• Title/Summary/Keyword: Neurologic

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Transient asymptomatic white matter lesions following Epstein-Barr virus encephalitis

  • Jang, Yoon-Young;Lee, Kye-Hyang
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.389-393
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    • 2011
  • We present the case of a patient with Epstein-Barr virus (EBV) encephalitis who developed abnormal white matter lesions during the chronic phases of the infection. A 2-year-old-boy was admitted for a 2 day history of decreased activity with ataxic gait. The results of the physical examination were unremarkable except for generalized lethargy and enlarged tonsils with exudates. Brain magnetic resonance imaging (MRI) at admission showed multiple high signal intensities in both basal ganglia and thalami. The result of EBV polymerase chain reaction (PCR) of the cerebral spinal fluid was positive, and a serological test showed acute EBV infection. The patient was diagnosed with EBV encephalitis and recovered fully without any residual neurologic complications. Subsequently, follow-up MRI at 5 weeks revealed extensive periventricular white matter lesions. Since the patient remained clinically stable and asymptomatic during the follow-up period, no additional studies were performed and no additional treatments were provided. At the 1-year follow-up, cranial MRI showed complete disappearance of the abnormal high signal intensities previously seen in the white matter. The patient continued to remain healthy with no focal neurologic deficits on examination. This is the first case of asymptomatic self-limited white matter lesions seen in serial MRI studies in a Korean boy with EBV encephalitis.

A Case of Lennox-Gastaut Syndrome due to 3-Methylcrotonyl CoA Carboxylase Deficiency (Lennox-Gastaut 증후군으로 발현된 3-Methylcrotonyl-CoA Carboxylase 결핍증 1례)

  • Kang, Hoon Chul;Han, Yu Sok;Lee, Hong Jin;Kim, Heung Dong
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.4 no.1
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    • pp.46-53
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    • 2004
  • 3-Methylcrotonyl-CoA carboxylase (MCC) is a biotin-dependent enzyme involved in leucine metabolism. We describe a patient with MCC deficiency who manifested with Reye syndrome-like illness with status epilepticus, metabolic acidosis, hypoglycemia, hyperammonemia, elevated liver enzymes and neurologic impairments after the viral gastroenteritis and then, has suffered from Lennox-Gastaut syndrome. Urinary organic acid analysis revealed increased excretion of 3-hydroxyisovaleric acid and 3-methylcrotonylglycine. This patient was managed with leucine restriction diet and supplementation of biotin and carnitine but was not so effective. He has suffered from neurologic sequelae such as Lennox-Gastaut syndrome, motor and cognitive impairement.

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Antagonism of Morphine Analgesia by the Pretreatment Sites with Ginseng Total Saponin (인삼사포닌의 전처치 부위에 따른 Morphine 진통력 길항작용)

  • Kim, Hack-Seang;Oh, Ki-Wan;Oh, Sei-Kwan;Ryu, Hang-Mook;Seong, Yeon-Hee
    • Journal of Ginseng Research
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    • v.15 no.1
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    • pp.6-12
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    • 1991
  • The analgesic effect of morphine was antagonized in mice pretreated with ginseng total saponin intraperitoneally, intracerebrally and intrathecally. The antagonized effects of morphine analgesia were reversed predominantly by treatment with L-3, 4-dihydroxyphenylalanine in the tail pinch test and 5-hydroxytryptophan in the tail flick test respectively. These indicate that the antagonistic action of ginseng total saponin might be due to their inhibitions of the activation of descending ihibitory systems at the cerebral site as well as spinal. In addition, any appreciable changes of brain biogenic monoamine levels were not observed in mice pretreated with ginseng total saponin at various time intervals. These results obtained suggest that a newly equilibrated state of neurologic function could be found in mice pretreated with ginseng total saponin, and modification of neurologic function in the mechanism for the antagonism of morphine analgesia by ginseng total saponin was more important than the changes of brain biogenic monoamine levels.

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Lame Disease (라임병에 관하여)

  • Shin, Sang-Won;Park, Seung-Chull
    • Journal of agricultural medicine and community health
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    • v.16 no.2
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    • pp.172-176
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    • 1991
  • Lyme disease, or Lyme borreliosis. is an infection caused by spirohete Borrellia burgdorferi. This disease was recognized in Lyme, Conneticut U.S.A. in 1975. The onset of the disease is usually heralded by the appearance of a pathognomic skin lesion, known as erythema chronicum migrans, and accompanied by flue like or meningitis like symptoms. Unless treatment is initiated early, the disease usually disseminated, often resulting carduac, neurologic, or joint manifestations. All stages of the disease are usually curable by appropriate antibiotic therapy, and can prevent severe late cardiac, neurologic, and joint complications. Lyme disease is typically defined by clinical evidence supported by serologic test. The diagnosis require serologic confirmantion of erythema chronicum migrans, occurring in patient in nonendemic countries. Determination of antibody titer against B. burgdorferi by enzyme linked immunosorbent assay(ELISA) currently the most practical diagnostic test. Currently Lyme disease occurs in U.S.A. Europe, and Australia. It has recently recognized in China, Japan, and Soviet Union also. In United States, Lyme disease is most common vector borne infection. There is no reported case of patients with this disease in Korea. But the vector of this disease, -Ixodes ticks- had been identified in Korea. And Korea is geographically closely related to China and Japan where Lyme disease is already reported. We expect first case of Lyme disease could he reported in near future. We review the clinical manifestations and diagnostic method of Lyme disease.

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Analysis of Clinical Nursing Activities Using Home Hospice Nursing Intervention Standards (가정호스피스 간호중재 표준서에 의한 임상간호활동 분석)

  • Yong, Jin-Sun
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.960-972
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    • 2008
  • Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

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A Case of Peripheral Facial Palsy in Ponto-medullary Junction Area Infarction (말초성 안면신경 마비로 발현된 교뇌-연수 인접 부위 뇌경색 1예)

  • Cho, Jeong-Seon;Kim, Doo-Eung;Kim, Jung-Mee;Han, Young-Su;Ha, Sang-Won;Park, Sang-Eun;Han, Jeong-Ho;Cho, Eun-Kyoung
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.186-189
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    • 2006
  • A 69 year-old woman was admitted with sudden left facial weakness. She had no other neurologic deficit, except for left peripheral type facial palsy. She had a presumptive diagnosis of Bell's palsy. The blink test was indicative of left facial neuropathy due to left medullary lesion. Diffusion weighted (DWI) brain MRI demonstrated high signal signal lesion in left dorsolateral ponto-medullary junction. Apperant diffusion coefficient (ADC) brain MRI showed low signal lesion in the same area. We present an unusual case of ipsilateral peripheral facial palsy in dosolateral ponto-medullary infarction without other neurologic deficits.

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A Clinical Analysis of Surgically Managed Primary Spondylitis (수술 치료를 받은 원발성 척추염 환자의 임상적 고찰)

  • Park, Jong Hoon;Kim, Kyu Hong
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1163-1169
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    • 2001
  • Objective : To assess the surgical outcome for patients with primary spondylitis who were treated surgically. Materials and Methods : We retrospectively analyzed the clinical characteristics of 19 patients who underwent surgical treatment from september 1997 to October 1999 in our department. Results : The 19 patients presented 13 tuberculous spondylitis and 6 pyogenic spondylitis. The male to female ratio was 1.4 : 1 and average age 48.4 years(range 15-68 years). The most prevalent location was thoracic region(47%) and paraparesis was frequently seen in patients with middle and lower spinal lesions. Operative approaches were either anterior(13) or posterior(6). All patients with neurologic deficits improved after surgery. Autogenous rib and/or iliac strut bone grafting was performed, followed by spinal instrumentation. Solid bone fusion was obtained in all patients. There was no need for prolongation of duration of antituberculous drug therapy and no increased incidence of secondary infection due to spinal instrumentation. Conclusion : From the results, it may be advised that patients of primary spondylitis who had neurologic deficit should receive an aggressive opeation in their early stage.

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Intradural Lumbar Disc Rupture - Case Report - (경막내 요추 추간반 탈출증 - 증례보고 -)

  • Jeong, Ju-Ho;Lee, Sang-Gu;Yoo, Chan-Jong;Han, Ki-Soo;Kim, Woo-Kyung;Kim, Young-Bo;Park, Cheol-Wan;Lee, Uhn
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1233-1236
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    • 2001
  • The intradural lumbar disc herniation which was first described by Dandy in 1942 is unusual. The pathogenesis is obscure and preoperative diagnosis is not easy. The patient usually have more severe neurologic deficits than those found in the much more common extradural disc herniations. We experienced two cases of the intradural lumbar disc herniation who had previous disc operations and the symptoms and neurologic signs were improved after removal of the intradural sequestration of disc fragments.

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Remote Cerebral and Cerebellar Hemorrhage after Massive Cerebrospinal Fluid Leakage

  • You, Sung-Hye;Son, Kyu-Ri;Lee, Nam-Joon;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.240-243
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    • 2012
  • Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.

An Unusual Case of Post-Operative Spondylitis Caused by $Mycobacterium$ $Intracellulare$ in an Immunosuppressed Patient

  • Kim, Sung-Hoon;Son, Dong-Wuk;Lee, Sang-Weon;Song, Geun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.460-463
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    • 2011
  • There are few reported cases of post-operative spondylitis caused by $Mycobacterium$ $Intracellulare$. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, $Mycobacterium$ $Intracellulare$ was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.