The median latencies were 3.1 and 0.5 ms for craniotomies and endonasal endoscopic surgeries, respectively (p=0.007). Additionally, the median amplitudes were 33.7 and 46.4 μV for craniotomies and endonasal endoscopic surgeries, respectively (p=0.40). Conclusion : This study showed reliably triggered EOG waveforms with stimulation of CNs III and VI during skull base surgery. The latency was different according to the point of stimulation and thus predictable. As EOG is noninvasive and relatively easy to perform, it can be used to identify the ocular motor nerves during surgeries as an alternative of electromyography.

• The Journal of the Society of Stroke on Korean Medicine
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• v.16 no.1
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• pp.103-109
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• 2015

This report is about a case of monocular partial oculomotor nerve palsy in a patient with midbrain hemorrhage. The patient developed diplopia while driving. The Brain MRI film demonstrated a hemorrhage in the right midbrain and left corona radiata and microbleedings in both cerebral and cerebellar hemispheres, basal ganglia, midbrain, pons. We used Korean medicine treatment modalities including acupuncture, electroacupuncture, pharmacoacupuncture and herb medicines. As a result, limitation of upward gaze was recovered to about 90% of normal range.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.250-252
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• 2015

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.723-728
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• 2001

Wernicke Disease is well known of nutriotional disorders Wernicke Disease is charaterized by ataxia, confusion and oculomotor disturbance. We diagnosis one patient, who has ataxia, confusion and oculomotor disturbance as Jusang(酒傷), and gave saenggangunbi-tang, bojungchiseub-tang and samchulgunbi-tang. We observed that clinical symptom and Liver function were improved by these herbal medicine Therefore We consider Wernicke Disease as Jusang(酒傷) and further reports with many case, however, will be needed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.2
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• pp.333-337
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• 2010

A 51-year-old man developed diplopia while driving. The brain CT film demonstrated a hemorrhage in the left midbrain and thalamus. On our first diagnosis after 8 days from onset, partial ptosis and limitation of adduction in the left eye were detected. We evaluated that the patinet's digestive system was weak, so that treated the patient with Bojungikki-tang and Sa-am acupuncture Bi-Jung-Geouk(脾正格). As a result, limitation of adduction was recovered to about 90% of normal range and Ptosis was recovered just likely with the normal eye.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.665-670
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• 2021

Symptomatic cerebral vasospasm (CVS) and delayed ischemic neurologic deficit (DIND) after unruptured aneurysm surgery are extremely rare. Its onset timing is variable, and its mechanisms are unclear. We report two cases of CVS with DIND after unruptured aneurysm surgery and review the literature regarding potential mechanisms. The first case is a 51-year-old woman with non-hemorrhagic vasospasm after unruptured left anterior communicating artery aneurysm surgery. She presented with delayed vasospasm on postoperative day 14. The second case is a 45-year-old woman who suffered from oculomotor nerve palsy caused by an unruptured posterior communicatig artery (PCoA) aneurysm. DIND with non-hemorrhagic vasospasm developed on postoperative day 12. To our knowledge, this is the first report of symptomatic CVS with oculomotor nerve palsy following unruptured PCoA aneurysm surgery. CVS with DIND after unruptured aneurysm surgery is very rare and can be triggered by multiple mechanisms, such as hemorrhage, mechanical stress to the arterial wall, or the trigemino-cerebrovascular system. For unruptured aneurysm surgery, although it is rare, careful observation and treatments can be needed for postoperative CVS with DIND.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1264-1273
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• 2022

Posterior communicating artery aneurysms (PcomAAs) are the second most common type of aneurysm. Large cerebral aneurysms show various neurological symptoms, especially oculomotor nerve palsy (ONP), due to PcomAAs. Recent research has shown that stent-assisted coil embolization has many side effects. We report the effectiveness of Korean medicine in the treatment of ONP due to PcomAAs after stent-assisted coil embolization. A patient with ptosis and limitation of eye movement was treated with Korean medicine, including herbal medicine (Samlyeongbaegchul-san-byeonbang [參苓白朮散變方] and Uwhangchungsim-won [牛黃淸心元]), acupuncture, electroacupuncture, cupping, and moxibustion. Clinical symptoms were observed by images of the inter-palpebral fissure and eyeball movement. After the treatment, the inter-palpebral fissure and eyeball movement were noticeably improved. These findings suggest that treatment with Korean medicine can be an effective option for the treatment of ONP due to PcomAAs after stent-assisted coil embolization.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.93-102
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• 2017

Objective: We describe the case of an 84-year-old man with a midbrain infarction causing pupil sparing oculomotor nerve palsy, with ipsilateral cerebellar ataxia diagnosed as Claude's syndrome. Methods: The patient was treated with Korean medicine, including herbal medicine, acupuncture, and electro-acupuncture, during 45 days of hospitalization. Improvements in the patient's symptoms and changes in ptosis were evaluated using the Korean version of the Scale for the Assessment and Rating of Ataxia (SARA). Results: After 45 days of treatment with the Korean medicine, the patient's symptoms, including ataxia and ptosis, improved. Conclusions: This study suggests that the treatment with Korean medicine was effective in aiding the patient's recovery.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.115-118
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• 2010

Objective : Cerebral aneurysms which cause oculomotor nerve [cranial nerve (CN) III] palsy, are frequently found with a daughter sac of the aneurysm dome. We assumed that CN III might be compressed by the daughter sac and it would be more helpful not to fill the daughter sac with coils than vice versa during endosaccular embolization for recovering from CN III palsy, because it may give a greater chance for the daughter sac to shrink by itself later. We reviewed the initial results of our experiences of such cases. Methods : Among 9 aneurysms accompanied by CN III palsy, 7 (6 unruptured, 1 ruptured) showed a daughter sac. We tried to fill the main dome completely and spare the daughter sac from coil filling to increase the possibility of decompression. We evaluated the short-term effectiveness of this concept using medical records and angiograms. Results : After initial embolization, all of CN III palsy caused by unruptured aneurysms (6/6) resolved completely after various periods (3-90 days) of time. No adverse effects were noted during and after the procedures except for one case of harmless coil stretching during coil filling using double microcatheter. Conclusion : During the coil embolization of the cerebral aneurysm causing CN III palsy, sparing the daughter sac from coil packing while tightly packing the main dome, can be helpful in increasing the effectiveness of decompression. However, a long-term follow-up will be required.

• The Journal of Internal Korean Medicine
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• v.27 no.2
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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.