• Title/Summary/Keyword: Neurologic

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Effects of Head Acupuncture Versus Upper and Lower Limbs Acupuncture on Signal Activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex (두침과 상하지 침자극이 뇌와 뇌의 체성감각피질에 미치는 영향에 대한 fMRI Study)

  • Park, Jung-Mi;Gwak, Ja-Young;Cho, Seung-Yeon;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Jang, Geon-Ho;Bang, Jae-Seung
    • Journal of Acupuncture Research
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    • v.25 no.5
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    • pp.151-165
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    • 2008
  • Objectives : To evaluate the effects of Head Acupuncture versus Upper and Lower Limbs Acupuncture on signal activation of Blood Oxygen Level Dependent(BOLD) fMRI on the Brain and Somatosensory Cortex. Subjects and Methods : 10 healthy normal right-handed female volunteer were recruited. The average age of the 10 subjects was 30 years old. The BOLD functional MRI(fMRI) signal characteristics were determined during tactile stimulation was conducted by rubbing 4 acu-points in the right upper and lower limbs($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$). After stimulation of Head Acupuncture in Sishencong($HN_1$), $GB_{18}$, $GB_9$, $TH_{20}$ of Left versus Upper and Lower Limbs Acupuncture($LI_1$, $LI_{10}$, $LV_3$, $ST_{36}$ of Right) and took off needles. Then the BOLD fMRI signal characteristics were determined at the same manner. Results : 1. When touched with cotton buds(sensory stimulation), left Parietal Lobe, Post-central Gyrus, primary somatosensory cortex(BA 1, 2, 3), and primary motor cortex(BA 4) were mainly activated. When $ST_{36}$ was stimulated, Frontal Lobe, Parietal Lobe, Cerebellum, and Posterior Lobe as well as Inter-Hemispheric displaying a variety of regions. 2. In signal activation before and after Head Acupuncture reaction, it showed signal activation after removing the acupuncture needle and right Somatosensory Association Cortex, Postcentral Gyrus, and Parietal Lobe were more activated. 3. In reactions of before and after Upper and Lower Limb Acupuncture, it also showed signal activation after removing the acupuncture needle and bilateral Occipital Lobe, Lingual Gyrus, visual association cortex, and Cerebellum were activated. 4. After acupuncture stimulation, In Upper and Lower Limb Acupuncture Group, left frontal Lobe, Precentral Gyrus and Bilateral parietal lobe, Postcentral Gyrus and Primary Somatosensory Cortex(BA 2) were activated. In Head Acupuncture Group, which has most similar activation regions, but especially right Pre-Post central Gyrus, Primary Somatosensory Cortex(BA 3), Primary Motor Cortex, frontal Lobe and Parietal Lobe were activated. Conclusions : When sensory stimulation was done with cotton buds on four acup-points($LI_1$, $LI_{10}4, $LV_3$, $ST_{36}$), while bilaterally activated, contralateral sense was more dominant. It showed consistency with cerebral cortex function. When $ST_{36}$ was stimulated Frontal Lobe, Parietal Lobe, Cerebellum, Posterior Lobe as well as Inter-Hemispheric were stimulated. In Head Acupuncture, it showed more contralateral activation after acupuncture. In Upper and Lower Limb Acupuncture, it showed typically contralateral activation and deactivation of limbic system after acupuncture stimulation. Therefore, there were different fMRI BOLD signal activation reaction before and after Head Acupuncture vs Upper and Lower Limb Acupuncture which might be thought to be caused by acu-points' sensitivity and different sensory receptor to response acupuncture stimulation.

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Transient Neurologic Deterioration after Total Removal of Parasagittal Meningioma Including Completely Occluding Superior Sagittal Sinus

  • Oh, In-Ho;Park, Bong-Jin;Choi, Seok-Keun;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.71-73
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    • 2009
  • In surgical planning of the parasagittal meningioma, invasion and occlusion of the superior sagittal sinus are important factors. When tumor is located within anterior 1/3, or when angiographic finding shows total occlusion of superior sagittal sinus, it is regarded that the ligation of superior sagittal sinus is safe. We report a case of parasagittal meningioma in 59-year-old male patient with complete occlusion of superior sagittal sinus which was confirmed by preoperative angiography, who developed temporary neurologic deterioration after superior sagittal sinus ligation and resection.

Spontaneous Spinal Subarachnoid Hemorrhage with Spontaneous Resolution

  • Kim, Jin-Sung;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.253-255
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    • 2009
  • Spontaneous spinal subarachnoid hematoma (SSH) is a rare entity to cause spinal cord or nerve root compression and is usually managed as surgical emergencies. We report a case of spontaneous SSH manifesting as severe lumbago, which demonstrated nearly complete clinical resolution with conservative treatment A 58-year-old female patient developed a large SSH, which was not related to blood dyscrasia, anticoagulation, lumbar puncture. or trauma. Patient had severe lumbago but no neurologic deficits. Because of absence of neurologic deficits, she was treated conservatively. Follow-up magnetic resonance (MR) image showed complete resolution. Conservative treatment of SSH may be considered if the patient with spontaneous SSH has no neurologic deficits.

A Case of Widespread Cavernous Malformations of the Central Nervous System Associated with Acute Neurologic Deficit

  • Noh, Kyung Chul;Chung, Sung Eun;Lee, Dokyung
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.34-37
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    • 2017
  • A 45-year-old female visited our clinic due to sudden right leg weakness and sensory loss. Brain and spinal cord magnetic resonance imaging showed widespread cavernous malformations. Cavernous malformation in L1 spine area was accompanied by a subacute stage hematoma with perilesional edema. Sensory loss subsided after corticosteroid therapy. Usually, neurologic deficit by spinal cavernous malformation appears more chronically in the adults compared to children. Treatment options are difficult to establish in a case with multiple cavernous malformations. Identifying hemorrhagic lesions by extensive neuroimaging evaluation could be helpful to select the treatment target for cavernous malformation.

Unilateral Paralysis of Lower Extremity Following Thoracic Sympathetic Ganglion Block -A case report- (흉부 교감신경절 차단 후 발생한 편측 하지마비 -증례 보고-)

  • Kim, Sung-Mo;Yang, Seung-Kon;Lee, Hyo-Keun;Lee, Hee-Jeon;Kil, Shun-Hee;Kim, Chan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.268-270
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    • 1996
  • We treated a patient who experienced motor weakness and sensory change on left lower extremity after thoracic sympathetic ganglion block with pure alcohol. The following factors were suspected of contributing to neurologic complication: (1) ischemia of spinal cord, (2) infection, (3) re-expression and aggravation of pre-existing neurologic disease, (4) improper position. Patient spontaneously recovered from neurologic complication with conservative therapy.

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Isolated Musculocutaneous Nerve Palsy after the Reverse Total Shoulder Arthroplasty

  • Kim, Sung-Guk;Choi, Chang-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.101-104
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    • 2016
  • Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.

Neurologic Complication Following Spinal Epidural Anesthesia in a Patient with Spinal Intradural Extramedullary Tumor

  • Kim, Sung-Hoon;Song, Geun-Sung;Son, Dong-Wuk;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.544-546
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    • 2010
  • Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.

A Clinical study of Neurologic Disorders (수족소력(手足少力).강직(强直).마비(痲痺)를 주소(主訴)로 입원(入院)한 환자(患者) 49명(名)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee Jin-Yong;Kim Deok-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.13 no.1
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    • pp.227-238
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    • 1999
  • The author studied 49 cases having neurologic disorders grossly, who admitted to the Oriental Medicine Hospital in Kyunghee university from May 1995 to March 1999. We have got the following results: 1. Age and sex distribution of children: from 4 to 6 was 34.7%, over 7 was 32.7%, 2 to 3 was 28.6%, below 1 was 4.0%, Male to female ratio was 1.33:1. 2. Distribution of chief complain as follows : Hemiplegia 59.2%, Quadriplegia 30.6%, Aphasia 42.9%, Facial palsy 18.4%, Convulsion 16.3%, Aphagia 12.2%. 3. Distribution of diagnosis as follows : Cerebral infarction 32.7%, Cerebral hemorrhage 12.2%, Hypoxic brain damage 10.2%, Brain tumor 6.1%, Guillian-Barre syndrom 6.1%, Moya-Moya disease 4.1% etc. 4. Improvement ratio as follows : Poor 14.3%, Fair 59.2%, Good 26.5%.

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Effect of LI4-LI11 Transcutaneous Electrical Nerve Stimulation on Regional Cerebral Blood Flow in Healthy Human Using SPECT and Statistical Parametric Mapping (뇌 SPECT와 SPM을 이용한 합곡-곡지 TENS 치료의 뇌혈류에 대한 효과)

  • Jeong, Dong-Won;Kim, Young-Suk;Park, Seong-Uk;Jung, Woo-Sang;Park, Jung-Mi;Ko, Chang-Nam;Cho, Ki-Ho;Bae, Hyung-Sup;Kim, Deok-Yoon;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.205-212
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    • 2008
  • Background and purpose: So far it was reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. A previous study demonstrated a correlation between LI4-11 electro-acupuncture (EA) and rCBF increase in frontal lobe. However, there remained a need to study further using various controls in acupuncture research. Transcutaneous electrical nerve stimulation (TENS) has been used as a non-invasive control in acupuncture study. This study was to evaluate the effect of LI4-LI11 TENS on regional cerebral blood flow (rCBF) in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (9 males, 1 female, mean age 26.6$\pm$0.5 years; age range from 26 to 27 years). On the other day, 7 days after the resting examination, 15 minute TENS were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 TENS, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 TENS were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by statistical parametric mapping with a threshold of p = 0.001, uncorrected (extent threshold: k=100 voxels). Results: TENS applied at right LI4-LI11 increased rCBF in the left somatosensory association cortex (Brodmann area 5, 7). However there was no area where LI4-11 TENS decreased rCBF. Conclusion and suggestions: These results demonstrate that right LI4-LI11 TENS increased rCBF only in corresponding somatosensory association cortex, which was different from the previous results using LI4-11 EA. It is suggested that there be a different mechanism between TENS and EA.

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Functional MRI Study of Changes in Brain Activity by Manual Acupuncture at LI11 or ST36 (곡지, 족삼리 침자극이 뇌활성화에 미치는 영향에 대한 뇌기능적 자기공명영상을 이용한 연구)

  • Cho, Seung-Yeon;Jahng, Geon-Ho;Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Gho, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Jung-Mi
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.81-92
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    • 2010
  • Objectives: The objective of this study was to assess bra in activation and difference by LI11 or ST36 acupuncture stimulation using functional MRI (fMRI). Methods: A total of 10 healthy right-handed volunteers were studied. LI11 acupuncture and ST36 acupuncture stimulations were applied in order on the left. The block design paradigm of RARARA was used for the task, with R representing rest and A representing stimulation, and each period lasted 30 seconds. fMRI data were analyzed using SPM2. Results: The left LI11 acupuncture stimulation activated both sides of the inferior parietal lobule, the left side of the extra-nuclear, culmen and inferior semi-lunar lobules. On the right side, the nodule and midbrain regions were activated by the left LI11 acupuncture stimulation. The left ST36 acupuncture stimulation activated the right side of the superior frontal gyrus, middle frontal gyrus, superior parietal lobule, inferior semi-lunar lobule and pyramis. On the left side, the sub-gyral, middle temporal gyrus, fusiform gyrus, supramarginal gyrus, extra-nuclear, cingulate gyrus and fastigium regions were activated by the left ST36 acupuncture stimulation. Besides, both sides of the paracentral lobule, inferior parietal lobule, culmen, cerebellar tonsil and midbrain regions were activated. Conclusions: In conclusion, brain signal activation patterns according to acupoints were observed to differ, and ST36 acupuncture stimulation activated more regions than LI11. It is supposed that LI11 and ST36 acupuncture stimulations have an influence on motor function and sensory aphasia, and these stimulations thus represent potential for ocular motor dysfunction, discriminative touch or position sense disorder. Moreover, ST36 acupuncture stimulation activated the cingulate gyrus of the limbic system, so it seems to have an influence over autonomic functions.