• 대한한방내과학회지
• /
• 제24권2_4호
• /
• pp.975-986
• /
• 2003

Introduction: Guillain-Barre syndrome(GBS) is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, a loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. Recently there is an opinion that Acute Inflammatory Demyelinating Polyradiculoneuropathy'(AIDP) is more effective than 'GBS' for the symptoms. These symptoms are applicable to rheumatic arthritis(痺), flaccid paralysis of limb(?) caused by wind, cold and dampness(風, 寒, 濕) from an oriental medical view point. On this, we reported one case that diagnosed as 'complex of rheumatic arthritis(痺) and flaccid paralysis of limb(?)' at our oriental medical hospital. Result: we considered these symptoms as 'complex of rheumatic arthritis(痺), flaccid paralysis of limb(?)'. In accordance with the result, we treated the patient with Chung-Sang Tong-Jung On-Ha(淸上通中溫下). We concluded that external factors such as wind, cold and dampness(風, 寒, 濕) and internal factors like vital energy's disharmony(生氣不調和) affected the patient.

• Annals of Clinical Neurophysiology
• /
• 제7권1호
• /
• pp.17-19
• /
• 2005

Polyneuropathy that is associated with monoclonal gammopathy of undetermined significance (MGUS) similar to chronic inflammatory demyelinating polyneuropathy (CIDP) has been reported before, whereas a connection to acute inflammatory demyelinating polyneuropathy (AIDP) has not been. A 52 year-old man was presented with ascending paralysis beginning 1 day ago. Neurological examinations showed facial diplegia and decreased motor power and deep tendon reflexes in all extremities. On electrophysiologic study, sensorimotor polyneuropathy was observed. Protein-and immunoelectrophoresis revealed IgA $\lambda$ monoclonal gammopathy. High dose steroid therapy was given and the symptoms improved slightly.

• 대한한방내과학회지
• /
• 제39권1호
• /
• pp.76-83
• /
• 2018

Objectives: This case study reports on one patient presenting atypical and chronic disorders after being diagnosed with $Guillain-Barr{\acute{e}}$ Syndrome (GBS). Methods: One patient was treated by Yeongseonjetong-eum-gami, Taklisodok-eum-gami, electroacupuncture, and physical therapy. Any improvement in symptoms was assessed by measuring changes in the motor grade of upper limb weakness, the numerical rating scale (NRS) of lower limb numbness, and GBS scores. Results: After 24 days of treatment, the patient's symptoms of GBS showed little improvement. Conclusions: Traditional Korean medical treatment appeared to be effective in reducing GBS symptoms, but more research is required to confirm these results. When treating GBS patients, the clinician should put effort into distinguishing GBS from other nervous disorders, such as acute onset Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).

• Annals of Clinical Neurophysiology
• /
• 제6권2호
• /
• pp.92-97
• /
• 2004

Background: There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenous immunoglobulin and plasmapheresis. However, there were controversies in what were significant factors and there were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This study was aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treated with intravenous immunoglobulin. Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to our hospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcome and prognosis were followed up after four weeks using the overall disability sum score. Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings, 17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence of abnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestations of bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcome in patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnostic features (P<0.018) were significant in the multivariate logistic regression analysis. Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly different according to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulin and preventing complications during acute stages are essential to minimize neurological deficit and shorten the periods of recovery.

• Annals of Clinical Neurophysiology
• /
• 제6권1호
• /
• pp.20-25
• /
• 2004

Background and Objectives: The proximal and distal nerve segments are preferentially involved in acquired demyelinating polyneuropathies (ADP). This study was undertaken in order to assess the usefulness of motor evoked potential (MEP) and somatosensory evoked potential (SSEP) in the detection of the proximal nerve lesion in ADP. Methods: MEP, SSEP and conventional NCS were performed in 6 consecutive patients with ADP (3 AIDP, 3 CIDP). MEP was recorded from abductor pollicis brevis and abductor hallucis using magnetic stimulation of the cortex and the cervical/lumbar spinal roots. SSEP were elicited by stimulating the median and posterior tibial nerves. Latency from cortex and cervical/lumbar roots, central motor conduction time (CMCT), EN1-CN2 interpeak latency were measured for comparison. Results: MEP was recorded in 24 limbs (12 upper and 12 lower limbs) and SSEP in 24 limbs (12 median nerve, 12 posterior tibial nerve). F-wave latency was prolonged in 25 motor nerves (25/34, 73.5%). Prolonged CML and PML were found in 41.7% (10/24) and 45.8% (11/24), respectively. Interside difference (ISD) of CMCT was abnormally increased in the upper extremity, 66.7% (4/6 pairs) in case of CML-PML. EN1-CN2 interpeak latency was abnormally prolonged in one median nerve (1/10) and LN1-P1 interpeak latency was normal in all posterior tibial nerves. Conclusions: MEP and SSEP may provide useful information for the proximal nerve and root lesion in ADP. MEP and SSEP is supplemental examination as well as complementary to conventional NCS.

• 대한한방소아과학회지
• /
• 제17권2호
• /
• pp.199-211
• /
• 2003

저자는 경희대학교(慶熙大學校) 한의과대학(韓醫科大學) 부속한방(附屬韓方) 병원(病院)에 내원한 Guillain-Barre syndrome 환자를 한약(韓藥)과 간접염(間接炎) 및 침치료(鍼治療를) 사용하여 환자의 증상이 호전되었음을 확인하였으므로 이에 문헌고찰과 함께 보고하는 바이다.

• Annals of Clinical Neurophysiology
• /
• 제1권2호
• /
• pp.91-98
• /
• 1999

Background : The pathogenesis of acute inflammatory demyelinating polyradiculoneuropathy (AIDP), Guillain Barre syndrome (GBS) is not clear, but it has been known that the immune mechanisms play an important role. Authors performed this study to establish an animal model of experimental allergic neuritis (EAN) by immunizing the myelin components of peripheral nerves and to understand the electrophysiological and histopathological features as well as the ${CD_5}^+$ B-lymphocyte changes in peripheral bloods in the EAN models. Methods : Lewis rats weighing 150-200 gm were injected subcutaneously in soles two times with total myelin, P0, P1, or P2 proteins purified from the bovine cauda eguina. The EAN induction was assessed by evaluating clinical manifestations. The electrophysiological and histopathological features were studied as routine methods. The ${CD_5}^+$ Blymphocytes were double stained using monoclonal FITC conjugated anti-rat CD45RA and R-PE conjugated anti-rat ${CD_5}^+$ antibodies and calculated using a fluorescence activated cell sorter (FACS). Results : The EAN animal models were established. In two out of five, in one out of two, in none out of three, and in none out of one Lewis rats injected with purified total myelin, P0, P1, P2 proteins respectively, They showed slow spontaneous motor activity and weak resistance against pulling back by tails. The typical electrophysiological and histologic findings in total protein and P0 induced EAN animal models were the decreased conduction velocity, the decreased compound muscle action potential (CMAP) amplitude and the dispersion phenomenon. The perivascular infiltrates of lymphocytes with focal demyelinating process were found in light microscopy. The ${CD_5}^+$ B-lymphocyte expression in three EANs were 2.38%, 3.50% 2.50%, which were not significantly increased, compared with those in normal controls. Conclusion : The EAN animal models were successfully established by injecting the total myelin and P0 myelin and they showed electrophysiological and histological features typical of demyelinating process. However they did not show an increased expression of ${CD_5}^+$ B-lymphocyte in peripheral bloods which could be indirect evidence of humoral autoimmunity.