• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.278-284
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• 2022

Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.221-227
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• 2001

Objective : The therapeutic impact of tumor resection in glioblastomas is poorly defined and still questionable. Therefore, we conducted the current study to verify the role of tumor resection in the treatment of these highly malignant tumors. Methods : A retrospective study was performed(1990-1999) to compare the treatment results of surgical resection plus radiotherapy(130 patients) with those of stereotactic biopsy plus radiotherapy(19 patients) in glioblastomas. Only adult patients with supratentorial, de novo glioblastoma located in one lobe were included. Survival time/rate was analysed with Kaplan-Meier method, and prognostic variables were obtained from the univariate log-rank test and the multivariate Cox's proportional hazards model. Results : The resection group and the biopsy group did not differ in terms of age, gender, duration of symptoms, presenting symptoms, tumor location, tumor side, tumor size, and the frequency of midline shift. Patients in the biopsy group more often were found to have worse preoperative Karnofsky performance status(KPS)(p=0.001). On univariate analysis, age, KPS, and tumor side were associated with survival(p=0.0053, 0.0001, and 0.0331 respectively). Median survival time and 1-year survival rate were also statistically improved by tumor resection ; resection group - 13 months and 61.2%, and biopsy group - 8 months and 19.7%, respectively(p=0.0001). In patients with midline shift of the tumor, resection was highly effective comparing to biopsy(p=0.0001), but in patients without midline shift, external beam radiation alone was as effective as tumor resection(p=0.0605). Other prognostic variables did not affect survival. On multivariate analysis after variable selection, survival was independently associated with KPS(p=0.001), but not the surgical resection(p=0.2837). Even in biopsy group with midline shift of the tumor, survival rate was not different from that seen after tumor resection(p=0.3505). Conclusions : Radiotherapy alone was as effective as tumor resection plus radiotherapy in patients without midline shift of the tumor. Although there was not statistically significant, tumor resection looked like effective in patients with midline shift. For supratentorial, lobar glioblastoma patients without mass effect of the tumor, biopsy with radiotherapy is one of rational treatment strategies. We consider that tumor resection should be performed in patients with pretreatment midline shift.

• 대한유전성대사질환학회지
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• 제22권1호
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• pp.15-20
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• 2022

The most common urea cycle disorder is ornithine transcarbamylase deficiency. More than 80 percent of patients with symptomatic ornithine transcarbamylase deficiency are late-onset, which can present various phenotypes from infancy to adulthood. With no regards to the severity of the disease, characteristic fluctuating courses due to hyperammonemia may develop unexpectedly, and can be precipitated by various metabolic stressors. Late-onset ornithine transcarbamylase deficiency is not merely related to a type of genetic variation, but also to the complex relationship between genetic and environmental factors that result in hyperammonemia; therefore, it is difficult to predict the prevalence of neurological symptoms in late-onset ornithine transcarbamylase deficiency. Most common acute neurological manifestations include psychological changes, seizures, cerebral edema, and death; subacute neurological manifestations include developmental delays, learning disabilities, intellectual disabilities, attention-deficit/hyperactivity disorder, executive function deficits, and emotional and behavioral problems. This review aims to increase awareness of late-onset ornithine transcarbamylase deficiency, allowing for an efficient use of biochemical and genetic tests available for diagnosis, ultimately leading to earlier treatment of patients.

• 대한핵의학회지
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• 제32권6호
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• pp.534-541
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• 1998

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with $^{18}F$-fluorodeoxyglucose revealed severe hypometabolisrn in the cerebellum, in accordance with cerebellar symptoms and signs of the patient. However, single-photon emission tomography with $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.

• 대한골관절종양학회지
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• 제5권1호
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• pp.76-81
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• 1999

Aneurysmal bone cysts are uncommon bony lesions of the spine. Approximately 3-20% of the aneurysmal bone cysts occur in the spine, predominantly in the lumbar region, but they may occur at the any level of the spine. These lesions commonly arise from the neural arch and occasionally invade the pedicle and the vertebral body. The clinical diagnosis of a spinal lesion can be very difficult in the early stages of the disease because specific symptoms and signs are usually absent or only amount to back pain. However, depending on the level of involvement and the extent of neurological compression, a wide variety of neurological symptoms and signs may appear, ranging from mild radicular symptoms to complete paraplegia or tetraplegia. Available treatment options include complete excision or curettage of the lesion with bone graft, but where excision cannot be achieved, low dose radiation or arterial embolization may be used. We report a case of aneurysmal bone cyst in the pedicle of the T10 spine with nonstructural scoliosis of $40^{\circ}$ Cobb's angle which was treated successfully with only curettage of the lesion.

• Annals of Clinical Neurophysiology
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• 제24권2호
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• pp.93-97
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• 2022

Posterior reversible encephalopathy syndrome (PRES) is a rare condition manifested by inflammation in certain areas of the brain. Rhabdomyolysis with acute kidney injury (AKI) complicated by PRES is rarely reported. A 26-year-old female presented with neurological symptoms, high blood pressure, and AKI. Her symptoms improved with blood pressure control, anticonvulsant drug medications, and renal replacement therapy. This case demonstrates that PRES should be considered in the differential diagnosis of patients who have rhabdomyolysis with AKI accompanied by neurological symptoms, including headaches and convulsions.

• Safety and Health at Work
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• 제11권2호
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• pp.173-177
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• 2020

Background: Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome). Methods: We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity. Results: The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called "brain fog", was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively. Conclusion: The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

• 한국전문물리치료학회지
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• 제5권1호
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• pp.51-62
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• 1998

Conversion disorder is defined as a specific and enduring sensorimotor dysfunction that contradicts known neurological or musculoskeletal pathology or physical findings. The patient with conversion symptoms unconsciously adopts these symptoms to convert their psychological stress to a physical phenomenon. Conversion disorder often involves the mimicry of organic symptoms similar to those experienced by a relative or an acquaintance. Because conversion symptoms are produced by psychological stress, specific treatment strategy and reinforcement program are needed for treatment. Treatment comprises avoiding unnecessary medical tests and removing symptoms by using graded exercises given by physical therapists. Clinical therapists must maintain a continuous and detailed follow-up to completely recover from conversion symptoms. The goal of treatment is to emphasize health rather than disease, to resolve physical symptoms, and to prevent recurrence. This study looks into the case reports of 4 patients diagnosed with conversion disorder.

• 동의신경정신과학회지
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• 제12궈1호
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• pp.219-229
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• 2001

The brainstem include midbrain, pons & medulla. In acute stage of brainstem infarction, neurologic symptoms may be progressive. So we must pay special attention to Wallenberg's syndrome. In other words, Wallenberg's syndrome is dorsolateral medullary syndrome. A-54-years-old woman was admitted because of vertigo, ataxia & somatic sensory loss of left face and right half-body. Brain MRI showed high SI in T2W, low SI in T1W lesion left medullary infarction. We diagnosed the case as Shin-heo type Oriental medically and prescribed Gihwangemjakamibang. Diabetes mellitus was found out. So We have controlled diabetes mellitus by Occidental medical therapy. In the end, The symptoms of the patient became better. We know that cooperative(oriental & occidental) medical therapy is better than one medical therapy.Here we present one case of Wallenberg's syndrome who was admitted at Kunpo Wonkwang University Hospital Oriental Neuropsychiatry from 14th March to 6th April. 2001.

• Annals of Clinical Neurophysiology
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• 제21권1호
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• pp.1-6
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• 2019

Anhidrosis refers to the condition in which the body does not respond appropriately to thermal stimuli by sweating. Sweating plays an important role in maintaining the body temperature, and its absence should not be overlooked since an elevated body temperature can cause various symptoms, even leading to death when uncontrolled. The various neurological disorders that can induce anhidrosis make a detailed neurological evaluation essential. The medication history of the patient should also be checked because anhidrosis can be caused by various drugs. The tests available for evaluating sweating include the quantitative sudomotor axon reflex sweat test, thermoregulatory sweat test, sympathetic skin response, and electrochemical skin conductance. Pathological findings can also be checked directly in a skin biopsy. This review discusses the differential diagnosis and evaluation of anhidrosis.