• Title/Summary/Keyword: Brainstem

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Orthostatic hypotension with meningoencephalitis involving the rostral ventrolateral medulla

  • Young, Ik-Jung;Sunwoo, Mun Kyung;Lee, Hee Jin;Seo, Jeong Hee;Kim, Jeongyeon
    • Annals of Clinical Neurophysiology
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    • v.21 no.1
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    • pp.66-69
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    • 2019
  • Orthostatic hypotension (OH) is commonly associated with autonomic failure in the peripheral nervous system. Less often it is related to central lesions in brainstem and cerebellum. We describe a patient with OH associated with tuberculosis meningoencephalitis involving the brainstem including rostral ventrolateral medulla. This is the first case of OH resulting from focal lesions in the dorsal medulla in a patient with meningoencephalitis.

Factors Influencing the Changes of BAEPs in Vertebrobasilar Transient Ischemic Attacks (추골기저동맥 일과성 허혈발작에서 뇌간청각유발전위변화에 영향을 미치는 인자)

  • Park, Young Hyuk;Yoo, Bong Goo;Kim, Kwang Soo;Yoo, Kyung Moo
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.101-106
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    • 2000
  • Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

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Case Reports about Brainstem Infarction -Dejerine′s syndrome and Wallenburg′s syndrome- (뇌간 경색에 대한 고찰 -Dejerine′s syndrome 1례 및 Wallenburg′s syndrome 1례-)

  • Cho Gwon Il;Han Myoung Ah;Lee Ji Yeon;Choi Jin Young;Kim Dong Woung;Jung Dae Young;Kim Kwan Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.6
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    • pp.1291-1296
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    • 2002
  • Blood circulation of brain is divided into two major categories; anterior one from carotid artery and posterior one from vertebrobasilar artery. In stroke patients, it is important to diagnose which is involved, because there is many difference in the aspects of clinical menifestations and prognosis, especially in the acute stage. In some cases of vertebrobasilar infarction, such as Wallenberg's syndrome, charicteristic cranial nerve signs, eye movement disorders and cerebellar signs are appeared. And in Dejerine's syndrome, only pure motor or sensory defecits can be appeared without any brainstem signs. So It shoud be differenciated by Brain MRI from those of the cerebral hemisphere lesions. And in the cases that nausea, vomitting and dysphagia are the first menifestations, it is frequently misdiagnosed as internal medical disease, causing appropriate treatment delayed. In this case report, we are to describe the clinical menifestations and progresses of two cases of brainstem infarctions, review previously published case reports about them and compare them to our cases. The first is Dejerine's syndrome i.e. medial medullary infarction, the second is Wallenberg's syndrome i.e. lateral medullary infarction. Simultaneously we are to investigate the oriental medical approach in the bran stem infarctions.

Inhibitory Effects of Extracts from Traditional Herbal Drugs on 5-Hydroxytryptamine Uptake in Primary Cultured Rat Brainstem Neurons (배양된 흰쥐 뇌간 신경세포에서 5-Hydroxytryptamine 흡수에 대한 각종 전통 생약 추출물의 억제 효과)

  • Cho, Hyun-Mi;Jung, Jun-Sup;Lee, Tae-Hee;Son, Kun-Ho;Suh, Hong-Won;Song, Dong-Keun;Kim, Yung-Hi
    • Korean Journal of Pharmacognosy
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    • v.26 no.4
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    • pp.349-354
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    • 1995
  • Crude methanolic(80%) extracts from 109 kinds of traditional herbal drugs were randomly screened for inhibitory effects on 5-hydroxytryptamine(5-HT) uptake in primary cultured rat brainstem neurons. Rat brainstem neurons were cultured from embryonic day 14, and maintained for 7-9 days in vitro. Clomipramine (500 nM), a reference drug, decreased 5-HT uptake to 16% of control values. Of the 109 herbal drugs screened, Citri immaturi Pericarpium(靑皮), Coptidis Rhizoma(黃蓮), Cnidii Rhizoma(土川芎) showed the most potent 5-HT uptake inhibiting activities. These herbal drugs, at the concentration of $10{\;}{\mu}g/ml$, inhibited 5-HT uptake 69, 69, and 57% respectively, when inhibition(%) was expressed as a relative value compared to the 500 nM clomipramine-induced inhibition.

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Rapid Progression to Brainstem Encephalitis Caused by Enterovirus 71 Without Throat and Skin Lesions After a One-Day Fever

  • Kyung Min Kim;Soo Yeon Kim;Mi Kyoung Song;Ji Young Kim;Anna Cho;Ji Young Park
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.91-96
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    • 2023
  • Infection with enterovirus (EV) 71 is usually associated with hand-foot-and-mouth disease and herpangina. The most frequent neurologic complication is brainstem encephalitis. A 30-month-old boy visited the pediatric emergency department with fever, lethargy, and abnormal eye contact. His mental status was slightly drowsy. On hospitalization day 2, the patient experienced respiratory arrest with apnea. Brain magnetic resonance imaging revealed bilateral symmetric T2-high signal lesions without enhancement in the posterior aspect of the brainstem and left medial temporal lobe. Electroencephalography was indicative of diffuse cerebral dysfunction with diffuse high amplitude and irregular delta activities. He underwent a gene study and was diagnosed with myoclonic epilepsy with ragged red fibers syndrome. We report a case of EV 71 brainstem encephalitis by polymerase chain reaction for nasopharyngeal aspirates and feces with rapid progression within one day of fever without the manifestation of throat and skin lesions because of his underlying mitochondrial disease.

Overlapping Guillain-Barr$\acute{e}$ syndrome and Bickerstaff's brainstem encephalitis associated with Epstein Barr virus

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.457-460
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    • 2014
  • A flaccid tetraparesis in Bickerstaff's brainstem encephalitis (BBE) is presumed to be a sign of overlapping Guillain-Barr$\acute{e}$ syndrome (GBS). In addition, BBE and Fisher syndrome, which are clinically similar and are both associated with the presence of the immunoglobulin G anti-GQ1b antibody, represent a specific autoimmune disease with a wide spectrum of symptoms that include ophthalmoplegia and ataxia. A 2-year-old boy presented with rapidly progressive ophthalmoplegia, ataxia, hyporeflexia, weakness of the lower extremities, and, subsequently, disturbance of consciousness. He experienced bronchitis with watery diarrhea and had laboratory evidence of recent infection with Epstein-Barr virus (EBV). He was diagnosed as having overlapping GBS and BBE associated with EBV and received treatment with a combination of immunoglobulin and methylprednisolone, as well as acyclovir, and had recovered completely after 3 months. In addition, he has not experienced any relapse over the past year. We suggest that combinations of symptoms and signs of central lesions (disturbance of consciousness) and peripheral lesions (ophthalmoplegia, facial weakness, limb weakness, and areflexia) are supportive of a diagnosis of overlapping GBS and BBE and can be helpful in achieving an early diagnosis, as well as for the administration of appropriate treatments.

The Comparisons of 4 Channel Auditory Brainstem Response for Tracking Auditory Neuro-Pathway

  • Woo, Jin-Wan;Lee, Sang-Min;Hong, Sung-Hwa;Sung, Young-Ju;Park, Sook-Kyoung;Lee, Yong-Hee;Kim, In-Young;Kim, Sun-I.
    • Journal of Biomedical Engineering Research
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    • v.25 no.3
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    • pp.195-200
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    • 2004
  • The Auditory Brainstem Response (ABR) with a click stimulation in guinea pigs was used to examine the auditory neuro-pathway from the cochlear nucleus to brain. Using multi-channel active electrodes, the 3-dimensional auditory pathway was examined from the cochlea to the inferior colliculus through the brainstem. These results are similar to the well-known neuro-pathway. This study on the multi-channel ABR shows that the positions of the ABR generators move to the central brain and the contralateral pathway. It is generally agreed that the ABR is generated by some structures along the auditory pathway. This study provides some information on the neuro-pathway where the ABR peak is generated.

Development of Electrical Stimulator for Auditory Stimulation (청각 자극용 전기자극기 개발)

  • Heo, Seung-Deok;Jung, Dong-Keun;Kim, Lee-Suk;Kim, Gwang-Nyeon;Kang, Myung-Koo;Kim, Jae-Ryong;Kim, Gi-Ryon
    • Speech Sciences
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    • v.11 no.3
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    • pp.201-211
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    • 2004
  • This paper introduces a development of an electrical stimulator for auditory stimulation. The electrical stimulator is useful in neurotological diagnosis, audiological evaluation, candidate selection for cochlear implantation, optimal device selection and decision making of MAP strategy for severe-to-profound hearing impaired persons. The development was based on sound parameters of auditory brainstem responses and auditory electrophysiological characteristic such as effective firing of auditory nerve and recording evoked potentials during refractory period of neuron. Besides pulse parameter could adjustable by programming for more varied electrical stimulation evoked response audiometry. Using the electrical stimulator, electrical square pulse was applied to promontory, and electrically evoked auditory brainstem response and electrically middle latency response were successfully recorded in cats.

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Pathogenesis of Enuresis: Brain, Sleep Dysfunction and Psychological Effects (야뇨증의 병태생리: 뇌, 수면장애 그리고 정신적 효과)

  • Park, Kwan-Jin
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.9-14
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    • 2012
  • The relationship between central nervous system (CNS) and enuresis has not been sufficiently elucidated despite the presence of several circumstantial evidences. Contrary to common belief, polysomnographic sleep analysis revealed that the disturbance of arousal rather than deep sleep was responsible for enuresis. Subsequent studies confirmed depressed sympathetic tone and retarded brainstem reflex indicating abnormal arousal threshold in enuretics. In accordance with the bladder-brain dialogue, chronic stimulation of bladder may modify the brainstem function elevating arousal threshold. Epidemiological studies have suggested the association between enuresis and various psychosomatic disorders like attention deficit hyperactivity disorder (ADHD), which has shown the abnormal brainstem reflex similar to enuresis. Taken together, CNS is assumed to play a crucial role in the pathogenesis of enuresis. Psychological assessment is vital to understand the psychodynamic effect of enuresis. Studies have shown that the prevalence of psychological problems was higher in enuretic children and externalization of the symptoms was usually found. Several explanations have been brought up regarding the development of enuresis and psychological problems. Enuresis may cause psychological problems and vice versa. Otherwise, both may be associated with other variables, such as socioeconomic status (SES).

Brainstem auditory evoked potential findings in a French bulldog with bilaterally congenital sensorineural deafness

  • An, Daegi;Jung, Dong-In;Kim, Ha-Jung;Kang, Ji-Houn;Chang, Dong-Woo;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • Korean Journal of Veterinary Research
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    • v.53 no.4
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    • pp.265-267
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    • 2013
  • A 3-month-old, intact male French bulldog was suspected of deafness. The dog was irresponsive to environmental noises generated out of sight, but normal responses were noted for visual stimuli. No abnormalities were observed on the neurological, otoscopic, radiographic, and blood examinations. To diagnose the apparent deafness, brainstem auditory evoked potential (BAEP) was recorded in the presented dog together with a normal dog. While the BAEP from the control dog showed a normal wave consisting of 5 peaks, absence of all peaks was noted in the suspected deaf dog. Therefore the dog was definitively diagnosed as bilaterally congenital sensorineural deafness.