• Title/Summary/Keyword: Neurological Disorder

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Current Issues in the Diagnosis of Malingering : Sensory and Motor Symptoms (꾀병 감별법 : 감각 및 운동 이상을 중심으로)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.103-121
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    • 2004
  • Conversion disorder and factitious disorder should be ruled out before making diagnosis of malingering. For this work, inspection of patient's behavior along with complete neurological examinations, psychological tests, and meticulous psychiatric interview are necessary. Facial expression test, thermography, dynamometry were failed differentiating conversion disorders to the malingered pain and motor symptoms, however, controlled diagnostic block showed positive result partly in patients with regional or cervical pain syndrome. Chronic pain patients who are related to the process of litigation encounter stressful life situations which lead them into various neurobehavioral and psychosocial complications. Most of suspected malingered patients would not revealed pure form rather mixed with factitious and/or conversion features. At the time of increasing number of chronic patients associated with traffic accidents or industrial injuries who are involved in litigation, psychiatrist are needed sharp eyes and tenacity for evaluating malingering or medically unexplained symptoms.

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Parent's Gestalt Speech Intervention for Fluency Development of Fluency Disorder he Subject of Essay (부모의 게슈탈트적 언어 중재가 유창성장애인의 유창성 개선에 미치는 영향)

  • Ko, Young-Ok
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.269-276
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    • 2013
  • This study was aimed of the effects of the Parent's Gestalt Speech Intervention for stuttering development of Fluency disorder Child. The Parent's Gestalt Speech Intervention was made up of a program understand phase, an awareness phase, a change phase and, finally, an arrangement and termination phase. The subjects 6 (female 2, male 4) of this research were developed a stuttering behavior without any apparent neurological damage or other speech or developmental impediments. To access their stuttering behaviors, I used methods for observing levels of behavioral in each phase. The results of the study are as follows: In regard to stuttering behavior, word repetition frequency decreased in the interim assessments, showing that the learning of fluent speech was acquired early in the therapy process. In conclusion, the results of the study show that Parent's Gestalt Speech Intervention for stuttering development of Fluency disorder Child.

A Case Report of Korean Medical Treatment on Parkinsonism Patient Complaining of Motor Disorder and Aphonia (한방치료로 운동 기능장애와 실성증이 호전된 파킨슨증후군 환자 치험 1례)

  • Hye-Min, Heo;Kyeong-Hwa, Lee;Ye-Chae, Hwang;Gyu-Ri, Jeon;Seung-Yeon, Cho;Seong-Uk, Park;Jung-Mi, Park;Chang-Nam, Ko
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.13-24
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    • 2022
  • ■Objectives This case study is to report the effectiveness of Korean medicine in Parkinsonism patient's treatment. ■Methods We used the acupuncture, electro-acupuncture, moxibustion, cupping therapy, herbal medicine, especially Palmulgunja-tang to the Parkinsonism patient with motor disorder such as Postural Instability and Gait Difficulty(PIGD) and aphonia. Unified Parkinson's Disease Rating Scale(UPDRS), analysis of gait pattern, voice dB and self-evaluation of speed and volume were used to assess the change of symptoms. ■Results ‌After treatment, the UPDRS score decreased in overall category and the walking pattern has improved. In addition, the improvement was observed in voice volume and in self assessment of the patient. ■Conclusion This case suggests the effect of Korean medical treatment on motor disorder and aphonia in Parkinsonism.

Neuroprotective effect of lithium after pilocarpine-induced status epilepticus in mice

  • Hong, Namgue;Choi, Yun-Sik;Kim, Seong Yun;Kim, Hee Jung
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.1
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    • pp.125-131
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    • 2017
  • Status epilepticus is the most common serious neurological condition triggered by abnormal electrical activity, leading to severe and widespread cell loss in the brain. Lithium has been one of the main drugs used for the treatment of bipolar disorder for decades, and its anticonvulsant and neuroprotective properties have been described in several neurological disease models. However, the therapeutic mechanisms underlying lithium's actions remain poorly understood. The muscarinic receptor agonist pilocarpine is used to induce status epilepticus, which is followed by hippocampal damage. The present study was designed to investigate the effects of lithium post-treatment on seizure susceptibility and hippocampal neuropathological changes following pilocarpine-induced status epilepticus. Status epilepticus was induced by administration of pilocarpine hydrochloride (320 mg/kg, i.p.) in C57BL/6 mice at 8 weeks of age. Lithium (80 mg/kg, i.p.) was administered 15 minutes after the pilocarpine injection. After the lithium injection, status epilepticus onset time and mortality were recorded. Lithium significantly delayed the onset time of status epilepticus and reduced mortality compared to the vehicle-treated group. Moreover, lithium effectively blocked pilocarpine-induced neuronal death in the hippocampus as estimated by cresyl violet and Fluoro-Jade B staining. However, lithium did not reduce glial activation following pilocarpine-induced status epilepticus. These results suggest that lithium has a neuroprotective effect and would be useful in the treatment of neurological disorders, in particular status epilepticus.

Trends in the Use of Oriental Medical Care Service and Treatment Satisfaction (지역주민의 한방의료 이용성향과 진료만족도)

  • Suh, Ho-Suk;Nam, Chul-Hyun;Kim, Jae-Don;Kim, Sung-Jin;Ryu, Jang-Gun;Jun, Bong-Chun;Kim, Mi-Ae
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.41-70
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    • 2007
  • The purpose of this study was to identify a tendency in patients who seek oriental medical service and factors influencing patient satisfaction. The study was conducted with 1,520 residents of a community during the period from February 5, 2005 through June 30, 2005 using a questionnaire. This study results are summarized as follows : 1. Of subjects who sought oriental medical service, 66.2% had musculoskeletal disorder and connective tissue disease, 18.9% had digestive tract disease, 16.4% had respiratory disease, 8.2% had endocrinemetabolic disease, 7.5% had circulatory disease and the remaining subjects had other diseases(p<0.001). 2. Of subjects who sought oriental medical service for the treatment of musculoskeletal disorder, 84.9% preferred acupuncture. Of those who had digestive tract diseases, 47.0% preferred packaged herbal medicine. Of those who had respiratory disease, 63.0% preferred packaged herbal medicine. 3. Acupuncture was the most often sought by subjects with musculoskeletal disorder. Packaged herbal medicine was sought by subjects with respiratory disease, digestive tract disease, endocrine-metabolic disease or circulatory disease. Tablet-type herbal medicine was sought by subjects with musculoskeletal disorder or digestive tract disease. Combined therapy was sought by subjects with musculoskeletal disorder, digestive tract disease, hematopoietic disease or immune disorder. 4. The level of satisfaction with oriental medical service was higher in subjects with circulatory disease, subjects with digestive tract disease, subjects with neurological disorder and subjects with musculoskeletal disorder in descending order. Of total subjects, 39.4% experienced side effects of oriental medical care, 38.1% experienced side effects of herbal medicine. About 51.9% considered the price of herbal medicine costly while 23.2% considered it reasonable. 5. Subjects' knowledge of herbal medicine was measured as $29.2{\pm}3.83$ out of 42 scores or 69 out of 100 points, indicating a low knowledge level. Subjects' knowledge was influenced by occupation, religion, side effects, sex, age, residence area, the type of insurance. These variables explained 15.2% of the variance. 7. Of total subjects, 56.8% were satisfied with oriental medical service. Patient satisfaction varied with occupation, religion, the type of insurance, health state and treatment outcomes. These variables explained 37.3% of the variance. Conclusion : The majority of subjects were satisfied with oriental medical service. However, oriental medical care are not widely used to treat all kinds of diseases while its use skews to a small categories of diseases. It is therefore necessary for the government and oriental medical service providers to develop new therapy approaches for the treatment of a broader range of diseases.

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Clinical, Neuroimaging and Neurophysiologic Evidences of Restless Legs Syndrome as a Disorder of Central Nervous System (하지불안증후군이 중추신경계 질환임을 시사하는 임상적, 신경영상학적, 신경생리학적 증거들에 관하여)

  • Jung, Ki-Young
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.98-100
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    • 2008
  • Restless legs syndrome (RLS) is a sensorimotor neurological disorder in which the primary symptom is a compelling urge to move the legs, accompanied by unpleasant and disturbing sensations in the legs. Although pathophysiologic mechanism of RLS is still unclear, several evidences suggest that RLS is related to dysfunction in central nervous system involving brain and spinal cord. L-DOPA, as the precursor of dopamine, as well as dopamine agonists, plays an essential role in the treatment of RLS leading to the assumption of a key role of dopamine function in the pathophysiology of RLS. Patients with RLS have lower levels of dopamine in the substantia nigra and respond to iron administration. Iron, as a cofactor in dopamine production, plays a central role in the etiology of RLS. Functional neuroimaging studies using PET and SPECT support a central striatal D2 receptor abnormality in the pathophysiology of RLS. Functional MRI suggested a central generator of periodic limb movements during sleep (PLMs) in RLS. However, to date, we have no direct evidence of pathogenic mechanisms of RLS.

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A Case of Neonatal Atrial Flutter Treated by Propafenone after Fetal Echocardiographic Diagnosis (태아 심초음파 검사로 진단 된 뒤 출생 후 Propafenone으로 치유된 신생아 심방조동 1례)

  • Lee, Kyung Hwa;Ha, Chang Woo;Kim, Chul Ho;Song, Min Seob;Sung, Moon Su
    • Clinical and Experimental Pediatrics
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    • v.45 no.7
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    • pp.928-932
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    • 2002
  • Perinatal atrial flutter is a potentially lethal arrhythmia. Management of this disorder is difficult and controversial. Fetal atrial flutter is a serious and life threatening rhythm disorder particulary when it causes hydrops; it may be associated with fetal death or neurological damage. Although the initial episode of flutter may be difficult to control, recurrence of atrial flutter after successful resolution of the arrhythmia seems highly unlikely and long-term prognosis is excellent. We experienced a case of a atrial flutter diagnosed in utero at $38^{+6}$ weeks' gestation by fetal cardiac echocardiography. He was treated with maternal digoxin, but he continued to have atrial flutter until delivery. Restoration of sinus rhythm occured with propafenone therapy in this patient after failure of initial digoxin therapy and direct current cardioversion.

Altered Complexin Expression in Psychiatric and Neurological Disorders: Cause or Consequence?

  • Brose, Nils
    • Molecules and Cells
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    • v.25 no.1
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    • pp.7-19
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    • 2008
  • Complexins play a critical role in the control of fast synchronous neurotransmitter release. They operate by binding to trimeric SNARE complexes consisting of the vesicle protein Synaptobrevin and the plasma membrane proteins Syntaxin and SNAP-25, which are key executors of membrane fusion reactions. SNARE complex binding by Complexins is thought to stabilize and clamp the SNARE complex in a highly fusogenic state, thereby providing a pool of readily releasable synaptic vesicles that can be released quickly and synchronously in response to an action potential and the concomitant increase in intra-synaptic $Ca^{2+}$ levels. Genetic elimination of Complexins from mammalian neurons causes a strong reduction in evoked neurotransmitter release, and altered Complexin expression levels with consequent deficits in synaptic transmission were suggested to contribute to the etiology or pathogenesis of schizophrenia, Huntington's disease, depression, bipolar disorder, Parkinson's disease, Alzheimer's disease, traumatic brain injury, Wernicke's encephalopathy, and fetal alcohol syndrome. In the present review I provide a summary of available data on the role of altered Complexin expression in brain diseases. On aggregate, the available information indicates that altered Complexin expression levels are unlikely to have a causal role in the etiology of the disorders that they have been implicated in, but that they may contribute to the corresponding symptoms.

Antidepressant-Induced Somnambulism:A Case of Mirtazapine (항우울제와 몽유병:Mirtazapine에 의한 증례 1례)

  • Chung, Sang-Keun;Oh, Keun-Young;Cho, Kwang-Hyun;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.10 no.2
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    • pp.113-115
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    • 2003
  • Somnambulism is classified as a parasomnia and has been reported with the use of antidepressants and other psychotropics. However, to our knowledge, there have been no reports of somnambulism associated with the use of mirtazapine (a noradrenergic and specific serotonergic antidepressant;NaSSA). We experienced a case of the mirtazapine (30 mg/day)- induced somnambulism in a 65 year-old woman with major depressive disorder who has never been diagnosed as panic disorder, somnambulism, other parasomnias, neurological disorders (including epilepsy), and other medical diseases. The sleepwalking symptoms disappeared after the antidepressant was replaced with paroxetine (20 mg/day).

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A Case of Multiple Sclerosis with Depression (우울증상을 동반한 다발성 경화증 재발 환자의 치험 1례)

  • Heo, Eun-Jung;Kim, Ji-Hyon;Yoon, Chang-Jun;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.217-227
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    • 2009
  • Objectives : Multiple sclerosis (MS) is a demyelination disease of central nervous system, presenting a various neurological disorders depending on the lesion. In the view of oriental medicine, MS is similar to Flaccidity-syndrome(痿證). Also, since MS is a chronic disease which repeats the recurrences with periods of remission of the symptoms in between, it may usually be accompanied by depression. However, the etiology, treatment, and cause of recurrence of MS remain unknown, and also, as the recurrences of MS have been repeated, disease burden has been accumulated, which aggravates disorder. This case of MS experienced depression after the patient had been diagnosed as bad consequence based on the past 5 times recurrences of multiple sclerosis. Methods : We saw the causes as vicera and bowels functional disorder which might have come from a poor diet. Thus, we diagnosed this case as dual deficiency of spleen and kidney(脾腎兩虛), stagnant qi transforming into fire(氣鬱化火) and liver-kidney deficiency(肝腎不足) and treated it with Herb medication, acupuncture therapy, and supportive therapy, making the patient better. Results : We have improved the patient's condition to the time before 5th recurrence. Conclusions : This result suggests that our oriental medical treatments was effective on multiple sclerosis with depression.

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