DOI QR코드

DOI QR Code

전신성 근긴장이상을 호소하는 환자에 대한 한의 치료 1례

A Case Study of Korean Medicine Treatment in a Patient Complaining of Generalized Dystonia

  • 이경화 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 허혜민 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 김동주 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 곽민제 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 황예채 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 조승연 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박정미 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 고창남 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박성욱 (경희대학교 대학원 한방순환신경내과학교실)
  • Kyeong-hwa Lee (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Hye-min Heo (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Dong-joo Kim (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Min-jae Kwak (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Ye-chae Hwang (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Seung-yeon Cho (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Jung-mi Park (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Chang-nam Ko (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Seong-uk Park (Dept. of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 투고 : 2024.04.23
  • 심사 : 2024.05.20
  • 발행 : 2024.05.30

초록

We report a case of generalized dystonia that developed from oromandibular dystonia and improved following Korean medicine treatment. The patient was hospitalized for 18 days and treated with herbal medicine, mainly Hyeongbangsabaek-san and Soyangbowi-tang, acupuncture, electroacupuncture, pharmacopuncture, cupping, and moxibustion. To evaluate the clinical effects of the treatment, we used the Unified Dystonia Rating Scale (UDRS) and Global Dystonia Severity Rating Scale (GDS) and checked dyskinesia occurrence in a diary recorded by the patient's guardian. After 18 days of hospitalization, the UDRS for the trunk, upper extremities, and lower face improved by more than 50%, and the GDS for the whole region, except the larynx and lower face, also improved. In addition, the maximum duration of dystonia decreased from 6 hours to 3 hours, and the pain and numbness associated with dystonia disappeared. This case suggests that Korean medicine treatment is effective in treating generalized dystonia.

키워드

참고문헌

  1. 강석윤, 강지훈, 고성범, 고성호, 고임석, 구본대, et al. 신경학. 서울: 범문에듀케이션; 2012, p. 604-7.
  2. Albanese A, Di Giovanni M, Lalli S. Dystonia: diagnosis and management. European Journal of Neurology 2019;26(1):5-17. https://doi.org/10.1111/ene.13762
  3. Bailey GA, Rawlings A, Torabi F, Pickrell O, Peall KJ. Adult-onset idiopathic dystonia: A national data-linkage study to determine epidemiological, social deprivation, and mortality characteristics. European Journal of Neurology 2022;29(1):91-104. https://doi.org/10.1111/ene.15114
  4. Jinnah HA, Factor SA. Diagnosis and treatment of dystonia. Neurol Clin 2015;33(1):77-100. https://doi.org/10.1016/j.ncl.2014.09.002
  5. Buhmann C, Huckhagel T, Engel K, Gulberti A, Hidding U, Poetter-Nerger M, et al. Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences. PLoS One 2017;12(7):e0178984.
  6. Lubarr N, Bressman S. Treatment of Generalized Dystonia. Current Treatment Options in Neurology 2011;13(3):274-89. https://doi.org/10.1007/s11940-011-0122-0
  7. Lee MR, Kim SB, Woo JM, Kang AR, Cho KH, Moon SK, et al. Case study of a patient with dystonia due to dystonic cerebral palsy treated with traditional korean medicine. The Journal of Internal Korean Medicine 2016;37(2):257-64.
  8. Park H, Lee HK, Lee SW, Cho KH, Mun SK, Jung WS, et al. Case Report of Psychogenic Dystonia Treated with Traditional Korean Medicine. The Journal of Internal Korean Medicine 2021;42(2):152-64. https://doi.org/10.22246/jikm.2021.42.2.152
  9. Jin HW, Bak JR, Bak JR, Yun JM, Moon BS. A Case Report of Korean Medicine Treatment for a Patient with Cervical Dystonia. The Journal of Internal Korean Medicine 2023;44(5):948-56. https://doi.org/10.22246/jikm.2023.44.5.948
  10. Ku J, Jung C, Hwang JH. Toxicological study of SU-Eohyeol Pharmacopuncture in an in vivo micronucleus test in Sprague-Dawley rats. Korean Journal of Acupuncture 2022;39(2):54-62. https://doi.org/10.14406/acu.2022.008
  11. 박성욱. 약침의 정석. 서울: 우리의학서적; 2020, p. 41-78, 107-81.
  12. 정철, 안영성, 정진호, 구자승. 면역약침 임상가이드. 파주: 군자출판사; 2023, p. 168-83
  13. Comella CL, Leurgans S, Wuu J, Stebbins GT, Chmura T. Rating scales for dystonia: A multicenter assessment. Movement Disorders 2003;18(3):303-12. https://doi.org/10.1002/mds.10377
  14. Grutz K, Klein C. Dystonia updates: definition, nomenclature, clinical classification, and etiology. J Neural Transm (Vienna). 2021;128(4):395-404. https://doi.org/10.1007/s00702-021-02314-2
  15. Tarsy D. Chapter 3 - Movement Disorders. In: Samuels MA, Feske SK, editors. Office Practice of Neurology (Second Edition). Philadelphia: Churchill Livingstone; 2003, p. 13-25.
  16. Listik C, Listik E, de Paiva Santos Rolim F, Meneses Cury Portela DM, Perez Lloret S, de Alves Araujo NR, et al. Development and Validation of the Dystonia-Pain Classification System: A Multicenter Study. Mov Disord 2023;38(7):1163-74. https://doi.org/10.1002/mds.29423
  17. Meneret A, Garcin B, Frismand S, Lannuzel A, Mariani LL, Roze E. Treatable Hyperkinetic Movement Disorders Not to Be Missed. Frontiers in Neurology 2021;12:659805.
  18. Gilmour GS, Lidstone SC, Lang AE. The diagnosis of functional movement disorder. Pract Neurol 2022:40-53.
  19. Gn S, Nag A. Management of Oromandibular Dystonia: A Case Report and Literature Update. Case Reports in Dentistry 2017;2017:1-7. https://doi.org/10.1155/2017/3514393
  20. Sankhla C, Lai EC, Jankovic J. Peripherally induced oromandibular dystonia. Journal of Neurology, Neurosurgery & Psychiatry 1998;65(5):722-8. https://doi.org/10.1136/jnnp.65.5.722
  21. Handa S, Shaefer JR, Keith DA. Oromandibular dystonia and temporomandibular disorders. J Am Dent Assoc 2022;153(9):899-906. https://doi.org/10.1016/j.adaj.2021.07.026
  22. Britton D, Alty J, Mannion C. Oromandibular dystonia: a diagnosis not to miss. British Journal of Oral and Maxillofacial Surgery 2020;58(5):520-4. https://doi.org/10.1016/j.bjoms.2020.02.018
  23. Slaim L, Cohen M, Klap P, Vidailhet M, Perrin A, Brasnu D, et al. Oromandibular dystonia: demographics and clinical data from 240 patients. Journal of movement disorders 2018;11(2):78-81. https://doi.org/10.14802/jmd.17065
  24. 전국한의과대학. 한방순환.신경내과학. 서울: 우리의학서적; 2016, p. 309-11
  25. Yoon MJ, Kim SY, Park JY. Recent study trends of the liver-tonification and liver-sedation of Saam acupuncture. Korean Journal of Acupuncture 2018;35(1):1-17. https://doi.org/10.14406/acu.2018.004
  26. Hong JA, Kim SJ, Lee YJ, Chang JW, Kim MC. A case of Parkinson's disease patient with kinematic symptoms which was improved by acupture and moxibustion on Dokmak. J Oriental Rehab Med 2004;14(1):195-201.