• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.101-107
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• 2000

Objectives : The evaluation of peripheral nerve injuries has traditionally relied on a clinical history, physical examination, and electrodiagnostic studies. The purpose of the present study was to examine serial magnetic resonance image(MRI) changes following acute muscle denervation under experimental conditions and to identify potential advantages and disadvantages of this use of MRI. Methods : An experimental transection of right sciatic nerve on Spargue-Dawley rats was performed. MRI was performed with T1-weighted spin-echo and STIR sequences. The imaging findings were compared with EMG in order to determine its sensitivity relative to this standard procedure. A simultaneous histopathological study provided information about the morphological basis of the imaging findings. Signal intensities were expressed as a ratio of abnormal to normal. Results : The signal intensity ratio of muscles with the STIR sequence was increased significantly at 2 weeks after sciatic nerve transection(p<0.05), although definite signal change was seen as early as 4 days postdenervation in one. EMG revealed significant denervation potential from 3 days after nerve transection. Diffuse cell atrophy was revealed hostologically at 2 weeks after transection, which was at the same time of significant signal change in MRI. Conclusion : MRI signal changes in denervated muscles secondary to nerve injury correlate with the degree of muscle atrophy on histologic examination. In addition to EMG, MRI can document the course of muscle atrophy and mesenchymal abnormalities in denervation. These results indicate that MRI can play a complementary role in the evaluation of patients with denervation.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.212-216
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• 2003

A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.15-21
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• 2012

Primary radial nerve palsy occurs in association with approximately 10% of humerus shaft fractures. Secondary radial nerve palsy, which is iatrogenic, occurs in association with approximately 10% to 20% of humerus shaft fractures. Whether the radial nerve palsy is caused primarily by the fracture or secondarily by the surgery, it is necessary to determine whether the radial nerve is being disrupted or compressed by the surrounding structures. This evaluation will dictate whether to await natural recovery or to perform surgical exploration. The current authors report one case of primary radial nerve palsy, due to the humerus fracture, and one case of secondary radial nerve palsy, associated with the osteosynthesis procedure. In both patients, the radial nerve was assessed for anatomical integrity with ultrasonography. Nerve disruption was found in one patient, and a sural nerve graft was performed. Nerve adhesion was found in the other patient, and neurolysis was performed. In both cases, the clinical results were satisfactory. This report focuses on the usefulness of ultrasonography in radial nerve assessment in patients with radial nerve palsy.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.148-152
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• 2015

The goal of cancer treatment is generally pain reduction and function recovery. However, drug therapy does not treat pain adequately in approximately 43% of patients, and the latter may have to undergo a nerve block or neurolysis. In the case reported here, a 42-year-old female patient with lung cancer (adenocarcinoma) developed paraplegia after receiving T8-10 and $11^{th}$ intercostal nerve neurolysis and T9-10 interlaminar epidural steroid injections. An MRI results revealed extensive swelling of the spinal cord between the T4 spinal cord and conus medullaris, and T5, 7-11, and L1 bone metastasis. Although steroid therapy was administered, the paraplegia did not improve.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.264-266
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• 2012

Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent aspiration. Swallowing study was repeated and no evidence of aspiration was found. The patient was discharged with incomplete recovery of a high pitched tone and improved state of neurologic status. The SLN is an important structure; therefore, spine surgeons need to be concerned and be cautious about SLN injury during high cervical neck dissection, especially around the level of C3-C4 and a suspicious condition of a contralateral nerve injury.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.39-45
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• 1996

Tachyphylaxis to local anesthetics has shown to be promote longer interanalgesic intervals between injections. Previous study demonstrated thermal hyperalgesia accelerates development of tachyphylaxis to sciatic nerve blockade in rats, while MK-801 prevents development of tachyphylaxis. Dextromethorphan is one of NMDA receptor antagonist similar to MK-801. A hypothesis that dextromethorphan would prevent the development of tachyphylaxis was tested in this study. A catheter was surgically implanted along the sciatic nerve a in rat. After recovery from surgery, the animal received repeated injections of 3% 2-chloroprocaine followed by motor block testing with or without hot-plate testing at $56^{\circ}C$. In other experiments, dextromethorphan was administrered by intraperiotneal injection prior to an injection of local anesthetic therough the implanted catheter. Sensory and motor testing was then carried out. Rats injected with 2-chloroprocaine and subjected to hot-plate testing, developed tachyphylaxis to motor and sensory blockade. However, animals pretreated with dextromethorphan did not develop tachyphylaxis over series of three injections. Dextromethorphan seems to prevent development of tachyphylaxis to sciatic nerve blockade in this rat model. Dextromethorphan, one of N-Methyl-D-aspartate receptor antagonist, can be applied to prolong the effect of local anesthetic.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.1
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• pp.46-49
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• 2015

Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.3
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• pp.138-152
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• 2020

Objectives : The aim of this study is to report a case of idiopathic oculomotor nerve palsy improved by Korean Medicine therapy including needle-embedding therapy. Methods : We treated a 69-year old male patient who has Rt. ptosis, Rt. eye movement impairment, and dizziness with various Korean medical therapy including acupuncture, Bojungikgitanggami, and Hominis Placenta pharmacopuncture. To promote recovery, we additionally performed needle-embedding therapy to periocular acupoints. Results : Ptosis started to remarkably improve after performing needle-embedding therapy. After 54 days of treatment, ptosis and eye movement impairment of Rt. eye were significantly improved similar to the normal eye. Dizziness was cured in a few days after administration. Conclusions : This case suggests Korean medicine including needle-embedding therapy is effective against oculomotor nerve palsy symptoms especially for ptosis.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.152-156
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• 2021

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

• The Journal of the Korean dental association
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• v.11 no.6
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• pp.407-414
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• 1973