• 제목/요약/키워드: spasm

검색결과 282건 처리시간 0.027초

중풍발병 예측인자로서 경항부강직과 안면경련에 관한 임상연구 (A Clinical Study on Stroke Presymtoms as Prospective Factors)

  • 최동준;한창호;이원철;전찬용;조기호;최선미
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.758-762
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    • 2007
  • Objectives : This study investigated the relationship between presymtoms and stroke subtype in early state of stroke patients. Methods : From Oct. 2005 to May 2007, 623 early state stroke patients were included. Patients were hospitalized within 30 days after the onset of stroke at DongGuk University International Hospital, Kyungwon University In-cheon Oriental Medical Hospital, or Kyung Hee University Oriental Hospital. We investigated general characteristics, stroke subtype, and presymtoms (facial spasm, neck stiffness). Results : Hemorrhagic stroke had more facial spasm than ischemic stroke(odds ratio 2.80). Small vessel occlusion had more neck stiffness than others(odds ratio 1.59). Conclusions : Facial spasm and neck stiffness would be valuable as stroke presymtoms.

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광범위 식도경련 -수술치험 2례- (Surgical Experience of Diffuse Esophageal Spasm - A report of 2 cases -)

  • 이창민;박성달;조성래
    • Journal of Chest Surgery
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    • 제31권4호
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    • pp.427-431
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    • 1998
  • 광범위 식도경련은 연하장애로 인해 식도운동 검사실에서 식도내압검사를 시행받는 모든 환자의 약 4%정도에서 발견되는 드문 질환으로, 그 진단 및 치료방법에 대해서 현재까지 논란이 되고 있다. 저자들은 연하장애와 흉통을 주소로 내원한 60대 여자환자 2명에서 식도조영술과 식도내압검사를 시행하여 광범위 식도경련으로 확진하고 대동맥궁 직상부부터 식도위 접합부 0.5cm 하부까지 길게 식도 근절개술을 시행하였다. 술후 연하장애와 흉통이 소실되었고 식도조영술과 식도내압검사를 시행하여 만족스러운 결과를 얻었으며, 환자는 술후 각각 3년 및 3개월째 양호한 상태로 외래 추적관찰 중이다.

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관상동맥 우회술 직후에 발생한 자가 혈관의 연축에 의한 저심박출 (Low Cardiac Output Syndrome Caused by a Coronary Artery Spasm following CABG)

  • 김영학;정윤상;강정호;정원상;신성호;김혁
    • Journal of Chest Surgery
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    • 제40권9호
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    • pp.633-636
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    • 2007
  • 관상동맥 우회술 직후에 발생하는 자가혈관의 연축은 흔하게 발생하지는 않지만, 갑작스럽게 발생하는 심한 저혈압 상태나 심실성 부정맥의 원인이 될 수 있다. 수술 전 관상동맥 조영술에서 의미있는 협착이 없어 우회술을 시행하지 않았던 우 관상동맥의 연축 현상에 의한 저심박출의 발생에 관한 증례를 보고하고자 한다.

Delayed Unilateral Soft Palate Palsy without Vocal Cord Involvement after Microvascular Decompression for Hemifacial Spasm

  • Park, Jae Han;Jo, Kyung Il;Park, Kwan
    • Journal of Korean Neurosurgical Society
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    • 제53권6호
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    • pp.364-367
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    • 2013
  • Microvascular decompression is a very effective and relatively safe surgical modality in the treatment of hemifacial spasm. But rare debilitating complications have been reported such as cranial nerve dysfunctions. We have experienced a very rare case of unilateral soft palate palsy without the involvement of vocal cord following microvascular decompression. A 33-year-old female presented to our out-patient clinic with a history of left hemifacial spasm for 5 years. On postoperative 5th day, patient started to exhibit hoarsness with swallowing difficulty. Symptoms persisted despite rehabilitation. Various laboratory work up with magnetic resonance image showed no abnormal lesions. Two years after surgery patient showed complete recovery of unitaleral soft palate palsy. Various etiologies of unilateral soft palate palsy are reviewed as the treatment and prognosis differs greatly on the cause. Although rare, it is important to keep in mind that such complication could occur after microvascular decompression.

편측 안면경련을 동반한 급성기 안면신경마비 한방 치험 1례 (A Case of Acute Facial Nerve Palsy with Hemifacial Spasm Treated with Korean Medicine)

  • 경다현;김서희;임승환
    • 한방안이비인후피부과학회지
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    • 제35권4호
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    • pp.163-171
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    • 2022
  • Objectives : The aim of this study was to report that effect of Korean medicine treatment for patient with peripheral facial nerve palsy accompanied by hemifacial spasm through hospitalization. Methods : We treated a patient with facial nerve palsy by acupuncture, electroacupuncture, herbal medicine, pharmacopuncture and cupping. The effect of treatment was evaluated using the House-Brackmann scale, the Yanagihara grading system, and the visual analogue scale(VAS). Results : During the 18 days hospitalization period, the symptoms of hemifacial spasm disappeared and the facial palsy improved. The House-Brackmann scale changed from 4 grade to 2 grade, the Yanagihara grading system changed from 19 to 47, and the VAS changed from 3 to 0. Conclusions : This case report suggests that Korean medicine could be effective for facial palsy accompanied by hemifacial spasms.

편측성 안면경련 환자의 미세혈관 감압수술에서 효과적인 수술 중 신경계 감시검사를 위한 제안 (Suggestions for the Effective Intraoperative Neurophysiological Monitoring in Microvascular Decompression Surgery of Hemifacial Spasm)

  • 임성혁
    • 대한임상검사과학회지
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    • 제48권3호
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    • pp.262-268
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    • 2016
  • 편측성 안면경련(hemifacial spasm)은 불수의적으로 안면의 근육에서 발작적인 경련이 일측성으로 반복해서 발생하는 질환이다. 한 근육의 수축으로 인해 동시적으로 여러 근육이 동시에 수축되는 동시 수축성(synkinesia)이 특징이다. 발병원인은 제 7뇌신경인 안면신경이 혈관에 의해 압박을 받아서 나타나게 된다. 본 연구는 편측성 안면경련 환자의 미세혈관 감압 수술을 받은 환자를 대상으로 수술 중 진행되는 신경계 감시검사 방법들에 대해 다루었다. 청각유발전위 검사에서는 수술용 뇌 견인기의 사용시 주의 사항과 검사시기에 대해 언급하였다. 안면신경의 근전도검사에서는 잡파의 혼입과 신경손상 시 근전도 파형의 감별에 대해, 측면전파 반응 검사에서는 마취의 유지의 중요성에 대해 그리고 체성감각 유발전위검사에서는 환자를 좀더 자세하게 검사할 수 있도록 새로운 방법을 제안하였다. 위에 언급한 내용들을 토대로 검사한다면 수술 중 신경계 감시 검사를 원활하게 할 수 있으리라 생각된다.

Infranuchal Infrafloccular Approach to the More Vulnerable Segments of the Facial Nerve in Microvascular Decompressions for the Hemifacial Spasm

  • Park, Heung-Sik;Chang, Dong-Kyu;Han, Young-Min
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.340-345
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    • 2009
  • Objective : We investigated the locations of compressing vessels in hemifacial spasm. To approach compression sites, we described and evaluated the efficacy of the infranuchal infrafloccular (INIF) approach. Methods : A retrospective review of 31 consecutive patients who underwent microvascular decompression (MVD) through INIF with a minimum follow-up of 1 year was performed. Along the intracranial facial nerve, we classified the compression sites into the transitional zone (TRZ), the central nervous system (CNS) segment and the peripheral nervous system (PNS) segment. The INIF approach was used to inspect the CNS segment and the TRZ. Subdural patch graft technique was used in order to achieve watertight dural closure. The cranioplasty was performed using polymethylmethacrylate. The outcome and procedure-related morbidities were evaluated. Results : Twenty-nine patients (93%) showed complete disappearance of spasm. In two patients, the spasm was resolved gradually in 2 and 4 weeks, respectively. Late recurrence was noted in one patient (3%). The TRZ has been identified as the only compression site in 19 cases (61.3%), both the TRZ and CNS segment in 11 (35.5%) and the CNS segment only in 1 (3.2%). There was no patient having a compressing vessel in the PNS segment. Infection as a result of cerebrospinal fluid leak occurred in one patient (3%). Delayed transient facial weakness occurred in one patient. Conclusion : The TRZ and the CNS segment were more vulnerable area to the compression of vessels. We suggest that surgical avenue with the INIF approach provides early identification of this area.

미만성 식도경련의 한방 치료 : 증례보고 (Case Study of Korean Medicine Treatment of Diffuse Esophageal Spasm)

  • 김동윤;황미니;고휘형;백소영;이하늘;정해인;하나연;김진성
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.814-821
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    • 2019
  • Objective: This case study reports on the result of Korean medicine treatment of diffuse esophageal spasm. Methods: A 46-year-old female Korean patient with diffuse esophageal spasm received electroacupuncture, herbal medicine, and moxibustion treatment for 2 weeks in hospital. Results: Decreases in the visual analog scale (VAS) (from 8.7 to 7.0), numeric rating scale (NRS) (from 7.0 to 5.5), gastrointestinal symptom rating scale (GSRS) (from 9 to 6), and gastroesophageal reflux disease-health related quality of life questionnaire (GERD-HRQL) (from 46 to 38) scores were observed after the treatment. Conclusion: Evaluation of Korean medicine treatment is worthwhile for rare diseases like diffuse esophageal spasm.

Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients

  • Kang, Kwan Woo;Choi, Byoung Geol;Rha, Seung-Woon
    • Yonsei Medical Journal
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    • 제59권9호
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    • pp.1057-1063
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    • 2018
  • Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.