• Title/Summary/Keyword: Cerebellar diseases

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A Case Report of Multiple System Atrophy in a Cerebellar Ataxia Patient Suffering from Gait Disturbance Treated with Korean Medicine (보행장애를 주소로 하는 소뇌형 다계통 위축증 환자의 한방 치료 1례)

  • Woo, Seong-jin;Baek, Kyung-min;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.806-814
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    • 2016
  • Objective: To describe the effect of Korean medicine on gait disturbance in a patient with multiple system atrophy and cerebellar ataxia. Methods: We observed a 75-year-old female patient who had multiple system atrophy and cerebellar ataxia. The patient was treated with Korean medicine, including acupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang-gamibang and Boyanghwano-tang-gamibang) for 38 days. We evaluated the patient with the Korean version of the Berg Balance Scale (K-BBS), the Unified Multiple System Atrophy Rating Scale (UMSARS), and the Numeric Rating Scale-11 (NRS-11). Results: After treatment, the patient’s symptoms were improved. The K-BBS score increased from 9 to 19, while the UMSARS score decreased from 16 to 12 in Part I, from 15 to 7 in part Ⅱ, and from 4 to 3 in part Ⅳ. The NRS-11 score of gait disturbance decreased from 10 to 5. Conclusions: Korean medicine may be an effective treatment for gait disturbance in multiple system atrophy with cerebellar ataxia.

Case Report of Ataxia, Gait Disturbance, Tremor, and Dizziness with Cerebellar Atrophy Treated by Korean Traditional Medicine, Including Kuibiondam-tang-gami (귀비온담탕가미방을 포함한 복합적 한방치료로 호전된 소뇌위축증으로 인한 운동실조, 보행장애, 떨림 및 현훈 증상의 한의학적 경험증례 : 귀미온담탕가미방의 소뇌위축증에대한 효과)

  • An, Yu-min;Lee, Yoo-na;Kim, Jun-seok;Jang, Woo-seok
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.165-174
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    • 2021
  • This study reported on the effect of traditional Korean medicine on ataxia, gait disturbance, tremor, and dizziness with cerebellar atrophy. The patient was treated with traditional Korean medicines, such as acupuncture, moxibustion, and herbal medicine (Kuibiondam-tang-gami). The effectiveness of the treatment was evaluated with the scale for the assessment and rating of ataxia (SARA). After treatment, the symptoms had improved. The SARA score decreased by 18 points after Korean medicine treatment. According to this study, traditional Korean medicine can be effective to treat ataxia, gait disturbance, tremor, and dizziness in patients with cerebellar atrophy.

A Case of Joubert Syndrome Associated with Nephrocalcinosis and Agenesis of Cerebellar Vermis (신석회화와 소뇌 충부의 무형성을 동반한 Joubert 증후군 1례)

  • Kim Ji-Hee;Shin Hye-Kyung;Hong Young-Sook;Lee Joo-Won;Kim Soon-Kyum;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.266-271
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    • 2002
  • There are several diseases characterized by neurologic abnormalities and renal disease. Joubert syndrome is one of them. Joubert syndrome Is a relatively rare autosomal recessive syndrome. The most significant and constant neurologic finding is hypoplasia of the cerebellar vermis. Joubert syndrome is associated with hypotonia, retinal dystrophy, abnormal eye movement, delayed development, abnormal respiratory pattern (neonatal episodic tachypnea or apnea) and nephronophthisis. We report a boy with Joubert syndrome associated with nephrocalcinosis and agenesis of the cerebellar vermis. This patient had also abnormal eye movement, hypotonia, abnormal respiratory pattern, delayed development and chronic renal failure.

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A Case of Dizziness Patient diagnosed as Cerebellar infarction and treated with Qingyanligetang(淸咽利膈湯) (소뇌경색(小腦梗塞)으로 인한 중추성(中樞性) 현운환자(眩暈患者)의 치험(治驗) 1례(例))

  • Han, Gi-Sun;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.9
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    • pp.25-33
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    • 2000
  • Dizziness is one of the common symptoms in many patients. The disorders of the labyrinth, vestibular nerve, vestibular neclei, or their central connections are responsible for practically all vertigo. Most disorders of the central connections are the vascular diseases and tumors. This study is based on the clinical consideration of one patient who sufferd from the cerebellar infarction and the upper respiratory infection. The patient, 61 - year - old man was diagnosed as the cerebellar infarction has been troubled with dizziness, a headache, a sore throat, a cough etc. The symptoms are classed as the Sanchopungyeul.(上焦風熱) Pungdam(風痰), and we prescribed Qingyanligetang(淸咽利膈湯) for him and his symptoms took a tum for the better.

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Optimized Immunohistochemical Analysis of Cerebellar Purkinje Cells Using a Specific Biomarker, Calbindin D28k

  • Kim, Byung-Joo;Lee, So-Yeon;Kim, Hyung-Woo;Park, Eun-Jung;Kim, Jun;Kim, Sang-Jeong;So, In-Suk;Jeon, Ju-Hong
    • The Korean Journal of Physiology and Pharmacology
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    • v.13 no.5
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    • pp.373-378
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    • 2009
  • Cerebellar Purkinje cells (PCs) play a crucial role in motor functions and their progressive degeneration is closely associated with spinocerebellar ataxias. Although immunohistochemical (IHC) analysis can provide a valuable tool for understanding the pathophysiology of PC disorders, the method validation of IHC analysis with cerebellar tissue specimens is unclear. Here we present an optimized and validated IHC method using antibodies to calbindin D28k, a specific PC marker in the cerebellum. To achieve the desired sensitivity, specificity, and reproducibility, we modified IHC analysis procedures for cerebellar tissues. We found that the sensitivity of staining varies depending on the commercial source of primary antibody. In addition, we showed that a biotin-free signal amplification method using a horseradish peroxidase polymer-conjugated secondary antibody increases both the sensitivity and specificity of ICH analysis. Furthermore, we demonstrated that dye filtration using a $0.22\;{\mu}m$ filter eliminates or minimizes nonspecific staining while preserving the analytical sensitivity. These results suggest that our protocol can be adapted for future investigations aiming to understand the pathophysiology of cerebellar PC disorders and to evaluate the efficacy of therapeutic strategies for treating' these diseases.

A Case Report of Complex Korean Medicine Treatment Including Modified Gamiguibi-tang in a Paraneoplastic Cerebellar Degeneration Patient with Dysarthria and Weakness of Distal Extremity (구음장애와 사지원위부 무력감을 호소하는 신생물딸림소뇌변성 환자에 대한 가미귀비탕가감방을 포함한 한의복합치료 1례)

  • Ji-hyeon Kang;Seo-hyun Kim;Chae-eun Kim;Hee-ju Won;Kyungmin Baek
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.497-507
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    • 2024
  • Objectives: This study investigated the treatment response to Korean medicine of a paraneoplastic cerebellar degeneration (PCD) patient with dysarthria and weakness of distal extremity. Case presentation: A 53-year-old female diagnosed with PCD complained of dysarthria and weakness of distal extremity. During 32-day hospitalization, she was treated with Korean medicine, namely, herbal medicine (modified Gamiguibi-tang), acupuncture (15 minutes twice a day at CV23, HT7, LI4, LR3, ST36, SP6, GB20, TE17, PC6, GV20, Ex-HN1, GV24 etc.), moxibustion, and cupping, combined with Western medicine (prednisolone, azathioprine) and physical therapy. Post-treatment, the patient global assessment (PGA) score of dysarthria fell from 100 to 60; grasp power rose from 15 kg to 19 kg and 13 kg to 17 kg in the right and left hands, respectively; and the 5-level EQ-5D version (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Beck depression inventory (BDI-II) scores changed from 10 to 8, 0 to 80, and 34 to 7 respectively. Follow-up visits continued for about a month after discharge, improvement in symptoms maintained, and there were no significant side effects. Conclusions: Given the lack of standard treatment for PCD, Korean medicine can be tried clinically for the treatment of PCD patients with dysarthria and weakness of distal extremity. However, further studies with control groups are needed.

Inhibitory Effect of Fangchinoline on Excitatory Amino Acids. Induced Neurotoxicity in Cultured Rat Cerebellar Granule Cells

  • Kim, Su-Don;Oh, Sei-Kwan;Kim, Hack-Seang;Seong, Yeon-Hee
    • Archives of Pharmacal Research
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    • v.24 no.2
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    • pp.164-170
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    • 2001
  • Glutamate receptors-mediated excitoxicity is believed to play a role in the pathophysiology of neurodegenerative diseases. The present study was performed to evaluate the inhibitory effect of fanschinoline, a bis-benzylisoquinoline alkaloid, which has a characteristic as a $Ca^{2+}$channel blockers on excitatory amino acids (EAAS)-induced neurotoxicity in cultured rat cerebellar granule neuron. Fangchinoline (1 and 5$\mu\textrm{m}$) inhibited glutamate (1 ${m}M$), N-methyl-D-aspartate (NMDA; 1 ${m}M$) and kainate (100$\mu\textrm{m}$)-induced neuronal cell death which was measured by trypan blue exclusion test. Fangchinoline (1 and 5$\mu\textrm{m}$) inhibited glutamate release into medium induced by NMDA (1 ${m}M$) and kainate (100$\mu\textrm{m}$), which was measured by HPLC. And fangchinoline (5$\mu\textrm{m}$) inhibited glutamate (1 ${m}M$)-induced elevation of intracellular calcium concentration. These results suggest that inhibition of $Ca^{2+}$influx by fangchinoline may contribute to the beneficial effects on neurodegenerative effect of glutamate in pathophysiological conditions.

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Epidermoid Cyst of the Fourth Ventricle

  • Jeon, Ji-Young;Kim, Jae-Min;Cheong, Jin-Hwan;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.478-480
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    • 2005
  • The authors describe a case of intracranial epidermoid cyst with fourth ventricle involvement. A 43-year-old woman presented with progressive aggravating headache and cerebellar syndrome due to a large tumor in the fourth ventricle, that extended into the left side of foramen of Luschka. The histopathological workup following gross total removal of tumor had revealed the typical features of an epidermoid cyst. Four months after surgery, the cerebellar sings recovered to normal with a remarkable improvement of headache. Epidermoid cysts involving the fourth ventricle have been known to be one of the most rare diseases in the central nervous system. This rare case is discussed and a review of the relevant literature is presented.

Fatal Balamuthia Amebic Encephalitis in a Healthy Child: A Case Report with Review of Survival Cases

  • Krasaelap, A.;Prechawit, S.;Chansaenroj, J.;Punyahotra, P.;Puthanakit, T.;Chomtho, K.;Shuangshoti, S.;Amornfa, J.;Poovorawan, Y.
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.335-341
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    • 2013
  • Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

Toxic Encephalopathy

  • Kim, Yangho;Kim, Jae Woo
    • Safety and Health at Work
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    • v.3 no.4
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    • pp.243-256
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    • 2012
  • This article schematically reviews the clinical features, diagnostic approaches to, and toxicological implications of toxic encephalopathy. The review will focus on the most significant occupational causes of toxic encephalopathy. Chronic toxic encephalopathy, cerebellar syndrome, parkinsonism, and vascular encephalopathy are commonly encountered clinical syndromes of toxic encephalopathy. Few neurotoxins cause patients to present with pathognomonic neurological syndromes. The symptoms and signs of toxic encephalopathy may be mimicked by many psychiatric, metabolic, inflammatory, neoplastic, and degenerative diseases of the nervous system. Thus, the importance of good history-taking that considers exposure and a comprehensive neurological examination cannot be overemphasized in the diagnosis of toxic encephalopathy. Neuropsychological testing and neuroimaging typically play ancillary roles. The recognition of toxic encephalopathy is important because the correct diagnosis of occupational disease can prevent others (e.g., workers at the same worksite) from further harm by reducing their exposure to the toxin, and also often provides some indication of prognosis. Physicians must therefore be aware of the typical signs and symptoms of toxic encephalopathy, and close collaborations between neurologists and occupational physicians are needed to determine whether neurological disorders are related to occupational neurotoxin exposure.