• 제목/요약/키워드: Cranial nerve

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목의 비특이 국소염증에 의해 유발된 Vernet증후군 1예 (A Case of Vernet's Syndrome Caused by Non-specific Focal Inflammation of the Neck)

  • 하상욱;김종국;강성진;김민정;유봉구;김광수;이주호
    • Annals of Clinical Neurophysiology
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    • 제9권2호
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    • pp.81-84
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    • 2007
  • Vernet's syndrome is a complex of multiple cranial nerve palsy including ninth, tenth, and eleventh cranial nerves which results from various lesions involving the jugular foramen. There are several kinds of lesions that can cause Vernet's syndrome. It includes congenital cholesteatoma, vascular lesions such as protruded jugular bulb, infections such as external otitis or abscess, and tumoral lesions such as schwannoma or paraganglioma. We present a rare case of Vernet's syndrome caused by non-specific inflammatory mass lesion in the neck area sparing jugular foramen.

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Ramsay Hunt 증후군 -2예 보고- (Ramsay Hunt Syndrome -Case report on two cases-)

  • 이상곤;여상임;고준석;민병우
    • The Korean Journal of Pain
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    • 제5권2호
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    • pp.263-268
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    • 1992
  • Ramsay Hunt 증후군으로 확진된 환자 2예를 경험하였다. 첫 예인 경우 안면신경마비가 발생하던 날 바로 방문하여 대상포진에 대한 치료와 환측 성상신경절 차단 15회, TENS, 안면운동 훈련 반복 등으로 발병 후 3주만에 완전 치유 되었으며, 두번째 환자는 발병 후 7주일 후에 방문하여 대상포진에 대한 치료는 생략하고 안면신경마비에 대한 치료라고 사료되는 환측 성상신경절 차단 50회, TENS 수백회, 안면운동 훈련 반복시행하였으나 부분적인 회복을 하였을 뿐이다. 그러므로 Ramsay Hunt 증후군의 치료도 다른 여러 질환과 마찬가지로 조기에 치료하면 회복이 빠르고 거의 완전하며, 늦어질수록 예후가 좋지 않다는 것을 경험하였다. 두 예 모두에서 대상포진 후 신경통으로의 이행은 없었다.

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Somatosensory evoked potentials are abnormal with plagiocephaly

  • Harma, Maiju;Lauronen, Leena;Leikola, Junnu;Hukki, Jyri;Saarikko, Anne
    • 대한두개안면성형외과학회지
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    • 제23권2호
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    • pp.59-63
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    • 2022
  • Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.

요추 경추간공 경막외강 약물주입 시 조영상의 분석 (An Analysis of the Contrast Patterns of Lumbar Transforaminal Epidural Injection)

  • 김세영;한경림;김찬
    • The Korean Journal of Pain
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    • 제21권3호
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    • pp.217-223
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    • 2008
  • Background: Lumbar transforaminal epidural injections (LTEIs) have been utilized in the treatment of radicular pain, and LTEIs have the advantage of target-specificity. However, there have not been enough studies on the contrast patterns in LTEIs with using fluoroscopy. The purpose of this study was to evaluate the spreading epidural contrast patterns that are seen during real-time fluoroscopic guided LTEIs. Methods: A total of 131 patients who underwent fluoroscopic guided LTEIs were studied. The inclusion criteria were those patients with low back pain and/or lower extremity pain that was caused by a herniated nucleus pulposus, lumbar spinal stenosis, failed back surgery syndrome, and herpes zoster-associated pain. We classified the contrast patterns in regard to the contrast flow spreading to the nerve root and/or the unilateral, bilateral or cylinderic type of epidural spreading on the AP view of the fluoroscopy and the ventral or dorsal epidural filling on the lateral view. In addition to the pattern analysis, we evaluated the range of contrast spreading from the cranial to the caudal epidural filling and the incidence of an intravascular flow pattern. Results: Epidural spreading was seen in 126 cases (96.2%) of the total patients through the nerve root. Ventral spreading occurred in 120 cases (95.2%). On the AP view, a nerve root with unilateral, bilateral and cylinderic epidural filling was noted for 108 (85.7%), 9 (7.1%) and 9 (7.1%) cases, respectively. The contrast spreading to vertebral segments was smaller for the patients with lumbar spinal stenosis and failed back surgery syndrome than for the other groups (P < 0.0083). The incidence of intravascular injection was 11.1% (14/126). Conclusions: LTEIs using fluoroscopic visualization provided excellent assessment of the ventral epidural filling as well as nerve root filling. However, unilateral epidural spreading was prominent for the LTEIs.

뫼비우스 증후군에서 측두근 전위술을 이용한 역동적 재건 (Dynamic Reconstruction with Temporalis Muscle Transfer in Mobius Syndrome)

  • 김백규;이윤호
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.325-329
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    • 2007
  • Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.

Diagnostic Significance of Brainstem Auditory Evoked Potentials in Microvascular Decompression of Patients with Hemifacial Spasm or Trigeminal Neuralgia

  • Park, Sang-Koo;Lim, Sung-Hyuk;Park, Chan-Woo;Park, Jin-Woo;Chang, Sung-Ho;Park, Keun-Hye;Park, Hae-Ja;Song, Ji-Hye;Uhm, Dong-Ok;Kim, Ki-Bong
    • 대한임상검사과학회지
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    • 제43권1호
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    • pp.19-25
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    • 2011
  • The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V' was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

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Ganglion cardiacum or juxtaductal body of human fetuses

  • Kim, Ji Hyun;Cho, Kwang Ho;Jin, Zhe Wu;Murakami, Gen;Abe, Hiroshi;Chai, Ok Hee
    • Anatomy and Cell Biology
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    • 제51권4호
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    • pp.266-273
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    • 2018
  • The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretinin-positive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart.

Application of the foramina of the trigeminal nerve as landmarks for analysis of craniofacial morphology

  • Lim, Ba-Da;Choi, Dong-Soon;Jang, Insan;Cha, Bong-Kuen
    • 대한치과교정학회지
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    • 제49권5호
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    • pp.326-337
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    • 2019
  • Objective: The objective of this study was to develop new parameters based on the foramina of the trigeminal nerve and to compare them with the conventional cephalometric parameters in different facial skeletal types. Methods: Cone-beam computed tomography (CBCT) scans and cephalograms from 147 adult patients (57 males and 90 females; mean age, 26.1 years) were categorized as Class I ($1^{\circ}$ < ANB < $3^{\circ}$), Class II (ANB > $5^{\circ}$), and Class III (ANB < $-1^{\circ}$). Seven foramina in the craniofacial area-foramen rotundum (Rot), foramen ovale (Ov), infraorbital foramen, greater palatine foramen, incisive foramen (IF), mandibular foramen (MDF), and mental foramen (MTF)-were identified in the CBCT images. Various linear, angular, and ratio parameters were compared between the groups by using the foramina, and the relationship between the new parameters and the conventional cephalometric parameters was assessed. Results: The distances between the foramina in the cranial base did not differ among the three groups. However, the Rot-IF length was shorter in female Class III patients, while the Ov-MTF length, MDF-MTF length, and Ov-MDF length were shorter in Class II patients than in Class III patients of both sexes. The MDF-MTF/FH plane angle was larger in Class II patients than in Class III patients of both sexes. Most parameters showed moderate to high correlations, but the Ov-MDF-MTF angle showed a relatively low correlation with the gonial angle. Conclusions: The foramina of the trigeminal nerve can be used to supplement assessments based on the conventional skeletal landmarks on CBCT images.

비글견에서 앞쪽목신경절 차단술이 정상 안압에 미치는 영향 (The Influence of Cranial Cervical Ganglion Block in Beagle Dogs with Normal Intraocular Pressure)

  • 박우대;배춘식;김휘율
    • 생명과학회지
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    • 제17권11호
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    • pp.1472-1476
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    • 2007
  • 본 연구는 정상적인 안압을 가진 비글견에서 4가지의 다른 농도를 가진 lidocaine을 사용하여 앞쪽목신경절차단 후 안압의 변화를 관찰하기 위하여 시행하였다. 실험군은 전향적 교차시험으로 10두의 비글견을 2%, 1%, 0.5% 및 0.25% lidocaine group으로 4군으로 나뉘었다. 모든 실험견들은 4 가지의 다른 농도를 가진 2 ml의 lidocaine을 사용하여 각 4번의 앞쪽목신경절 차단을 받았으며 신경 차단은 무작위로 1주일 간격으로 각각 시행되었다. 실험결과 호르너 증후군은 모든 실험군에서 관찰되었다. 1% lidocaine group에서는 대조군과 비교하여 차단 후 5분에서 안압의 유의한 상승이 있었으며(p<0.05), 2%와 1% lidocaine group의 안압은 앞쪽목신경절 차단 후 25분과 45분 사이 감소하였으나, 0.5%와 0.25% lidocaine group은 변화가 없었다. 이상의 결과를 종합하면, 앞쪽 목신경절 차단술은 정상 안압의 변화에 영향을 미치며 0.5%와 0.25% lidocaine은 안압을 변화시키기에는 부적당한 농도로 사료된다.

수술 중 신경계감시검사에서 검사에 따른 전극의 삽입 및 제거방법 (Principles of Intraoperative Neurophysiological Monitoring with Insertion and Removal of Electrodes)

  • 임성혁;박순부;문대영;김종식;최영두;박상구
    • 대한임상검사과학회지
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    • 제51권4호
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    • pp.453-461
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    • 2019
  • 수술 중 발생하는 신경계 손상 여부를 감별하는 검사인 수술 중 신경계 모니터링(intraoperative neurophysiological monitoring, INM) 검사는 다양한 수술에서 안정적으로 수술이 잘 진행되고 있음을 확신하며 수술을 진행할 수 있도록 도움을 주는 매우 중요한 검사다. 수술실이라는 특수한 환경에서 검사의 최적화를 위하여 침 전극을 사용하여 검사를 진행하며, 수술실검사에 대하여 정확한 자극부위와 측정부위에 대한 교재나 안내책자가 없는 것이 실정이다. 그래서 이번 논문에서 운동유발전위검사, 체성감각유발전위검사, 청각유발전위검사, 시각유발전위검사에서 올바른 자극부위와 측정부위에 대하여 자세하게 설명을 하였다. 그리고 자유진행 및 유발근전도검사(free-running and triggered EMG)는 근육에서 발생하는 근전도의 관찰로 대부분의 뇌신경(cranial nerve)과 척수신경근(spinal nerve root)의 기능상태 파악을 한다. 검사의 이해를 돕기 위해 각각의 해당 근육에 전극을 삽입하는 사진을 첨부하였고, 척수신경근에 따른 해당근육도 표로 제시하였다. 검사 후 전극제거를 할 때에도 환자와 검사자 모두 안전한 방법을 제시하여 보다 완벽한 검사가 되었으면 한다.