• Title/Summary/Keyword: Movement disorder

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Narcolepsy Variant Presented with Difficult Waking (각성장애로 발현한 기면증의 변종)

  • Lee, Hyang-Woon;Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.115-119
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    • 2000
  • Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.

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The Effect of TENS by Physiotherapist versus Home based TENS Intervention to reduce Pain and Improve Disability in Patients with Mechanical Neck Disorder (치료사에 의해 적용된 경피신경전기자극과 가정에서 시행된 경피신경전기자극이 경부통 환자의 통증과 장애에 미치는 영향)

  • Park, Jae-Myoung;Yang, Sung-Hwa;Lee, Jun-Yong;Lee, Jae-Min;Jung, Min-Keun
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.61-66
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    • 2010
  • Purpose: The purpose of this study was to determine the effect of TENS by physiotherapist versus home based TENS intervention to reduce pain and improve disability in patients with mechanical neck disorder. Methods: The subjects of the study were 30 selected patients who had been diagnosed with subacute or chronic neck disorders without neurological damage, during the period of four weeks, three times a week, and thirty minutes for one session, 15 patients received TENS by physiotherapist. 15 patients received home based TENS intervention. The primary outcome was pain intensity measured in using the Visual Analog Scale(VAS). The second outcome was Neck Disability Index to patient's disability. Results: The change in the pain perception degree were statistically significant in both group(p<0.05). TENS by physiotherapist group showed significantly improvement in disability, but, Home based TENS intervention group is not. TENS by physiotherapist group showed significantly greater improvement in pain intensity and patient's disability than the home based TENS intervention group. Conclusion: This study shows that received TENS by physiotherapist was effective in reducing pain, improving disability for mechanical neck disorder patient, physiotherapist' knowledge need to improve patient's pain and disability.

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The Spiral Taping Treatment on Temporomandibular Disorder in oral Medicine (구강내과영역에서 측두하악장애 환자의 Spiral Taping 치료)

  • Kim, Myung-Hee;Lee, Jeong-Hun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.65-70
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    • 2011
  • The purpose of this study is introduce the spiral taping treatment on Temporomandibular Disorder in oral Medicine. The taping treatment is relatively simple and dosen't have any adverse effect, so it has high stability and superior effect of treatment. In this study, using the spiral taping treatment as one of the effective taping treatments, non-stretched tape was attatched to the muscles which set limit to the range of joint movement and cause pain to temporomandibular joint. With that treatment this study tried to make effective results of treatment of temporomandibular disorder. These results suggest spiral taping treatments contribute to the improvement of tempermandibular disorders. Further this study is needed for the confirmation of this effect of spiral taping treatments on temporomandibular disorders.

EVALUATION OF EFFICACY OF TMJ ARTHROCENTESIS IN THE PATIENTS WITH MANDIBULAR FRACTURE (하악골 골절 환자의 치료시 상관절강 세정술의 유용성 평가)

  • Kim, Young-Kyun;Yun, Pil-Young;Kim, Ji-Hong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.6
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    • pp.532-535
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    • 2005
  • The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.

A Case Report of a Patient with Probable-REM Sleep Behavior Disorder Treated by Ukgan-san with Western Medicine (렘 수면행동이상 유병 환자의 수면장애에 대한 억간산 병행 치험 1례)

  • Jung, Da-hae;Park, Choong-hyun;Youn, Hye-soo;Lee, Eun-chang;Jo, Hye-mi;Han, Da-young;Lee, Jung-eun
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.436-443
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    • 2022
  • Objectives: This study examined the case of a 69-year-old man with a history of stroke and Alzheimer's disease who had been diagnosed with probable-rapid eye movement sleep behavior disorder (probable-RBD). Methods: The patient was treated with herbal medicine (Ukgan-san, Ukgansangayonggolmoryeo-tang, and powdered Gamisoyo-san extract), Western medicine (clonazepam, antiplatelet, psychotropic agents, antihypertensive drugs, and others), and acupuncture. Their effects were evaluated by the frequency and severity of sleep-related behavioral symptoms. Results: After treatment, the observed frequency and severity of sleep-related behavior decreased. Conclusion: The results suggest that using traditional Korean medicine with clonazepam can be effective in the treatment of patients with probable-RBD.

The Effects of Upper Limb Coordinated Movement Based Task Oriented Approach on Improving Handwriting Performance in Children With Developmental Coordination Disorder (상지 협응 움직임을 기반으로 한 과제중심적 접근 훈련이 발달성 협응 장애아동의 글씨쓰기 능력에 미치는 효과)

  • Kim, Miji
    • Therapeutic Science for Rehabilitation
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    • v.5 no.1
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    • pp.77-87
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    • 2016
  • Objective : The purpose of this study is to investigate the impact of task-oriented approach based on upper limb coordinated movement on the ability of the Korean handwriting in children with developmental coordination disorder(DCD). Methods/Design : This randomized controlled trial designed as a pre-/post- test will compare the effectiveness of task-oriented approach and process-oriented approach on handwriting performance for children with DCD aged 5 to 10. These interventions consist of 10 training sessions and 4 assessment sessions over 7weeks. Children will be measured regard to handwriting legibility, speed and pre-handwriting skills including upper limb movement skills, visual perception and visual motor coordination. Conclusion : This is the first attempt to investigate effects of a task-oriented approach in children with DCD. The significance of this study is to provide the clinical evidences to apply the task-oriented approach improves the children's handwriting performance. Furthermore it will also present a more effective intervention for handwriting by figuring out each approach's impact on the improvement of pre-handwriting skills.

Case Report : Botulinum Toxin Treatment in Oromandibular Dystonia (보툴리눔 톡신을 이용한 구강하악 근긴장이상증의 치료 증례)

  • Ryu, Ji-Won;Hong, Seong-Ju;Bae, Kook-Jin;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.421-427
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    • 2009
  • Oromandibular dystonia is a focal neurological movement disorder characterized by involuntary sustained and often painful muscle contraction, usually producing repetitive movements or abnormal positions of the mouth, jaw and.or tongue. Patients suffering from oromandibular dystonia often experience difficulties in chewing, swallowing and speaking, resulting from the impairment of mandibular movements. At present there is no etiologic treatment for oromandibular dystonia, because the pathophysiology of primary and focal dystonia is still incompletely understood. Many treatments such as medication, behavioral therapy, surgery are suggested to decrease the involuntary movements. But these success rates are relatively low and they have a lot of complications. many studies suggested that chemodenervation with botulinum toxin is the most effective treatment for oromandibular dystonia. We reported the 2 cases which were treated oromandibular dystonia with botulinum toxin and reviewed the orofacial movement disorders(especially oromandibular dystonia) and botulinum toxin treatment for oromanfibular dystonia.

Preliminary Study of The Periodic Limb Movement Disorder Following Nasal CPAP : Is It Associated With Supine-Sleeping Position? (지속적 양압술과 수면중 주기적 사지운동 장애의 관계에 대한 예비적 연구 : 앙와위가 주기적 사지운동 장애와 관련되는가?)

  • Yang, Chang-Kook;Clerk, Alex A
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.164-171
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    • 1997
  • Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

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Positional changes of the mandibular condyle in unilateral sagittal split ramus osteotomy combined with intraoral vertical ramus osteotomy for asymmetric class III malocclusion

  • Park, Jun;Hong, Ki-Eun;Yun, Ji-Eon;Shin, Eun-Sup;Kim, Chul-Hoon;Kim, Bok-Joo;Kim, Jung-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.373-381
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    • 2021
  • Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

Phosphodiesterase-5 Inhibitor Attenuates Anxious Phenotypes and Movement Disorder Induced by Mild Ischemic Stroke in Rats

  • Yu, Yeon Hee;Kim, Seong-Wook;Kang, Juhyeon;Song, Yejin;Im, yHyuna;Kim, Seo Jeong;Yoo, Dae Young;Lee, Man-Ryul;Park, Dae-Kyoon;Oh, Jae Sang;Kim, Duk-Soo
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.665-679
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    • 2022
  • Objective : Patients with mild ischemic stroke experience various sequela and residual symptoms, such as anxious behavior and deficits in movement. Few approaches have been proved to be effective and safe therapeutic approaches for patients with mild ischemic stroke by acute stroke. Sildenafil (SIL), a phosphodiesterase-5 inhibitor (PDE5i), is a known remedy for neurodegenerative disorders and vascular dementia through its angiogenesis and neurogenesis effects. In this study, we investigated the efficacy of PDE5i in the emotional and behavioral abnormalities in rats with mild ischemic stroke. Methods : We divided the rats into four groups as follows (n=20, respectively) : group 1, naïve; group 2, middle cerebral artery occlusion (MCAo30); group 3, MCAo30+SIL-pre; and group 4, MCAo30+SIL-post. In the case of drug administration groups, single dose of PDE5i (sildenafil citrate, 20 mg/kg) was given at 30-minute before and after reperfusion of MCAo in rats. After surgery, we investigated and confirmed the therapeutic effect of sildenafil on histology, immunofluorescence, behavioral assays and neural oscillations. Results : Sildenafil alleviated a neuronal loss and reduced the infarction volume. And results of behavior task and immunofluorescence shown possibility that anti-inflammation process and improve motor deficits sildenafil treatment after mild ischemic stroke. Furthermore, sildenafil treatment attenuated the alteration of theta-frequency rhythm in the CA1 region of the hippocampus, a known neural oscillatory marker for anxiety disorder in rodents, induced by mild ischemic stroke. Conclusion : PDE5i as effective therapeutic agents for anxiety and movement disorders and provide robust preclinical evidence to support the development and use of PDE5i for the treatment of mild ischemic stroke residual disorders.