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Annals of Clinical Neurophysiology

The Korean Society of Clinical Neurophysiology

  • Semi Annual
  • /
  • 2508-691X(pISSN)
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  • 2508-6960(eISSN)

Domain

  • Health Sciences ＞ Biomedical Sciences
  • Health Sciences ＞ Clinical Medicine

Aim & Scope

ACN publishes scientific and creative research papers in clinical neuroscience and clinical neurophysiology supporting all of the academic fields of clinical neurology. Its scope therefore includes the following topics: ─ Nerve conduction studies ─ Electromyography ─ Evoked potentials ─ Electroencephalography ─ Brain mapping ─ Magnetoencephalography ─ Transcranial Doppler ─ Duplex sonography ─ Polysomnography ─ Neuromuscular sonography ─ Vestibular neurophysiology ─ Movement related potential ─ Transcranial magnetic stimulation ─ Functional neuroimaging ─ Therapeutic brain stimulation ─ Therapeutic spinal cord stimulation ─ Neural excitability testing ─ Autonomic function testing ─ Intraoperative neurophysiological monitoring ─ Clinical neurophysiology evaluating peripheral or central pain pathway ─ Gastro-intestinal neurophysiology ─ Neurophysiological monitoring ─ Neurourology ─ Experimental neurophysiology and neurobiology ─ Clinical trials utilizing parameters of clinical neurophysiology ─ Basic science contributing to advances in clinical neurophysiology ─ Diseases of the peripheral and central nervous systems requiring assessments by clinical neurophysiology This journal publishes full-length original papers, case reports, letters to the editor, invited reviews, images in clinical neurophysiology, and other articles commissioned by the editorial board. All unsolicited articles are subject to peer review. Commissioned articles are reviewed by the Editorial Board. ACN provides clinicians and researchers with peer-reviewed articles in all of the academic fields of clinical neurology, including clinical neuroscience and clinical neurophysiology,with the aim of enhance patient management, education, clinical and experimental research, and professionalism.

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Volume 3 Issue 1

  1. Lee, Dong Kuck 1
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    The distal myopathies(DM) are clinically defined as inherited or sporadic primary muscle disorders characterized by progressive muscular weakness and atrophy beginning in the hands or feet and pathologically by myopathic changes in skeletal muscles. The pathologic changes are somewhat similar to those seen in chronic muscular dystrophy, but necrotic and regenerative processes are less prominent and creatine kinase levels are either normal or only mildly elevated. The most representative diseases are dominantly inherited Welander distal myopathy and tibial muscular dystrophy, and the recessively inherited distal myopathy with rimmed vacuoles and distal muscular dystrophy(Miyoshi myopathy). At present, further study is necessary to determine why rimmed vacuoles are so common in the DM, and what role they play in the pathogenesis of muscle fiber atrophy and loss, predominantly in the distal portions of the extremities.
  2. Suh, Sang Il;Bae, Joon Soek;Kim, Sung Je;Kim, Tae Il;Kim, Ji Eun;Lee, Dong Kuck;Shin, Im Hee 9
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    Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of acute onset, accounting for more than 50% of all cases of facial paralysis. Different theories on the etiology of BP have been proposed. Herpes simplex virus-1(HSV) has been the most suspicious causative agent, but varicella zoster virus(VZV) also is suspected. Objectives : We evaluated the serological changes of IgG and IgM titer of HSV and VZV to know the causative agent of BP. Materials and Methods : Subjects consisted of 35 patients who developed acute idiopathic unilateral facial palsy(16 men and 19 women from 9 to 78 years old) within a week of onset. We took the serum of the acute and convalescent stages, respectively. Serum IgG and IgM titer of HSV and VZV were measured in acute and convalescent stages by EIA method. Results : Only the HSV IgG titer showed statistically significant elevation in the convalescent stage(p=0.0291). Others did not show any significant change between the acute and convalescent stage. Conclusion : We concluded that HSV may be related to the causative agent of BP.
  3. Kim, Ja-Young;Park, Hae-Yoon;Kang, Sung-Soo 15
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    Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.
  4. Kim, Byung Jo;Koh, Seong Beom;Park, Min Kyu;Park, Kun Woo;Lee, Dae Hie 21
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    Background & Object : Myasthenia gravis(MG) is an autoimmune disease due to binding of antibody to acetylcholine receptors on the muscle membrane. It is well known that other autoimmune diseases infrequently accompany myasthenia gravis. The aim of this study was to evaluate the clinical significance of associated autoimmune diseases(AAD) and compare prognosis between MG with AAD and MG without AAD. Method : A total of 65 MG patients(24 men and 41 women) were enrolled at this study. From the clinical records of these patients, we investigated the clinical characteristics and prognosis of MG with AAD and compared these data with those of MG without other such diseases. Results : AAD were found in 10 of 65 cases(15%). 9 cases of 10 MG with AAD were generalized MG type. The most common disease was thyroid disorder. The rate of AAD was higher in thymic abnormal patients. There was no significant remission rate difference between MG with AAD and MG without AAD, but the percentage of patients experienced crisis was higher in MG with AAD. Conclusion : The occurrence of AAD may suggest a more generalized autoimmune disturbance that could be associated with a less favorable prognosis.
  5. Shim, Yong-Soo;Choi, Seong-Ho;Lee, Il-Keun 26
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    Purpose : Eyeball movement is one of the main artifacts in EEG. A new approach to the removal of these artifacts is presented using independent component analysis(ICA). This technique is a signal-processing algorithm to separate independent sources from unknown mixed signals. This study was performed to show that ICA is a useful method for the separation of EEG components with little data deformity. Methods : 12 sets of 10 sec digital EEG data including eye opening and closure were obtained using international 10~20 system scalp electrodes. ICA with 18 tracings of double banana bipolar montage was performed. Among obtained 18 independent components, two components, which were thought to be eyeball movements were removed. Other 16 components were reconstructed into original bipolar montage. Power spectral analysis of EEGs before and after ICA was done and compared statistically. Total 12 pairs of data were compared by visual inspection and relative power comparison. Results : Waveforms of each pair looked alike by visual inspection. Means of relative power before and after ICA were 29.16% vs. 28.27%, 12.12% vs. 12.41%, 10.55% vs. 10.52%, and 19.33% vs. 18. 33% for alpha, beta, theta, and delta, respectively. These values were statistically same before and after ICA. Conclusions : We found little data deformity after ICA and it was possible to isolate eyeball movements in EEG recordings. Many other components of EEG could be selectively separated using ICA.
  6. Joo, Eun-Yeon;Kim, Eung-Su;Park, Ki-Duck;Choi, Kyoung-Gyu 31
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    Background & Objectives : Fractal Dimension(FD) could be an index of correlation between variable parameters in non-linear chaotic signals. We tried to demonstrate that EEG wave is compatible with chaotic waves by measuring the Lyapunov exponent index and compared the difference of FD between variable age groups(teens, 30's, 50's) Methods : We estimated the Lyapunov exponent index and the FD from digital EEG data among five persons in each normal age groups by using the software which is programmed in our laboratory. Statistical analysis was done with SPSS win 8.0. The statistical differences of Lyapunov exponent index and FD between each electrodes and each age groups were done with ANOVA and paired sample t-test. Result : The Lyapunov exponent indexes were larger than 1 in each electrode and age group. There is no statistical difference in FD between each electrodes and each age groups. Except in 30th age group. In this group the FD of right hemisphere is larger than that of left hemisphere. Conclusion : The result of Lyapunov exponent index means EEG wave is a non-linear chaotic signal. And the results of FD suggest that chaotic parameters of right hemisphere is larger than those of left hemisphere at rest at least in younger people. We think that chaotic parameters can be a useful tool in investigating the variable diseases or brain states.
  7. Ko, Yung-Chai;Kang, Sung-Soo;Lee, Young-Bae;Park, Hyeon-Mi;Shin, Dong-Jin 37
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    Although the etiology and pathogenesis of amyotrophic lateral sclerosis(ALS) is unknown, increasing evidence supports a role for autoimmune mechanisms in motor neuron degeneration. The coexistence of immune disease in ALS supports that an altered immune system may contribute to disease pathogenesis. A 55-year-old woman was admitted to our department due to dysarthria and gait disturbance. On physical and neurologic examination, she showed thyroid enlargement, tongue atrophy, muscle weakness, fasciculation, and increased deep tendon reflex. The electrophysiological studies are compatible with motor neuron disease. Cytological findings of thyroid were compatible with Hashimoto's thyroiditis. Thus, we report a case of ALS combined with Hashimoto's thyroiditis. And the simultaneous presentation with ALS and Hashimoto's thyroiditis led us to consider whether this was simply a chance association or not.
  8. Kim, Han-Joon;Kim, Sung Hun;Lee, Kwang-Woo 40
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    Anorexia nervosa(AN) is a disorder characterized by disturbance of body image, fear of gaining weight, severe weight loss and, in female, amenorrhea. Compared with normal persons, patients with AN have neuropathic symptoms more frequently. But electrophysiologic abnormalities have rarely been reported. We experienced a case with recurrent neuropathic symptoms after severe weight loss. Further evaluation revealed AN. Electrophysiologic study showed sensorimotor polyneuropathy and focal neuropathy with conduction block. As far as we know, this feature of neuropathy in AN has not been described. We describe unusual feature of neuropathy in our patient with literature review.
  9. Chun, Jong-Un;Lee, Yong-Seok;Nam, Hyunwoo;Park, Seong-Ho 43
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    Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.
  10. Lee, Dong Kuck 47
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    Lateral antabrachial cutaneous neuropathy(LACN) was diagnosed in a 42-year-old woman who developed pain and paresthesia in the left forearm after several days of heavy labor. The symptoms were resolved with conservative treatment, including cessation of heavy labor and a brief course of oral corticosteroids. But the symptoms recurred after 9 months. Those were also resolved with same treatment as the first attack. LACN is important to recognize because the symptoms may mimic the pathology of a cervical root, the brachial plexus, the radial and median nerves at the level of the elbow, and a focal idiopathic inflammatory neuritis.
  11. Park, Kyung-Seok;Chung, Jae-Myun;Joo, Mee;Lim, Kyung Ho;Lee, Kwang-Woo 50
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    Licorice is widely used as a Chinese(herbal) medicine. The glycyrrhizin, a main ingredient of the natural licorice, has a potent mineralocorticoid effect which may cause severe hypokalemia and muscle paralysis. We present a 60-year-old woman, who had been ingesting one or two spoonful of licorice powder daily for about one year, developed acute flaccid quadriparesis with high levels of serum muscle enzymes and the typical features of mineralocorticoid excess such as severe hypokalemia and metabolic alkalosis. Both plasma renin activity and serum aldosterone level were below the normal values. This case indicates that licorice-induced hypokalemic myopathy should be considered in the differential diagnosis of a patient with acute quadriparesis and hypokalemia.