• Title/Summary/Keyword: peripheral polyneuropathy

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Pros (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란: 긍정적인 관점에서)

  • Kwon, Ohyun
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.29-32
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    • 2008
  • Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.

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A case of the patient with Wei symptom suspected Guillain-Barre syndrome (Guillain-Barre syndrome으로 추정되는 계증 치험 1례(例))

  • Jeong, Byoung-Mu;Sin, Won-Yong;Choi, En-Young;Yoon, Cheol-Ho;Jeong, Ji-Cheon;Hyun, Min-Kyung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.450-456
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    • 2004
  • Guillain-Barre syndrome, or acute inflammatory polyneuritis, is a disorder in which the body's immune system attacks parts of the peripheral nervous system. The causes and mechanisms of this syndrome are unknown. Typically, Guillain-Barre syndrome can be diagnosed from the patient's symptoms and physical examination such as the rapid onset of weakness, paralysis and loss of reflexes. The analysis of CSF and electrical tests on nerve and muscle function can be performed to confirm the diagnosis. Most cases occur shortly after a viral infection. This is a clinical report about one patient suspected as having Guillain-Barre syndrome. The patient, a 62-year-old man had weakness in both legs after gastroduodenal disease. His weakness and general condition improved after Korean medical treatments, so this is reported as a potential treatment.

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A case of Diabetic Neuropathy Treatment (糖尿病性 神經病症 1例에 대한 臨床的 考察)

  • Park, Ji-Hyeon;Hwang, Hui-Jeong;Kim, Jong-Dae;Kang, Seog-Bong;,
    • Herbal Formula Science
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    • v.9 no.1
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    • pp.386-386
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    • 2001
  • Diabetic neuropathy may affect every part of the nervous system with the possible exception of the brain. While it is rarely a direct cause of death, it is a major cause of morbidity. Distinct syndromes can be recognized, and several different types of neuropathy may be present in the same patient. The most common picture is that of peripheral polyneuropathy. Usually bilateral, the symptoms include numbness, paresthesias, severe hyperesthesias and pain. The pain, which may be deep-seated and severe, is often worse at night. In this case, chief complaints were numbness and paresthesia of lower extremities and the symptoms were improved through Oriental medical treatment.

A case of Diabetic Neuropathy Treatment (당뇨병성(糖尿病性) 신경병증(神經病症) 1례(例)에 대한 임상적(臨床的) 고찰(考察))

  • Park, Ji-Hyeon;Hwang, Hui-Jeong;Kim, Jong-Dae;Kang, Seog-Bong
    • Herbal Formula Science
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    • v.9 no.1
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    • pp.387-395
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    • 2001
  • Diabetic neuropathy may affect every part of the nervous system with the possible exception of the brain. While it is rarely a direct cause of death, it is a major cause of morbidity. Distinct syndromes can be recognized, and several different types of neuropathy may be present in the same patient. The most common picture is that of peripheral polyneuropathy. Usually bilateral, the symptoms include numbness, paresthesias, severe hyperesthesias and pain. The pain, which may be deep-seated and severe, is often worse at night. In this case, chief complaints were numbness and paresthesia of lower extremities and the symptoms were improved through Oriental medical treatment.

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The Study on Clinical relations of Mamok and Abnormal sensations (마목(麻木)과 이상감각(異常感覺)과의 연관성에 관한 연구(1))

  • Ko, Seong-Kyu
    • The Journal of Korean Medicine
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    • v.18 no.1
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    • pp.251-266
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    • 1997
  • The results are as follows. 1. Oriental medical terms which express abnormal sensations are Bulin, Mamok, Mamokbulin. 2. Bulin, Oriental medical terminology, was used from Naegyeong's era to the Song Dynasty era and expressed as one of the symptoms in Jungpung(Stroke), Bi syndrome(Obstruction syndrom of Gi and Hyeol), Wi syndrome(Flaccid paralysis of the limbs), Hyeolbi(One of the Bi syndroms). But since the Keum Dynasty era, Mamok or Mamokbulin were more used than Bulin and that was refered as seperated disease. 3. Ma is paresthesia or dysthesia on the skin and the limbs, and the symtoms are not itchy, patients are felt like insect's crawling or bite. Mok is a stubborn symptom , the patients are felt like tree, which don't know pain and itching sensation. And therefore Ma is similar to positive phenomena and Mok is similar to negative phenomena in clinical aspect. 4. Mamok is GiHyeol(Gi is functional activities, Hyeol is blood) and Gyeonglak(Meridian system)'s disease. It's main causes are Giheo(Deficiency of Gi) and Hyeolhel(dificiency of Blood) and inducing tactors are Pung-Han-Seub(pathogenic wind-cold-dump) and Damtak(Phlegm-turbity), Eohyeol(Stagnated blood). 5. Mamok is induced from mononeuritis, multiple mononeuritis, polyneuropathy in the peripheral nervous lesions and also induced from cervical spondylosis, spinal tumour, multiple sclerosis, cerebrospinal vascular disease in central nervous systems.

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Charcot-Marie-Tooth Disease Type 1A Diagnosed Based on Abnormalities in a Nerve Conduction Study in a Patient with Myotonic Dystrophy Type 1: A Case Report (신경전도검사의 이상소견을 보이는 근긴장디스트로피 환자에서 진단된 1형 샤르코-마리-투스 병: 증례보고)

  • Lee, Hyung Nam;Won, Yu Hui
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.148-152
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    • 2018
  • Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disorder and one of the most common muscular dystrophies affecting adults. Charcot-Marie-Tooth (CMT) disease, a common hereditary neuropathy, is characterized by atrophy of the distal limbs and peripheral nerve abnormalities. The authors report a rare case involving a 24-year-old female who was diagnosed simultaneously with both DM1 and CMT1A based on the results of a nerve conduction study (NCS). The patient, who had previously been diagnosed with DM1, was admitted for lower extremity pain. Her electrodiagnostic examination continued to reveal severe sensorimotor demyelinating polyneuropathy, and a genetic study was performed to confirm whether she had other hereditary neuropathies, except DM1, that suggested CMT1A, the most common phenotype of CMT. Severe abnormalities in an NCS in a DM1 patient may suggest the incidental coexistence of hereditary neuropathies, and further evaluations, such as genetic studies, should be performed for proper diagnosis.

A Case of Churg-Strauss Syndrome with Interstinal Perforation (장천공이 동반된 Churg-Strauss 증후군 1예)

  • Park, Jung Hoon;Jung, Yun Seok;Kim, Yang Ki;Lee, Young Mok;Hwang, Jung Hwa;Kim, Ki-Up;Kim, Dong Won;Uh, Soo-Taek;Kim, Jae Jun
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.5
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    • pp.374-379
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    • 2009
  • Churg-Strauss syndrome (CSS) or allergic granulomatous angiitis is a rare syndrome that is characterized by hypereosinophilic systemic necrotizing vasculitis affecting small- to medium-sized arteries and veins. In general, it occurs in individuals with pre-existing allergic asthma. When CSS appears in patients, it has the following characteristics: eosinophilia of more than 10% in peripheral blood, paranasal sinusitis, pulmonary infiltrates, histological proof of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. Therapeutic trials dedicated to Churg-Strauss syndrome have been limited due to the rarity of this disorder and the difficulty in making a histological diagnosis. Proper treatment of patients with CSS is not widely known. In this case study, we report on our experience with an unusual patient case, characterized by purpura and a perforation of the small intestine after inadequate steroid therapy.

Diagnostic Usefulness of Quantitative Sensory Test Comparison with Photoplethysmography (광용적맥파와 정량적 감각검사의 비교를 통한 진단적 유용성)

  • LEE, Sang-Bong;SEO, Jeong-Hyeok
    • Journal of the Korean Society of Radiology
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    • v.9 no.5
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    • pp.315-322
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    • 2015
  • The purposes of this study were to compare the sensitivities of two tests, QST(quantitative sensory test)and PPG(photoplethysmography) in normal adults. We evaluated the sensory thresholds of QST and PPG and diabetes mellitus test in 17 normal adults. The finding of this study can be summarized as follow :The diagnostic sensitivities of QST was similar to PPG. There is a direct correlation between the amount of Blood sugar and parasympathetic nerve in ANS. Concluded that the QST might be complement to NCS for early of diabetic polyneuropathy. A new diagnostic approach, QST was introduced and exploited for diagnosis. This study provides support for PPG performed a ANS analysis.

A case of Acute Autonomic and Sensory Neuropathy (급성 자율 감각 신경병증 1례)

  • Lee, Jong-Mun;Kwon, Do-Young;Koh, Seong-Beom;Kim, Byung-Jo;Park, Min-Kyu;Park, Kun-Woo;Lee, Dae-Hie
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.70-73
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    • 2002
  • Acute autonomic neuropathy is a rare disease. Since the first case was reported by Young et.al., in 1969, a number of similar cases have been described, with some variation of the accompanied neurologic deficits. Acute autonomic and sensory neuropathy(AASN) is characterized by the acute onset of autonomic dysfunction and sensory disturbances. A 16-year-old girl experienced high fever($40^{\circ}C$) and erythematous rash on whole trunk and face followed by pain and sensory loss over the whole body, dysphagia, ataxia, urinary retention, and postural hypotension. There was no evidence of limb weakness. The electrophysiologic studies of this patient revealed sensory polyneuropathy and the various autonomic function test showed autonomic dysfunction. The recovery of her autonomic and sensory symptoms is incomplete, three months after the onset of the symptoms. The etiology of the acute autonomic and sensory neuropathy is not known. Most previous authors have suggested the dysautonomia may be an acute immunological damage to peripheral fibers of the autonomic nervous system. We report a case of acute autonomic and sensory neuropathy.

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Concurrency of Guillain-Barre syndrome and acute transverse myelitis: a case report and review of literature

  • Tolunay, Orkun;Celik, Tamer;Celik, Umit;Komur, Mustafa;Tanyeli, Zeynep;Sonmezler, Abdurrahman
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.161-164
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    • 2016
  • Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis manifest as demyelinating diseases of the peripheral and central nervous system. Concurrency of these two disorders is rarely documented in literature. A 4-year-old girl presenting with cough, fever, and an impaired walking ability was admitted to hospital. She had no previous complaints in her medical history. A physical examination revealed lack of muscle strength of the lower extremities and deep tendon reflexes. MRI could not be carried out due to technical problems; therefore, both Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis were considered for the diagnosis. Intravenous immunoglobulin treatment was started as first line therapy. Because this treatment did not relieve the patient's symptoms, spinal MRI was carried out on the fourth day of admission and demyelinating areas were identified. Based on the new findings, the patient was diagnosed with acute transverse myelitis, and high dose intravenous methylprednisolone therapy was started. Electromyography findings were consistent with acute polyneuropathy affecting both motor and sensory fibers. Therefore, the patient was diagnosed with concurrency of Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis. Interestingly, while concurrency of these 2 disorders is rare, this association has been demonstrated in various recent publications. Progress in diagnostic tests (magnetic resonance imaging and electrophysiological examination studies) has enabled clinicians to establish the right diagnosis. The possibility of concurrent Guillain-$Barr{\acute{e}}$ syndrome and acute transverse myelitis should be considered if recovery takes longer than anticipated.