• Title/Summary/Keyword: Cranial nerve

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Use of Magnetic Resonance Neurography for Evaluating the Distribution and Patterns of Chronic Inflammatory Demyelinating Polyneuropathy

  • Xiaoyun Su;Xiangquan Kong;Zuneng Lu;Min Zhou;Jing Wang;Xiaoming Liu;Xiangchuang Kong;Huiting Zhang;Chuansheng Zheng
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.483-493
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    • 2020
  • Objective: To evaluate the distribution and characteristics of peripheral nerve abnormalities in chronic inflammatory demyelinating polyneuropathy (CIDP) using magnetic resonance neurography (MRN) and to examine the diagnostic efficiency. Materials and Methods: Thirty-one CIDP patients and 21 controls underwent MR scans. Three-dimensional sampling perfections with application-optimized contrasts using different flip-angle evolutions and T1-/T2- weighted turbo spin-echo sequences were performed for neurography of the brachial and lumbosacral (LS) plexus and cauda equina, respectively. Clinical data and scores of the inflammatory Rasch-built overall disability scale (I-RODS) in CIDP were obtained. Results: The bilateral extracranial vagus (n = 11), trigeminal (n = 12), and intercostal nerves (n = 10) were hypertrophic. Plexus hypertrophies were observed in the brachial plexus of 19 patients (61.3%) and in the LS plexus of 25 patients (80.6%). Patterns of hypertrophy included uniform hypertrophy (17 [54.8%] brachial plexuses and 21 [67.7%] LS plexuses), and multifocal fusiform hypertrophy (2 [6.5%] brachial plexuses and 4 [12.9%] LS plexuses) was present. Enlarged and/or contrast-enhanced cauda equina was found in 3 (9.7%) and 13 (41.9%) patients, respectively. Diameters of the brachial and LS nerve roots were significantly larger in CIDP than in controls (p < 0.001). The largest AUC was obtained for the L5 nerve. There were no significant differences in the course duration, I-RODS score, or diameter between patients with and without hypertrophy. Conclusion: MRN is useful for the assessment of distribution and characteristics of the peripheral nerves in CIDP. Compared to other regions, LS plexus neurography is more sensitive for CIDP.

Nasopharyngeal Cancer (비인강암)

  • Choi Jong-Ouck;Yoo Jong-Seon;Yoo Hong-Kyun;Choi Myong-Seon
    • Korean Journal of Head & Neck Oncology
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    • v.6 no.2
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    • pp.108-113
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    • 1990
  • Thirty nine cases of nasopharyngeal malignant tumor from 1981 to 1989 in Korea univeristy hospital were reviewed retrospectively. The results were as follows; 1) The most common initial symptom was neck mass(41.0%), and cranial nerve involvement was found in 6 cases. Lateral wall of the nasopharynx including $Rosenm\"{u}ller's$ fossa was the frequent predelection site(68.4%). 2) Histopathologically, squamous cell carcinoma was the most common and stage IV were 71.8%. 3) Thirty four cases were treated by radiation therapy alone and 5 cases were treated by combined modality(radiation therapy+chemotherapy). Overall 5 year survival rate was 28.2%(squamous cell carcinoma; 23.5%, undifferentiated carcinoma; 35.7%).

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A Research on 7 Cases of the Treatment Process for Patients with Idiopathic Parkinson's Disease or Parkinsonism (특발성 파킨슨병.파킨슨증후군 환자 7례의 치료경과사례 고찰)

  • Park, Byeong-Jun
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.3
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    • pp.283-295
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    • 2009
  • Objectives : Parkinson's disease is a chronic neuron-degenerative disease. The medication of dopamine, one of the most common treatment for the disease, has effects of improving the symptom, but when taken for a long term, the medicine brings about side-effects such as the phenomenon of medicinal efficacy disappearance and dyskinesia. In addition, it doesn't have any effects in slowing down or stopping the development of Parkinson's disease. Methods : Accordingly, this study aims to investigate the clinical cases to stop or improve the development of Parkinson's disease by carrying out an independent treatment with Oriental medicine and a combined treatment with Western and Oriental medicines respectively for over 6 months. Results and Conclusions : The results of the study is expected to be an important precedent for the treatment of neuron-degenerative diseases of cranial nerve including Parkinson's disease in the future.

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A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis (급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.140-145
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    • 2002
  • Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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A Case of Schwannoma of the Pterygopalatine Fossa (익돌구개와에 발생한 신경초종 1예)

  • Lee, Hyoung-Shin;Hong, Jong-Chul;Yu, Tai-Hyun;Lee, Hwan-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.163-166
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    • 2006
  • Schwannomas are benign tumors arising from the nerve sheaths of peripheral, autonomic and cranial nerves. Between 25% and 45% of all schwannomas occur in the head and neck region but only 4% involve the nasal cavity and paranasal sinus. Moreover, schwannoma of the pterygopalatine fossa is extremely rare. We present a case of schwannoma of the pterygopalatine fossa in a 43-year-old woman. The patient was surgically managed with endoscopic transnasal approach combined with transantral approach. After 16 months, the patient shows no evidence of recurrence.

Astrocytoma in the Third Ventricle and Hypothalamus Presenting with Parkinsonism

  • Choi, Kang-Ho;Choi, Seong-Min;Nam, Tai-Seung;Lee, Min-Cheol
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.144-146
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    • 2012
  • Parkinsonism secondary to intracranial mass lesions usually results from compression or distortion of the basal ganglia. Secondary parkinsonism due to midbrain infiltration or compression is rare and generally associated with other neurologic signs caused by pyramidal tract and/or cranial nerve involvement. We report a case of 30-year-old woman in whom mild parkinsonism was the major clinical manifestation of an astrocytoma in the anterior third ventricle and hypothalamus. She underwent surgical resection, ventriculoperitoneal shunt and radiation therapy. All symptoms of parkinsonism were completely recovered 3 months after the treatment. Brain tumors can be manifested only by the symptoms of parkinsonism. This case emphasizes the significance of neuroimaging in the evaluation of parkinsonism.

Chronic recurrent trigeminal neuritis of the maxillary branch confirmed by magnetic resonance imaging

  • Hong, Soon-Ho;Kim, Yong-Duk;Na, Sang-Jun;Lee, Kee Ook;Park, Yun Kyung;Yoon, Bora
    • Annals of Clinical Neurophysiology
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    • v.19 no.2
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    • pp.145-147
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    • 2017
  • Trigeminal neuralgia (TN) is generally characterized by lancinating, unilateral, paroxysmal pain occurring in the distribution of the fifth cranial nerve. TN is diagnosed clinically based on the typical patient history, negative findings in a neurologic examination, and the response to medication. Idiopathic TN is the most common type, but TN can result from vascular malformation, compression, trauma, neoplasm, multiple sclerosis, or inflammation. We report a TN case diagnosed as recurrent trigeminal neuritis of the maxillary branch confirmed by magnetic resonance imaging.

Prototype Development of a Robotic System for Skull Drilling (로봇을 이용한 두개골 드릴링 시스템의 프로토타입 개발)

  • Chung, Yun-Chan
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.3
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    • pp.198-207
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    • 2012
  • This paper presents an overview of automated robotic system for skull drilling, which is performed to access for some neurosurgical interventions, such as brain tumor resection. Currently surgeons use automatic-releasing cranial perforators. The drilling procedure must be performed very carefully to avoid penetration of brain nerve structures; however failure cases are reported. The presented prototype system utilizes both preoperative and intraoperative information. Preoperative CT image is used for robot path planning. A NeuroMate robot with a six-DOF force sensor at the end effector is used for intraoperative operation. Intraoperative cutting force from the force sensor is the key information to revise an initial registration and preoperative path plans. Some possibilities are verified by path simulation but cadaver experiments are required for validation of this prototype.

Neurolymphomatosis in patients with mantle cell lymphoma diagnosed by FDG PET-CT

  • Kim, Sooyoung;An, Hakyeu;Choi, Yoon Seok;Park, Kee Hong;Sohn, Eun Hee
    • Annals of Clinical Neurophysiology
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    • v.22 no.1
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    • pp.37-40
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    • 2020
  • Neurolymphomatosis (NL) is characterized by the infiltration of malignant lymphoma cells into peripheral nerves, nerve roots, plexuses, or cranial nerves. This is a very rare complication of mantle-cell lymphoma. Diagnosing NL is made difficult by cerebrospinal fluid cytology and bone-marrow biopsy results often being negative. NL can appear as the only sign of recurrence in a patient with a previous diagnosis of lymphoma. Here we present two cases of NL in patients with mantle-cell lymphoma diagnosed by positron emission tomography with deoxy-fluoro-D-glucose integrated with computed tomography.

A case of huge neurilemmoma arising from retropharyngeal space (후인두강에 발생한 거대 신경초종 1례)

  • Jung, Woo-Jin;Kim, In-Kyeong;Lee, Hyun-Seok;Lee, Dong-Wook
    • Korean Journal of Bronchoesophagology
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    • v.11 no.2 s.22
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    • pp.36-39
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    • 2005
  • Neurofibromatosis type II is an autosomal dominant, highly penetrant disease whose hallmark is bilateral vestibular schwannoma. Hearing loss is the most symptom in Neurofibromatosis type II. The patient can also present with tinnitus, disequilibrium, and headache. Cranial nerve symptoms, such as facial numbness or weakness, dysphagia, or hoarseness, can also be present. The authors experienced a case of neurofibromatosis type II having huge retropharyngeal mass, retropharyngeal abscess, and bilateral acoustic neuromas. The infection was controled with aggressive antibiotics with drainage. The huge neurilemmoma in retropharyngeal space was removed successfully via transoral approach. The authors report the case with literature review.

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