• Title/Summary/Keyword: Intractable

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Intractable Hiccup as the Presenting Symptom of Cavernous Hemangioma in the Medulla Oblongata : A Case Report and Literature Review

  • Lee, Kyung-Hwa;Moon, Kyung-Sub;Jung, Min-Young;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.379-382
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    • 2014
  • A case of intractable hiccup developed by cavernous hemangioma in the medulla oblongata is reported. There have been only five previously reported cases of medullary cavernoma that triggered intractable hiccup. The patient was a 28-year-old man who was presented with intractable hiccup for 15 days. It developed suddenly, then aggravated progressively and did not respond to any types of medication. On magnetic resonance images, a well-demarcated and non-enhancing mass with hemorrhagic changes was noted in the left medulla oblongata. Intraoperative findings showed that the lesion was fully embedded within the brain stem and pathology confirmed the diagnosis of cavernous hemangioma. The hiccup resolved completely after the operation. Based on the presumption that the medullary cavernoma may trigger intractable hiccup by displacing or compression the hiccup arc of the dorsolateral medulla, surgical excision can eliminate the symptoms, even in the case totally buried in brainstem.

Treatment of Intractable Hiccups With an Oral Agent Monotherapy of Baclofen -A Case Report-

  • Lee, Ju-Hwan;Kim, Tai-Yo;Lee, Hyun-Wook;Choi, Yu-Sun;Moon, Seo-Young;Cheong, Yong-Kwan
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.42-45
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    • 2010
  • Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups that are caused by gastric distention, spicy foods and neural dysfunction can resolve themselves without any treatment. Some hiccups are associated with certain diseases or they occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be quickly determined so as to administer the proper treatment. Hiccups often remit spontaneously within a short period of time, but they may also occur without remission for a prolonged period in some cases. We report here on a 36-year-old man who suffered with intractable hiccups for 5 years. We administered a single oral dose of baclofen, and then the hiccups disappeared. We conclude that a single dose of baclofen is a good treatment for intractable hiccups.

Sacral Nerve Stimulation for Treatment of Intractable Pain Associated with Cauda Equina Syndrome

  • Kim, Jong-Hoon;Hong, Joo-Chul;Kim, Min-Su;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.473-476
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    • 2010
  • Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

A study on Intractable disease in the sight of Lee Je Ma (이제마(李濟馬)의 난치병(難治病)에 대(對)한 시각(視角)에 관(關)한 연구(硏究))

  • Jang, Hyun Jin
    • Journal of Sasang Constitutional Medicine
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    • v.7 no.2
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    • pp.129-134
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    • 1995
  • Lee Je Ma (1837~1900) wrote the DongEuSuSeBoWon in 1894. Constitutional Medicine what is called Sasang Medicine has originated from him. In this book he refers to mild, serious, intractable, incurable and fatal disease. In the sight of his Medical theory each state of disease deserves to be researched. 1. In the case of Soumin exhaustion of Yang, Taeyang-Kwolum, noxious Yin, Yang is kept in the exterior by excessive Yin in the interior, middle diabetes and swelling belong to intractable disease and solid mass in the right epigastric zone belongs to fatal disease. 2. In the case of Soyangin exhaustion of Yin, lower diabetes, afternoon fever due to deficiency of Yin, spitting blood and swelling belong to intractable disease and distention of abdomen with gas or fluid belongs to fatal disease. 3. In the case of Taeumin syncope due to chills, dryness-heat, diabetes, pain of chest and abdomen and swelling belong to intractable disease and apoplexy with dosed eyes belongs to fatal disease. 4. In the case of Taeyangin vertebral disease makes flaccidity of lower limbs and dysphagia with vomiting of frothy fluid belongs to fatal disease.

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Tracheoesophageal Diversion for Chronic Aspiration Pneumonia (만성 흡인성폐렴에서 기관식도 우회로술)

  • 심성보
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.329-332
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    • 1993
  • Breakdown of the normal protective function of the larynx, either through primary or neurologic cause, leads to chronic aspiration, recurrent pneumonitis and possibly death. Lindemann`s tracheoesophageal diversion has three main advantages; first, it eliminates intractable aspiration in all patients who underwent the procedure, second, it preserves larynx, and third, if the underlying neurologic condition is recorved, the procedure can be reversed. We had performed tracheoesophageal diversion in two cases of intractable aspiration pneumonia patients. The postoperative courses were uneventful and they were receiving oral alimentation on the 22th and 9th postoperative days respectively, and could be discharged on 43th and 20th postoperative days respectively.

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Case of Oriental Medicine Therapy on Intractable Hiccup Induced by Pontine Infarction (뇌교경색 발병후 병발된 난치성 애역의 치험 1례)

  • Kang, Baek-Gyu;Lee, Sun-Woo;Park, Sang-ParkMoo;Han, Deok-Jin;Lee, Jung-Wook;Kim, Hye-Jung;Moon, Byung-Soon;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.222-225
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    • 2008
  • Hiccup is one of common symptoms that remains poorly understood. The hiccups coordinating center is located in the brain-stem reticular formation. Hiccups may be derived from 400 medical origins. Stroke is an infrequent cause of intractable hiccups. Intractable hiccups in pontine infarction remain poorly understood. As for treatments of hiccups, physical stimulating methods, pharmacological therapies and surgery are occidental conventional methods. In Pharmacological therapies, antidepressants, gastric motility stimulants, antispastic drugs are commonly used. Oriental medicines and acupuncture are also used frequently to treat hiccups. We have treated a case of intractable hiccup induced by pontine infarction with herbal medication; Gwakhyangjeonggi-san gami, acupuncture and moxibustion, and successfully improved. This case showed oriental medicine therapy is effective in intractable hiccup induced by pontine infarction.

Oral Symptoms of Intractable Ulcerating Enterocolitis of Infancy and Differential Diagnosis: A Case Report (난치성 궤양성 소장결장염 영아의 구강 내 증상과 감별진단: 증례보고)

  • Min, Hyoseon;Choi, Hyungjun;Lee, Jaeho;Choi, Byungjai;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.80-84
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    • 2014
  • Intractable ulcerating enterocolitis is an uncommon inflammatory bowel disease syndrome of neonatal onset first described in 1991. Intractable ulcerating enterocolitis usually presents in the neonate with a mouth ulceration and the subsequent development of perianal disease and colitis. In this case report, an infant, 18 days from birth, with ulcerative lesion on hard palate for systemic differential diagnosis about oral lesion is referred from the department depiatrics. At that time, there is no abnormality, except oral lesion-like Aphthous ulcer. The patient was discharged from pediatrics, but returned to the hospital 3weeks later with blood diarrhea. As a result of endoscopy, there were large ulcerating lesions and the patient was diagnosed intractable ulcerating enterocolitis. Early recognition of Intractable ulcerating enterocolitis appears to be beneficial because colectomy, as opposed to immunosuppression, appears to be effective in controlling disease symptoms and progression. Most of the infants who were affected intractable ulcerating enterocolitis were normal at birth and oral manifestation appeared earlier than others. So, it is very meaningful for dentists to know about Intractable ulcerating enterocolitis.