• Title/Summary/Keyword: Cranial nerves

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Nerve conduction studies: basic principal and clinical usefulness

  • Ahn, Suk-Won;Yoon, Byung-Nam;Kim, Jee-Eun;Seok, Jin Myoung;Kim, Kwang-Kuk;Lim, Young Min;Kwon, Ki-Han;Park, Kee Duk;Suh, Bum Chun;Korean Society of Clinical Neurophysiology Education Committee
    • Annals of Clinical Neurophysiology
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    • v.20 no.2
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    • pp.71-78
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    • 2018
  • Nerve conduction study (NCS) is an electrophysiological tool to assess the overall function of cranial and peripheral nervous system, therefore NCS has been diagnostically helpful in the identification and characterization of disorders involving nerve roots, peripheral nerves, muscle and neuromuscular junction, and are frequently accompanied by a needle Electromyography. Furthermore, NCS could provide valuable quantitative and qualitative results into neuromuscular function. Usually, motor, sensory, or mixed nerve studies can be performed with using NCS, stimulating the nerves with the recording electrodes placed over a distal muscle, a cutaneous sensory nerve, or the entire mixed nerve, respectively. And these findings of motor, sensory, and mixed nerve studies often show different and distinct patterns of specific abnormalities indicating the neuromuscular disorders. The purpose of this special article is to review the neurophysiologic usefulness of NCS, to outline the technical factors associated with the performance of NCS, and to demonstrate characteristic NCS changes in the setting of various neuromuscular conditions.

Aneurysms Presenting with Neural Compression : Response to Treatment with Guglielmi Detachable Coils Embolization (뇌동맥류에 의한 신경 압박의 GDC 색전 치료 반응)

  • Park, Jin Young;Ahn, Jung Yong;Huh, Ryoong;Choi, Hun Kyu;Lee, Byung Hee;Shin, Moon Soo;Chung, Bong Sub
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1491-1498
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    • 2000
  • Objectives : Embolization of intracranial aneurysms by using Guglielmi detachable coils(GDC) is proving to be a safe method of protecting aneurysms from rupture. Occasionally, patients with unruptured intracranial aneurysms present with symptoms related to the aneurysm's mass effect on either the brain parenchyma or cranial nerves. In the present study, the authors conducted a retrospective review to evaluate the response to GDC embolization in a series of 6 patients presenting with cranial nerve dysfunction due to mass effect. Patients and Methods : Aneurysms were classified by size, shape, and amount of intraluminal thrombus. Patients were classified by duration of symptoms prior to GDC treatment(range<1 month to>4 years). Clinical assessment was performed within days of the GDC procedure and at later follow-up appointments(range 5-16 months, mean 9 months). Results : In the immediate post-GDC embolization period, one of the five patients had transient worsening of third nerve palsy, which later improved to better than baseline status. Two patients who presented with third nerve deficit from a internal carotid artery-posterior communicating artery junction aneurysm had complete recovery. One patient who presented with hemiparesis and dysarthria from a giant mid-basilar aneurysm showed improvement of these symptoms. One patient who presented with sixth cranial nerve deficit from a cavernous aneurysm showed no change at the 8-months follow-up examination. Conclusion : The endovascular treatment of intracranial aneurysms by using GDC is suggested as an alternative therapeutic method for improving or alleviating neurological deficits produced by mass effect.

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Cryoanalgesia for the Post-thoracotomy Pain (늑간 신경 냉동요법에 의한 개흉술후 흉부 동통 관리)

  • Kim, Uk-Jin;Choe, Yeong-Ho;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.54-63
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    • 1991
  • Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

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A Case of Tolosa-Hunt Syndrome with Facial Palsy (안면마비를 동반한 Tolosa-Hunt Syndrome 환자 1례)

  • Sim, Sung-Yong;Um, Yu-Sik;Hong, Chul-Hee;Kim, Kyung-Jun;Byun, Hak-Sung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.2
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    • pp.86-92
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    • 2005
  • Painful ophthalmoplegia due to idiopathic granulomatous inflammation of the cavernous sinus/superior orbital fissure has been termed Tolosa-Hunt syndrome(THS). The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. There was the 56 years old man who suffered from painful ophthalmoplegia and facial palsy. The oriental medical treatment without steroids and analgesics reduced the symptoms of the patient remarkably during 5 weeks. There is few report that treat THS with oriental medical method. If more clinical trials like this are proved to be effective, we can expect that oriental medical treatment will be a good method in THS.

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A Review of Burning Mouth Disorders (구강작열감질환에 관한 고찰 및 의료분쟁 증례보고)

  • Hur, Yun-Kyung;Jung, Jae-Kwang;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.48 no.9
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    • pp.688-695
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    • 2010
  • Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

Trigeminal Neuralgia Patient who has Contralateral Hemifacial Spasm -A case report- (삼차신경통과 반대측 안면경련이 동반된 환자의 치료 경험 -증례 보고-)

  • Kim, Chan;Kim, Seong-Mo;Lee, Hyo-Keun;Hyang, Hyuk-Yi;Kim, Seung-Hee;Lee, Young-Chul;Kim, Bu-Seong;Cho, Young-Rye
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.423-425
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    • 1996
  • Tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs predominantly in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery - less frequently an arteriovenous malformation or cholesteatoma - which compresses the trigeminal and facial nerve roots in the postetior fossa. In rare instances this syndrome may be caused by brain tumor. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography should be performed in every case. We experienced a case of trigeminal neuralgia(mandibular division)and contralateral hemifacial spasm.

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Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

  • Cho, Tack-Geun;Nam, Taek-Kyun;Park, Seung-Won;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.284-286
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    • 2011
  • Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

MAXILLARY OSTEONECROSIS;RARE COMPLICATION IN PATIENTS WITH HERPES ZOSTER (대상포진 환자에서 발생된 상악골 골괴사)

  • Kim, H.J.;Kim, B.Y.;Cha, I.H.;Park, H.S.;Yoon, J.H.;Kim, J.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.515-520
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    • 1994
  • Herpes Zoster is an acute viral infection characterized by the appearance of vesicles that occur on the skin and mucous membrane along the pathway of an involved sensory nerve. Although Herpes zoster is usually as benign viral infection, complications may occur especially when cranial nerves are involved. There are few reports of bony and dental complications by Herpes Zoster infection, all of which were isolated in a single quadrant. These include devitalized teeth, abnormal development of permanent teeth, internal resoption and spontaneous exfoliation of teeth with osteonecrosis of the alveolar bone. No agreement has been reached concerning the pathogenesis of osteonecrosis and tooth exfoliation associated with herpes zoster infection. We recently experienced series of maxillary osteonecrosis and spontaneous teeth exfoliation in patients with Herpes Zoster infection and present two cases with review of literature.

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Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa

  • Choi Jin-Woo;Reo Min-Suk;An Chang-Ryeon;Lee Jin-Koo;Yi Won-Jin;Lee Sam-Sun;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.34 no.4
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    • pp.215-218
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    • 2004
  • Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29-year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

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Solitary Schwannoma in the Psoas Muscle - A Case Report - (요근에 단독으로 발생한 신경초종 - 증례보고 -)

  • Seok, Sang Hun;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Hwan;Yeo, Hyung Tae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1127-1129
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    • 2001
  • The vast majority of schwannomas occur on cranial nerves, and rarely in the retroperitoneum. Solitary schwannoma in the psoas muscle is extremely rare. The authors present a case of retroperitoneal neoplasm in the psoas muscle identified as schwannoma which is not associated with von Recklinghausen's disease. A 68 years old female patient was admitted because of low back pain and weakness at the left leg. CT and MRI revealed a large cystic mass with well-defined margin and multiple internal septation within the left psoas muscle. The tumor was totally extirpated and histologically confirmed as a schwannoma.

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