• Title/Summary/Keyword: Neurological symptoms

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The Effect of Adding Kami-guibi-tang to Acetylcholinesterase Inhibitor Treatment on the Cognitive Function of Mild Alzheimer's Disease Patients: Study Protocol of a Randomized, Placebo-Controlled, Double-Blind Pilot Trial

  • Yang, Seung-bo;Kim, Ha-ri;Shin, Hee-yeon;Kim, Jeong-hwa;Lee, Chang-woo;Jahng, Geon-ho;Park, Seong-uk;Ko, Chang-nam;Park, Jung-mi
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.326-338
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    • 2020
  • Background: Alzheimer's disease (AD) is a chronic neurodegenerative disease that causes disorientation, mood swings, problems with language, and difficulty remembering recent events. Acetylcholinesterase inhibitors (AchEIs) and memantine have been used to slow the course of the disease, but they can neither modify its progression nor prevent disease onset. Previous studies have suggested that Kami-guibi-tang (KGT) could be beneficial for supporting cognitive function in AD patients, but few clinical trials have been published. This pilot study aimed to evaluate the effect of KGT in improving cognitive function in AD patients. Methods: The study will be a randomized, placebo-controlled, double-blind, single-center trial conducted using subjects diagnosed with mild AD by neurologists. Study subjects will be randomly assigned to either a treatment or control group. The treatment group will receive KGT granules for 24 weeks, while the control group will receive placebo granules. AchEI administration will be maintained in both groups during the entirety of the study. Subjects will be assessed using the following exams: the Seoul Neuropsychologic Screening Battery (SNSB) for cognitive function; brain magnetic resonance imaging (MRI) for brain metabolite, neurotransmitter, and cerebral blood flow (CBF) measurements; the Korean version of Quality of Life-Alzheimer's Disease (KQol-AD) for quality of life; the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI) for neurobehavioral symptoms; blood tests for amyloid and tau proteins and general blood parameters; and electrocardiography (ECG) before and after taking the medication. Discussion: Our findings will provide insight into the feasibility of large-scale trials to consolidate evidence for the efficacy of KGT for dementia treatment. Registration ID in CRIS: KCT0002904 (Clinical Research Information Service of the Republic of Korea).

Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status (의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성)

  • Rok Lee;Tae Yong Shin;Hyung Jun Moon;Hyun Jung Lee;Dongkil Jeong;Dongwook Lee;Sun In Hong;Hyun Joon Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.135-142
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    • 2023
  • Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

A case study on Gak-gi-byung that is similar to beriberi Disease (각기병(脚氣病) 1례에 대한 증례보고)

  • Bae, Jung-Kyu;Ahn, Taek-Won
    • Journal of Haehwa Medicine
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    • v.16 no.1
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    • pp.191-197
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    • 2007
  • Gak-gi-byung in Korean Medicine have many things in common with Beriberi disease, Guillain-Barre syndrome, Transverse myelitis and Cauda equina syndrome. Dong-Ui-Bo-Gam define Gak-gi-byung as syndrome that includes sudden lower limbs weakness, pain and edema. Gak-gi-byung start from the foregoing symptoms and could progress to general digestive, neurological or respiratory symptoms is found on many medical practitioners. In this case, we described a 60-years old man diagnosed as Gak-gi-byung in Korean Medicine. He complained Rt lower limb weakness, Rt Knee Clumsiness and limitation of his Rt knee & ankle motor. And his condition was improved through Korean Medical treatment such as acupuncture and herbal medicine like 'Chung-yul-sa-seup-tang' about 15 days.

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Cervical Disc Herniation as a Cause of Brown-S$\acute{e}$quard Syndrome

  • Choi, Kyeong-Bo;Lee, Choon-Dae;Chung, Dai-Jin;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.505-510
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    • 2009
  • The possible causes of Brown-S$\acute{e}$quard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and sensory deficits. On the basis of our cases, it is important to diagnose it early by cervical magnetic resonance imaging, especially in the absence of the typical symptoms of cervical disc herniation or other obvious etiology of extremity numbness. Immediate surgical treatment is also essential for a favorable functional neurological recovery.

Spontaneous Spinal Epidural Hematoma in an Infant : A Case Report and Review of the Literature

  • Lim, Jae-Joon;Yoon, Soo-Han;Cho, Ki-Hong;Kim, Sang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.84-87
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    • 2008
  • Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

Asymptomatic maternal 3-methylcrotonylglycinuria detected by her unaffected baby's neonatal screening test

  • Lee, Sun Hee;Hong, Yong Hee
    • Clinical and Experimental Pediatrics
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    • v.57 no.7
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    • pp.329-332
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    • 2014
  • 3-methylcrotonyl-coenzyme A carboxylase (3MCC) deficiency is an autosomal recessive disorder in which leucine catabolism is hampered, leading to increased urinary excretion of 3-methylcrotonylglycine. In addition, 3-hydroxyisovalerylcarnitine levels increase in the blood, and the elevated levels form the basis of neonatal screening. 3MCC deficiency symptoms are variable, ranging from neonatal onset with severe neurological abnormality to a normal, asymptomatic phenotype. Although 3MCC deficiency was previously considered to be rare, it has been found to be one of the most common metabolic disorders in newborns after the neonatal screening test using tandem mass spectrometry was introduced. Additionally, asymptomatic 3MCC deficient mothers have been identified due to abnormal results of unaffected baby's neonatal screening test. Some of the 3MCC-deficient mothers show symptoms such as fatigue, myopathy, or metabolic crisis with febrile illnesses. In the current study, we identified an asymptomatic 3MCC deficient mother when she showed abnormal results during a neonatal screening test of a healthy infant.

A Case Report of Neuro-Behcet's Disease with Paraparesis (하지부전마비를 동반한 Neuro-Behcet 병 1례 보고)

  • 김호준;이종립;신현대
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.286-291
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    • 2000
  • Behcet's disease is a systemic disease affecting multiple organs including the central nervous system. Neuro-Behcet's disease was regarded as relatively rare, but thanks to the development of diagnostic tools, more and more cases are being reported. We are reporting a case of neuro-Behcet's disease in which the patient displayed paraparesis, dysarthria and involuntary tremor as neurologic symptoms. The patient's brain MRI showed cerebellar atrophy, and a spinal cord MRI failed to reveal any significant lesions. The patient experienced a couple of fever attacks during hospitalization, which were managed adequately by herbal medicines. Her main neurological symptoms such as paraparesis were, however, grossly unchanged at discharge.

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Radiculopathy Caused by Internal Iliac Artery Pseudoaneurysm Managed with Endovascular Embolization

  • Choi, Il;Im, Soo-Bin;Kim, Bum-Tae;Shin, Won-Han
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.484-486
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    • 2007
  • The authors describe a case of pseudoaneurysm arising from internal iliac artery presented with radiculopathy mimicking the symptoms of lumbar disc disease or spinal cord tumor. Among the several preoperative evaluation including CT, MRI, electrophysiologic study and ultrasonography, important diagnostic clue was obtained by ultrasonographic findings of turbulence flow at the core of partially enhanced mass in the pelvic cavity. The patient was managed with endovascular coil embolization successfully. The current case makes us remind that assessment of neurological symptoms on lower extremity should include consideration of extraspinal cause in pelvis.

Brown Sequard Syndrome Resulting from Cervical Disc Herniation Treated by Anterior Foraminotomy

  • Kim, Yeon-Seong;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.136-140
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    • 2005
  • The authors describe two cases of Brown-Sequard syndrome associated with cervical disc herniation. In both cases, magnetic resonance images of the cervical spine showed a large paramedian disc herniation at C5-C6 with ipsilateral severe spinal cord compression. Microsurgical removal of the herniated disc via anterior foraminotomy was performed and complete decompression of the spinal cord was achieved. Postoperatively, the neurological symptoms recovered rapidly and both patients experienced a complete remission of their symptoms. Although Brown-Sequard syndrome is rarely associated with degenerative cervical spine disease, cervical disc herniation should be kept in mind and prompt evaluations are mandatory. To the best of our knowledge, these are the first reported case of Brown-Sequard syndrome produced by cervical disc herniation which was treated by anterior foraminotomy.

Surgical treatment of primary heart tumor -Report of 22 cases- (원발성 심장 종양의 수술적 치료)

  • 강면식
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.116-122
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    • 1989
  • During 22-year period ending in June 1988, operation was performed on 22 patients with primary heart tumor at Yonsei University College of Medicine. Mean age was 38.8*3.03[mean \ulcornerEM] ranging from 14 to 63 years old. Twenty cases were myxomas. Others were fibromyxoma and rhabdomyosarcoma. All patients complained of dyspnea on exertion. Nine cases had palpitation. Other constitutional symptoms were weight loss [7 cases], headache [4 cases], generalized edema [3 cases] and cough [3 cases]. Five cases had neurological symptoms and signs preoperatively. Preoperative NYHA Class was poor [Class II; 8 cases, III; 9 cases and IV; 5 cases]. The most common site of tumor origin was fossa ovalis limbus [16 cases; 72.8%]. Because of severe mitral regurgitation and of recurrent myxoma, 2 cases were reoperated for mitral valve replacement. Postoperative complications were postoperative mitral regurgitation [5 cases; 22.8%] and arrhythmia [4 cases; 18.2%], one of which was supra-His bundle block. All patient survived operation. Follow-up of 15 patients [mean 28.95*8.3 months] was good as functional class 1[8 cases] or II [7 cases]. More effective adjuvant therapy will be necessary to improve long-term prognosis for malignant primary heart tumor.

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