• Annals of Clinical Neurophysiology
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• 제9권1호
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• pp.33-35
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• 2007

Meralgia paresthetica (MP) is a benign entrapment neuropathy which is characterized by sensory impairment and paresthesia in the cutaneous distribution of the lateral femoral cutaneous nerve. A 79-year-old woman presented with intermittent right inguinal burning sensation. The sensory nerve conduction study (NCS) showed decreased right side sensory nerve action potential (SNAP) on lateral femoral cutaneous nerve compared to the contralateral one. Abdomino-pelvic CT showed bilateral huge renal cysts (The size of largest one on right side: about $6.2{\times}5.0cm$). We report a case of MP caused by a huge abdominal renal cyst, which should be considered when conventional examination reveals no responsible etiology.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.122-127
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• 2001

Background : Bell's palsy(BP) is defined as an idiopathic peripheral facial paralysis of sudden onset and account more than 50% of facial paralysis. It's etiology is unclear, but herpes simplex virus type-1(HSV-1) has been the most suspicious causative agent of BP that ever been studied. We evaluated the effect of add-on acyclovir in acute stage of BP. Methods : Subject consisted of 35 patients who developed acute idiopathic unilateral facial nerve palsy(16 men and 19 women with age 9-78 years old). The treatments were started within 10 days after onset of BP. Facial nerve function was assessed by the House-Brackman facial nerve grading scale and facial nerve conduction study including blink reflex. Follow-up evaluation were made 2 month after onset. Twenty of 35 patients were treated with combined therapy of acyclovir and prednisone. As a control group, 15 patients were treated with prednisone only. We compared the improvement of neurologic defects at recovery phase. Results : Compared with two groups, difference in grading scale at recovery phase is statistically significant(p<0.01). So, acyclovir-prednisone group showed a significant improvement in grading scale at recovery phase compared with prednisone group. Conclusion : We identified the benefits of add-on acyclovir in the acute stage of BP.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.121-128
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• 2024

This study presents a case of facial nerve injury that occurred after parotidectomy for a benign tumor of the parotid gland that improved with integrated Korean medicine (IKM). On June 24, 2023, the patient presented with facial nerve injury based on a facial nerve conduction study after parotidectomy, with a score of five on Yanagihara's unweighted grading system (Y-system) and a grade of five on the House-Brackmann facial grading scale (H-B scale). During the 15 days of admission, IKM treatments, including acupuncture, pharmacopuncture, moxibustion, herbal steam therapy, physiotherapy, herbal medicine, and thread embedding acupuncture treatment, were performed. After treatment, the strength of the orbicularis oculi, orbicularis oris, and masticatory muscles improved, with a Y-system score of 17 and an H-B scale of III. In conclusion, the findings of this study confirm the applicability and effectiveness of IKM in the treatment of facial paralysis following parotidectomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

• 대한골관절종양학회지
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• 제9권2호
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• pp.212-216
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• 2003

결절종으로 인한 총 비골 신경 마비는 매우 드문 예에서 보고되고 있지만, 잘 알려져 있는 질환이다. 결절종으로 인한 비골 신경 포착을 보이는 자기 공명 영상 소견에 대하여 3편이 보고되어 있다. 본 증례에서는 진단을 위해 초음파, 자기 공명 영상, 근전도, 신경전도 검사 및 조직 검사를 시행하였다. 비골 경부 주변의 관상 구조는 자기 공명 영상 소견 상 특징적으로 T2 강조영상에서 고신호를 보이면서 상부 경비골 관절의 아래 부분까지 종축으로 뻗어있는 소견을 보였다. 비골 신경을 노출시키고 결절종에 대해 병소내 절제술을 시행하였다. 수술 후에도 마비 증상이 지속되었으나, 수술 후 4개월부터 점차적으로 마비의 회복소견을 보이기 시작했고 술 후 7개월에 완전한 회복을 보였다. 본 증례에서 자기 공명 영상은 낭종의 범위, 위치, 기원을 밝혀 내는데 도움을 주었고, 외과적 절제술로 좋은 결과를 얻을 수 있다.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• 대한한방내과학회지
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• 제28권3호
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• pp.434-441
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• 2007

Objectives : Peripheral neurodegeneration occurs in diabetes mellitus (DM), both sensory and motor nerve. but we don't know exactly if DM affects central nerve pathway for all studies. Electrophysiologic study is one of the most important diagnostic tools for diabetic neuropathy. Electroneurography and electromyography are usually used. but evoked potentials (EP) is more sensitive to small nerve fiber damages and useful for central nerve evaluation in addition to peripheral nerves. Most diabetic neuropathy studies by EP have been performed with somatosensory evoked potentials (SSEP). In contrast, the objective of this study is to investigate if DM targets central motor neurons by assessing the relation between fasting blood sugar (FBS) and motor evoked potentials (MEP) latency. Methods : We inspected the medical records of 34 patients who had MEP tests during admitting days. The latency from cervical portion to abductor pollicis brevis was used as peripheral motor conduction time (PMCT). and the latency from vertex to cervical portion was used as central motor conduction time (CMCT). Then, they were correlated to FBS using correlation analysis. Results : There was a significant linear relation between FBS and PMCT (Pearson's correlation coefficient r=0.487, p<0.01), but a poor linear relation between FBS and CMCT (Pearson's correlation coefficient r=-0.l97. p>0.05). Conclusions : This study suggests that prolonged latencies of MEP in DM may be due to peripheral neuropathy rather than dysfunction of central motor pathway. therefore the clinical use of MEP to diabetic neuropathy has to be divided segmentally.

• Annals of Clinical Neurophysiology
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• 제2권1호
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• pp.21-26
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• 2000

저자들은 정상 대조군과 CTS 환자군을 대상으로 막대전극을 이용하여 M P P D N의 감각신경전도검사를 실시하여 다음과 같은 결과를 얻었다. 1. MPPDN의 감각신경전도속도의 정상범위는 $38.7{\pm}4.2$(D1), $32.0{\pm}4.6$(D2), $34.2{\pm}4.4$(D3) m/sec로서 서로 유의한 차이가 있었다. 2. MPPDN의 감각신경전도속도의 정상범위는 좌우에서 서로 유의한 차이가 없었다. 3. CTS 환자에서 측정한 MPPDN의 감각신경전도속도는 각각 $35.3{\pm}8.9$(D1), $20.2{\pm}5.2$(D2), $20.2{\pm}5.1$(D3) m/sec로서 대조군에서 얻은 정상범위와 유의한 차이가 있었다.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.92-95
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• 2012

장골근 파열은 매우 드물게 발생하는 손상으로 고에너지 외상이나 혈액 응고 기능 장애, 항혈액응고제 사용자, 혈우병 환자 등 출혈경향이 있는 환자에서 저에너지 손상을 받는 경우에 발생할 수 있다. 장골근의 파열로 인한 혈종의 압박에 의해 발생한 대퇴 신경 마비가 국내에도 드물게 보고된 바가 있다. 자기공명영상 검사로 병변 부위를 확진하고 신경전도 검사 및 근전도 검사로 대퇴신경 마비의 범위를 평가할 수 있고 혈액응고 기능에 문제가 있거나 출혈경향이 있는 환자를 선별하기 위해 반드시 혈액학적인 검사가 선행되어야 한다. 저자들은 정상적인 32세 남자가 축구 경기 도중 공을 차는 동작에서 발생한 장골근 파열 및 혈종의 압박으로 인한 부분적인 대퇴신경 마비의 증례를 경험하고 6개월간 추시 관찰하였으며, 양호한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.