• 제목/요약/키워드: secondary Parkinsonism

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Astrocytoma in the Third Ventricle and Hypothalamus Presenting with Parkinsonism

  • Choi, Kang-Ho;Choi, Seong-Min;Nam, Tai-Seung;Lee, Min-Cheol
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.144-146
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    • 2012
  • Parkinsonism secondary to intracranial mass lesions usually results from compression or distortion of the basal ganglia. Secondary parkinsonism due to midbrain infiltration or compression is rare and generally associated with other neurologic signs caused by pyramidal tract and/or cranial nerve involvement. We report a case of 30-year-old woman in whom mild parkinsonism was the major clinical manifestation of an astrocytoma in the anterior third ventricle and hypothalamus. She underwent surgical resection, ventriculoperitoneal shunt and radiation therapy. All symptoms of parkinsonism were completely recovered 3 months after the treatment. Brain tumors can be manifested only by the symptoms of parkinsonism. This case emphasizes the significance of neuroimaging in the evaluation of parkinsonism.

사상처방을 활용한 약물 유발성 속발성 파킨슨증 치험 2례 (Two Cases of Drug-induced Secondary Parkinsonism Treated with Sasang Constitutional Therapy)

  • 정성국;송정모
    • 사상체질의학회지
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    • 제24권4호
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    • pp.109-119
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    • 2012
  • Objectives : This study is about two patients of drug-induced secondary parkinsonism caused by antipsychotic drugs. The purpose of this study is to report the clinical effects of Sasang constitutional medicine. Methods : These two patients were treated by Sasang constitutional herbal medications based on "Donguisusebowon". We evaluated the symptoms through the score of the Unified Parkinson's Disease Rating Scale(UPDRS). Results and Conclusions : The patients' chief complaints were improved. This study shows that Sasang constitutional herbal medications are an effective treatment for drug-induced secondary parkinsonism patients, but further studies are still necessary.

조등산(Diaoteng-san, Choto-san, 釣藤散)과 GB34(陽陵泉) 전침치료를 활용한 약인성파킨슨증후군 환자의 증례 1례 (A Case Report of Drug-Induced Parkinsonism Treated with Jodeung-san and Electro-acupuncture at GB34)

  • 김은지;송호준;김현호;한양희;임정태
    • 대한한방내과학회지
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    • 제38권5호
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    • pp.600-609
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    • 2017
  • Drug-induced Parkinsonism is the most frequently observed type among the cases of secondary Parkinsonism. Besides typical parkinsonian symptoms, such as tremor, rigidity and bradykinesia, drug-induced Parkinsonism manifests with additional simultaneous symptoms like orobuccolingual dyskinesia, mixed type of tremor (resting, action), and symmetry of expressions. We present a case of drug-induced Parkinsonism, affected by taking the antiulcer drug cimetidine. Jodeung-san extract (Choto-san, Tsumura Co. 10) was administered for 7 days and acupuncture (electronic, auricular, pharmacopuncture) was conducted 3 times. The clinical outcomes were then evaluated through the patient's global impression of change, visual analogue scale, and Hoehn and Yahr stage. After the treatment, the clinical features, such as tremor and orobuccolingual dyskinesia, disappeared. The combination of Jodeung-san and electro-acupuncture at GB34 could therefore be a remedy for the patients with drug-induced Parkinsonism.

Risperidone으로 유발된 것으로 의심된 약물유발성 이상운동증에 대한 의심약물 중단 및 억간산가진피반하와 GB34(陽陵泉) 전침치료를 통한 외래기반 관리 : 증례보고 (Drug-Induced Dyskinesia Outpatient Suspected to be Induced by Risperidone Management with Yigan-san with Citri Pericarpium and Pinelliae Rhizoma (modified Yigan-san, Yokukan-san Kachimpihang), Electro-Acupuncture at GB34 (陽陵泉), and Stopping Suspected Medication: A Case Report)

  • 노민영;장승원;김현호;한양희;임정태
    • 대한한방내과학회지
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    • 제40권6호
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    • pp.1303-1310
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    • 2019
  • Objectives: Drug-induced Parkinsonism has similar symptoms to Parkinson's disease, but each has different causes. Drug-induced Parkinsonism accounts for the largest proportion of secondary Parkinsonism We report a outpatient case of drug-induced Parkinsonism after taking Risperidone, an atypical antipsychotic. Method: With discontinuing of antipsychotic drug, modified Yigan-san extract was administered for 12 weeks, and acupuncture and electroacupuncture procedures were performed 20 times. Results: Abnormal Involuntary Movement Scale (AIMS) score decreased from 23 to 3 during 59 days of treatment period without adverse events and worsening of depression. The Patient was highly satisfied. Conclusion: Modified Yigan-san and electroacupuncture (GB34) can be used as an treatment option in patients with drug-induced Parkinsonism.

보행 장애를 주소로 하는 특발성 정상압 수두증으로 인한 이차성 파킨슨증 환자의 한의치료 증례보고 1례 (A Case Report of Gait Disturbance in a Patient with Idiopathic Normal Pressure Hydrocephalus Induced by Secondary Parkinsonism Treated with Korean Medicine)

  • 최인우;양지혜;채인철;김찬영;유주영;정은선;김윤식;설인찬;유호룡
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.811-820
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    • 2020
  • Objective: The aim of this study was to report the effectiveness of traditional Korean medicine treatment of a gait disturbance in a patient with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism. Methods: The patient was treated with Korean herbal medicine (Yukmijihwang-tang-gami), acupuncture, moxibustion, and rehabilitation exercise. The gait of the patient was evaluated by the 10 m Walk Test, Timed Up and Go (TUG) test, 360° turning test, Functional Ambulatory Category (FAC), and GAITRite. Results: After 20 days of traditional Korean medicine treatment, we observed improvement in the symptoms of the gait disturbance. Conclusion: Traditional Korean medicine treatment might be effective in the treatment of gait disturbance in patients with idiopathic normal pressure hydrocephalus induced by secondary Parkinsonism.

Metabolic Topography of Parkinsonism

  • 김재승
    • Nuclear Medicine and Molecular Imaging
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    • 제41권2호
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    • pp.141-151
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    • 2007
  • 파킨슨병은 노년층에 가장 흔한 퇴행성 뇌질환 중의 하나로 진행성핵상마비, 다중계 위축, 루이체 치매 등과 같은 비전형 파킨슨병과 임상적으로 감별이 어려울 수 있다. 파킨슨병과 비전형 파킨슨병의 감별은 치료방침 결정과 예후평가뿐만 아니라 파킨슨병의 원인과 병태생리를 연구하고 새로운 치료법 개발에 있어서도 매우 중요하다. 파킨슨병과 비전형 파킨슨병과 같이 파킨슨 증후군을 유발하는 질환은 선조체내 도파민 신경의 퇴행성 변화를 흔히 동반하지만 병태생리학적으로 서로 다른 뇌피질 및 피질하 구조물에서의 신경세포 소실을 동반하고 있다. 따라서 국소 시냅스 활성도와 신경 및 시냅스의 손상, 그리고 원발병변과 기능적으로 연결된 원격부위의 기능이상 등을 대변하는 뇌포도당 대사를 F-18FDG PET으로 평가하는 것은 파킨슨 병의 감별진단과 병태생리를 평가하는데 유용하다.

약물부작용(藥物副作用)으로 인한 설부(舌部) 진전환자(震顫患者) 증례보고(症例報告) (Clinical study on a case of a patient with a glossal tremor caused by a side effect of drugs)

  • 김근우;구병수;김헌일
    • 동의신경정신과학회지
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    • 제14권1호
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    • pp.133-139
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    • 2003
  • 본 증례는 약물부작용으로 인한 이차성 파킨슨 중에서 설(舌), 하악(下顎), 수부(手部)에 진전(震顫)증상이 나타난 환자를 풍담(風痰)으로 인한 진전(震顫)증상으로 보고 척담탕(滌痰湯)을 투여하고, 합곡(合谷), 태충(太衝), 중완(中脘), 풍륭(豊隆), 염천(廉泉), 족삼리(足三里), 양릉천(陽陵泉), 풍지(風池), 백회(百會) 위주의 침(鍼)치료를 병행하여 치료한 결과, 빠른 증상회복을 보였던 예이다. 이런 결과는 약물부작용으로 인한 이차성 파킨슨증을 치료하는 기초적 자료가 될 것이며, 약물회피요법을 단독으로 시행하는 경우와 한의학적 치료를 병행하는 경우의 치료효과에 대한 비교분석을 포함하여 향후 객관적이고 지속적인 연구가 필요하 리라 사료된다.

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Salivary Gland Uptake on 18F-FP-CIT PET as a New Biomarker in Patients With Parkinsonism

  • Seo Young Kang;Ji Young Yun;Yeon-Koo Kang;Byung Seok Moon;Hai-Jeon Yoon;Min Young Yoo;Bom Sahn Kim
    • Korean Journal of Radiology
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    • 제24권7호
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    • pp.690-697
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    • 2023
  • Objective: 18F-FP-CIT positron emission tomography (PET) is known for its high sensitivity and specificity for evaluating striatal dopamine transporter (DAT) binding. Recently, for the early diagnose of Parkinson's disease, many researchers focused on the diagnosis of synucleinopathy in organs involved in non-motor symptoms of Parkinson's disease. We investigated the feasibility of salivary gland uptake on 18F-FP-CIT PET as a new biomarker in patients with parkinsonism. Materials and Methods: A total of 219 participants with confirmed or presumed parkinsonism, including 54 clinically diagnosed idiopathic Parkinson's disease (IPD), 59 suspected and yet undiagnosed, and 106 with secondary parkinsonism, were enrolled. The standardized uptake value ratio (SUVR) of the salivary glands was measured on both early and delayed 18F-FP-CIT PET scans using the cerebellum as the reference region. Additionally, the delayed-to-early ratio (DE_ratio) of salivary gland was obtained. The results were compared between patients with different PET patterns. Results: The SUVR in early 18F-FP-CIT PET scan was significantly higher in patients with IPD pattern compared that in the non-dopaminergic degradation group (0.5 ± 0.19 vs. 0.6 ± 0.21, P < 0.001). Compared with the non-dopaminergic degradation group, the DE_ratio was significantly lower in patients with IPD (5.05 ± 1.7 vs. 4.0 ± 1.31, P < 0.001) or atypical parkinsonism patterns (5.05 ± 1.7 vs. 3.76 ± 0.96, P < 0.05). The DE_ratio was moderately and positively correlated with striatal DAT availability in both the whole striatum (r = 0.37, P < 0.001) and posterior putamen (r = 0.36, P < 0.001). Conclusion: Parkinsonism patients with an IPD pattern exhibited a significant increase in uptake on early 18F-FP-CIT PET and a decrease in the DE_ratio in the salivary gland. Our findings suggest that salivary gland uptake of dual-phase 18F-FP-CIT PET can provide diagnostic information on DAT availability in patients with Parkinson's disease.

루이소체 치매로 추정되는 이차성 파킨슨증 환자의 Non-Motor Symptom Scale(NMSS)로 평가한 비운동성 증상을 한약과 침의 복합치료로 호전시킨 증례보고 1례 (A Case Report of Non-Motor Symptoms Evaluated Using the Non-Motor Symptom Scale in a Patient with Secondary Parkinsonism Presumed to be Probable Lewy Body Dementia and Improved with Combined Treatment with Herbal Medicine and Acupuncture)

  • 노민영;이지현;한양희;임정태
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.833-845
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    • 2021
  • Parkinson's syndrome is a degenerative brain disease that presents characteristic motor symptoms of tremor, rigidity, and gait disturbance. In addition to these motor symptoms, Parkinson's syndrome also presents non-motor symptoms (NMSs) such as sleep disturbance and cognitive decline. NMSs reduce patient's quality of life and psychosocial functioning and cause economic burden on the patient, so appropriate evaluation and treatment are required. Lewy body dementia is one of the several diseases belonging to Parkinson's syndrome. Its symptoms such as cognitive function, memory impairment, and hallucinations occur with Parkinsonism. Although drug therapy is being used with drug treatment to treat non-motor symptoms, it has limitations such as side effects, which stimulated interest in other complementary treatment methods such as oriental medicine treatment, dance, and yoga. The patient in this case complained of tremor in the right upper extremity, muscle hypertension and pain, and persistent vision, memory, and cognitive decline. The patient was diagnosed with probable Lewy body dementia. The patient was hospitalized for 4 months and received acupuncture and herbal medicines. After treatment, the patient's NMS scale scores decreased from 90 to 63, and the Unified Parkinson's Disease Rating Scale scores (summed I, II, and III) decreased from 17 points to 8 points. The Beck Depression Inventory score decreased from 22 points to 13 points. In addition, the patient's subjective evaluation revealed improvement. In this case, a patient diagnosed with probable Lewy body dementia who did not respond to the standard treatment and did not want to take medications showed improvement in not only motor symptoms but also NMSs after integrative Korean medicine treatment.