• Title/Summary/Keyword: Guillain-Barre Syndrome

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A case of acute motor sensory axonal neuropathy presenting reversible conduction block

  • Lee, Dongah;Kim, Hyung Chan;Park, Kang Min;Park, Jinse;Ha, Sam Yeol;Kim, Sung Eun;Lee, Byung In;Kim, Jong Kuk;Yoon, Byeola;Shin, Kyong Jin
    • Annals of Clinical Neurophysiology
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    • v.20 no.1
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    • pp.49-52
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    • 2018
  • Reversible conduction block (RCB) was rare in patients with acute motor sensory axonal neuropathy (AMSAN). A-46-year-old man presented with paresthesia, weakness, diplopia, and dysarthria. Nerve conduction study (NCS) exhibited axonal changes with conduction block in motor and sensory nerves. His symptoms were rapidly progressed and recovered. Conduction block was disappeared in the follow-up NCS performed after 2 weeks. The AMSAN case with RCB showed rapid progress and rapid recovery of clinical symptoms as acute motor axonal neuropathy patients with RCB.

A Case-Report of a Taeyangin Patient with Acute Motor Axonal Neuropathy Using Ogapijangchuk-tang (오가피장척탕을 사용하여 급성 운동 축색돌기 신경병증으로 진단받은 태양인 호전 1례)

  • Oh, Ji-Yeon;Kim, Won-Young;Lim, Eun-Chul
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.171-180
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    • 2021
  • Objectives This case report is about a Taeyangin patient with Acute Motor Axonal Neuropathy identified as Hae-Yeok pattern using Ogapijangchuk-tang. In this study, we report the significant improvement of lower extremity weakness and pain of this patient after Sasang Constitutional medicine treatment. Methods The patient was identified as Taeyangin Hae-Yeok pattern and treated with Ogapijangchuk-tang. Guillain-Barre Syndrome disability scale was used to assess the overall function of the patient. The Numeral Rating Scale was used to assess the change of lower extremity pain. Also the change of lower extremity weakness was measured by patient's expression and graded by Manual Muscle Test. Result and Conclusion After treatment with Ogapijangchuk-tang, patient's symptoms were improved. And there was not any side effect. In conclusion, this study shows that Sasang Constitutional medicine can be effective treatment for Taeyangin patient with Acute Motor Axonal Neuropathy.

Clinical and Electrophysiological Characteristics of the Patient with 'Mononeuropathy multiplex' (다발성 단신경병증의 임상적, 전기생리학적 특성)

  • Park, Kyung-Seok;Chung, Jae-Myun;Park, Seong-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.34-37
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    • 2002
  • Background : The term "mononeuropathy multiplex" means simultaneous or sequential involvement of individual noncontiguous nerve trunks, evolving over days to years. The aim of this study was to delineate the causes, clinical features, and detailed electrophysiological findings in the patients with mononeuropathy multiplex. Methods : We analyzed the medical records of 22 patients with mononeuropathy multiplex confirmed on electrophysiological studies in Inje University Seoul Paik Hospital, Seoul Municipal Boramae Hospital, and Seoul National University Hospital between 1991 to 2000. Results : The number of male and female patients was equal. The mean age was 48 years with a peak incidence in the sixth decade. The etiology could be divided into vasculitis(11 patients) or non-vasculitis group. In vasculitis group, Churg-Strauss syndrome, polyarteritis nodosa, and rheumatoid arthritis were included. The non-vasculitis group included diabetes mellitus, leprosy, and Guillain-Barre syndrome. Ulnar and median nerves were most commonly involved(91%). In descending order of frequency, peroneal, posterior tibial, sural, and radial nerves were also involved. Bilateral involvement occurred most commonly in ulnar nerve. The symptoms and signs of mononeuropathy multiplex were the initial manifestations in 12 patients(55%), which was more frequent in vasculitis group(73%). Nerve conduction abnormalities could be divided into axonal, demyelinating, or mixed type. Most(91%) of the patients in vasculitis group revealed axonal type abnormalities. The location of the nerve lesion was frequently related to potential site of entrapment in demyelinating type. Conclusions : Mononeuropathy multiplex is the presenting features of the etiological disease frequently, especially in vasculitis group. Nerve conduction studies(NCS) reveals not only axonal type but also demyelinating type abnormalities. The etiological diseases were different in each type. Therefore, NCS is very helpful for the early etiological diagnosis and therapeutic implication in the patients with mononeuropathy multiplex.

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Zika Virus-Encoded NS2A and NS4A Strongly Downregulate NF-κB Promoter Activity

  • Lee, Jeong Yoon;Nguyen, Thi Thuy Ngan;Myoung, Jinjong
    • Journal of Microbiology and Biotechnology
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    • v.30 no.11
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    • pp.1651-1658
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    • 2020
  • Since Zika virus (ZIKV) was first detected in Uganda in 1947, serious outbreaks have occurred globally in Yap Island, French Polynesia and Brazil. Even though the number of infections and spread of ZIKV have risen sharply, the pathogenesis and replication mechanisms of ZIKV have not been well studied. ZIKV, a recently highlighted Flavivirus, is a mosquito-borne emerging virus causing microcephaly and the Guillain-Barre syndrome in fetuses and adults, respectively. ZIKV polyprotein consists of three structural proteins named C, prM and E and seven nonstructural proteins named NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5 in an 11-kb single-stranded positive sense RNA genome. The function of individual ZIKV genes on the host innate immune response has barely been studied. In this study, we investigated the modulations of the NF-κB promoter activity induced by the MDA5/RIG-I signaling pathway. According to our results, two nonstructural proteins, NS2A and NS4A, dramatically suppressed the NF-κB promoter activity by inhibiting signaling factors involved in the MDA5/RIG-I signaling pathway. Interestingly, NS2A suppressed all components of MDA5/RIG-I signaling pathway, but NS4A inhibited most signaling molecules, except IKKε and IRF3-5D. In addition, both NS2A and NS4A downregulated MDA5-induced NF-κB promoter activity in a dosedependent manner. Taken together, our results suggest that NS2A and NS4A signifcantly antagonize MDA5/RIG-I-mediated NF-κB production, and these proteins seem to be controlled by different mechanisms. This study could help understand the mechanisms of how ZIKV controls innate immune responses and may also assist in the development of ZIKV-specific therapeutics.

Analysis of Clinical and Radiographic Outcome of the Reconstructive Surgery for the Cavovarus Foot Deformity (요내반족 변형에 대한 재건수술의 임상적 및 방사선학적 결과 분석)

  • Jung, Hong-Geun;Park, Jae-Yong;Lee, Dong-Oh;Eom, Joon-Sang;Chung, Seung-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.62-67
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    • 2014
  • Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009

  • Cho, Hye-Kyung;Lee, Na-Yong;Lee, Hyun-Ju;Kim, Hae-Soon;Seo, Jeong-Wan;Hong, Young-Mi;Lee, Seung-Joo;Lee, Sun-Wha;Cheon, Doo-Sung;Hong, Ji-Young;Kang, Byung-Hak;Kim, Jong-Hyun;Kim, Kyung-Hyo
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.639-643
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    • 2010
  • Purpose: Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital. Methods: Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed. Results: EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barre syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008. Conclusion: Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.