• Journal of Yeungnam Medical Science
• /
• v.39 no.2
• /
• pp.81-88
• /
• 2022

Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

• Journal of Medicine and Life Science
• /
• v.16 no.1
• /
• pp.1-5
• /
• 2019

Our purpose was to evaluate usefulness of the contrast-enhanced 3 dimensional fluid attenuated inversion recovery (3D-FLAIR) technique of half brain volume to diagnose the patients with facial neuritis based on segment-based analysis. We assessed retrospectively 17 consecutive patients who underwent brain MR imaging at 3 tesla for facial neuritis: 11 patients with idiopathic facial neuritis and 6 with herpes zoster oticus. Contrast enhanced 3D-FLAIR sequences of the half brain volume were analyzed and 3D T1-weighted sequence of the full brain volume were used as the base-line exam. Enhancement of the facial nerve was determined in each segment of 5 facial nerve segments by two radiologists. Sensitivity, specificity and accuracy of enhancement of each segment were assessed. The authors experienced a prompt fuzzy CSF enhancement in the fundus of the internal auditory canal in patients with enhancement of the canalicular segment. Interobserver agreement of CE 3D-FLAIR was excellent(${\kappa}$-value 0.885). Sensitivity, specificity, and accuracy of each segment are 1.0, 0.823, 0.912 in the canalicular segment; 0.118, 1.0, 0.559 in the labyrinthine segment; 0.823, 0.294, 0.559 in the anterior genu; 0.823, 0.529, 0.676 in the tympanic segment; 0.823, 0.235, 0.529 in the mastoid segment, respectively. In addition, those of prompt fuzzy enhancement were 0.647, 1.0, and 0.824, respectively. Incidence of prompt fuzzy enhancement with enhancement of the canalicular segment was 11 sites(55%): 6 (54.5%) in idiopathic facial neuritis and 5 (83.3%) in herpes zoster. Enhancement of the canalicular segment and prompt fuzzy enhancement on CE 3D-FLAIR was significantly correlated with occurrence of facial neuritis (p<0.001). CE 3D-FLAIR technique of the half brain volume is useful to evaluate the patients with facial neuritis as an adjunct sequence in addition to contrast-enhanced 3D T1-weighted sequence. On segment-based analysis, contrast enhancement of the canalicular segment is the most reliable. Prompt fuzzy enhancement is seen in not only herpes zoster, but in idiopathic facial neuritis.

• Parasites, Hosts and Diseases
• /
• v.51 no.6
• /
• pp.613-619
• /
• 2013

Angiostrongyliasis, caused by Angiostrongylus cantonensis infection, is a food-borne parasitic disease. Its larvae evoke eosinophilic inflammation in the central nervous system, but can also cause pathological changes in the eyes. Among ocular angiostrongyliasis cases, the incidence of optic neuritis is low and only few sporadic reports exist. Some patients with optic neuritis developed obvious hypopsia or even vision loss, which would seriously influence the quality of life of patients. Prompt treatment of optic neuritis caused by A. cantonensis is the key factor for minimizing the incidence of serious complications of this disease. In this review, we first provide a comprehensive overview of ocular angiostrongyliasis, and then focus on the clinical features of optic neuritis caused by A. cantonensis.

• The Journal of Internal Korean Medicine
• /
• v.44 no.4
• /
• pp.757-764
• /
• 2023

Background: Vestibular neuritis is a common cause of acute unilateral peripheral vestibulopathy. Vestibular neuritis is the second most common disease among patients with dizziness. Clinical symptoms of vestibular neuritis include the sudden onset of vertigo with spontaneous nystagmus, unsteady gait, nausea, and vomiting that last from days to weeks. However, even after the vertigo disappears, difficulty maintaining balance while walking may persist for weeks to months. Antihistamines, serotonin receptor blockers, and benzodiazepine vestibular suppressants are widely used as symptomatic treatments to reduce the severity of symptoms that occur in the acute phase. Case Summary: A patient diagnosed with acute vestibular neuritis was treated with acupuncture, moxibustion, and herbal medicine. We used the visual analog scale (VAS) to assess each symptom and the vertigo score to observe the effect of treatment. After treatment, the VAS scores for each symptom and the vertigo score decreased, and the severity of nystagmus was reduced. Conclusion: This study suggests that Korean medicine treatments, including Samchulgunbi-tang-gagam, could be effective in improving the clinical symptoms of vestibular neuritis.

• Clinics in Shoulder and Elbow
• /
• v.9 no.2
• /
• pp.246-250
• /
• 2006

Brachial neuritis is a rare disorder of unknown etiology that affects the lower motor neurons of the brachial plexus. The clinical course is characterized by acute onset of severe pain followed by weakness and gradual recovery. Among diagnostic tests, electromyography may be useful. The brachial neuritis has been confused with other painful shoulder conditions. The awareness of this disorder helps prevent unwarranted diagnostic studies & treatment. The authors report a case of brachial neuritis.

• The Journal of Internal Korean Medicine
• /
• v.37 no.2
• /
• pp.273-282
• /
• 2016

Objective: This clinical study was performed with a female patient to evaluate the effects of combined Eastern-Western medicine treatment on benign paroxysmal positional vertigo after acute vestibular neuritis.Method: We used acupuncture, herbal medication, Western medication, fluid therapy, and the canalith repositioning maneuver to treat a female patient suffering from dizzy spells. The vertigo scale was checked to assess any improvement in symptoms.Results: The patient had originally recovered from acute vestibular neuritis, but after the first discharge, she came down with benign paroxysmal positional vertigo and had to be rehospitalized. She eventually got better, however, and her score on the vertigo scale improved.Conclusion: This study demonstrates that combined Eastern-Western medicine treatment may be an effective option for treating benign paroxysmal positional vertigo after acute vestibular neuritis, despite the difficulty of the treatment in this case.

• Annals of Clinical Neurophysiology
• /
• v.7 no.1
• /
• pp.28-30
• /
• 2005

Bilateral brachial neuritis is clinically uncommon and accidentally involvement of bilateral phrenic nerves is rarely reported. We experienced a 26 year old man who developed subacute onset of asymmetric bilateral shoulder and arm weakness. The weakness slowly aggravated and finally suffered from dyspnea due to bilateral phrenic nerve palsy. Cervical spine MRI and CSF study showed no abnormality. Viral markers and other serological test showed no specific finding. Electromyographic study showed bilateral brachial axonal polyneuropathy with cervical and upper thoracic polyradiculopathy. And bilateral phrenic nerve conduction study showed no resopnse. He showed no improvement for 10 months after treatment and managed with continuous artificial ventilation. We report a case of idiopathic bilateral brachial neuritis accidentally involving bilateral phrenic nerves.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.17 no.2
• /
• pp.146-152
• /
• 2004

Introduction: Vertigo is one of the common symptoms that we can see often clinically. It is hallucination to motion of oneself or surroundings. Vertigo include not only simple whirling sensation but also leaning or falling down sensation. Particularly in vestibular neuritis, the principal symptoms is dizziness and accompanied by nystagmus, gait imbalance, nausea, vomiting. Cause of vestibular neuritis is inflammatory disease such as common cold. Objective: The aim of this study was to estimate the efficacy of oriental-treatment on vestibular neuritis patient Subjects: We diagnosed one patient who had severe vertigo and gait imbalance as "dizziness retention of phlegm"(담훈) and treat orientally. Conclusion: After oriental-treatment for 15 days, walk balance was improved and no more vertigo was appeared. We could assume that in the vertigo and gait inbalance due to vestibular neuritis, the acupuncture and herbal medicine can be used.

• Investigative Magnetic Resonance Imaging
• /
• v.20 no.3
• /
• pp.167-174
• /
• 2016

Purpose: To identify magnetic resonance imaging (MRI) findings of leukemic infiltration of optic nerve and optic neuritis in leukemic patients with emphasis of clinical findings as reference standard to differentiate them. Materials and Methods: MRI and clinical findings of 7 patients diagnosed as leukemic infiltration of optic nerve (n = 5) and optic neuritis (n = 2) in our institution between July 2006 and August 2015were reviewed retrospectively. In particular, MR imaging findings involved perineural enhancement and thickening of optic nerve and its degree, signal intensity, laterality (unilateral/bilateral), intraconal fat infiltration and its degree, and associated central nervous system abnormalities. Results: Of 5 cases of leukemic infiltration of optic nerve, 4 cases showed positive cerebrospinal fluid (CSF) study for leukemia relapse and 1 case was positive on bone marrow (BM) biopsy only. Moreover, of 5 leukemic infiltration of optic nerve, 2 cases showed the most specific MR findings for leukemic central nervous system involvement including 1 prominent leptomeningeal enhancement and 1 chloroma. However, other MR imaging findings of the patients with leukemic infiltration or optic neuritis such as thickening and perineural enhancement of optic nerves are overlapped. Conclusion: Enhancement and thickening of optic nerve were overlapped MR findings in leukemic infiltration of optic nerve and optic neuritis. Our findings suggest that enhancing optic nerve thickening with associated central nervous system MR abnormality favors the diagnosis of leukemic infiltration of optic nerve, especially in patients with history of acute lymphoblastic leukemia. However, CSF and BM study were required for differentiation between leukemic infiltration of optic nerve and optic neuritis.

• Annals of Clinical Neurophysiology
• /
• v.15 no.1
• /
• pp.13-18
• /
• 2013

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.