• 생물정신의학
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• 제4권1호
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• pp.108-115
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• 1997

The alcoholic neuropathies developed in approximately 34% of chronic alcoholics and the sexual dysfunction had been experienced in 8-54% of male alcoholics(Schiavi 1990). The aims of this study were to identify the prevalence of subclinical polyneuropathies and sexual disorders in alcohol dependence, and to evaluate the association between them. The nerve conduction velocity(NCV), electromyography(EMG), and pudendal somatosensory evoked potentials(SEPs) were tested for the male alcoholics(N=34) and controls(N=17 for NCV & EMG, N=25 for pudendal SEPs). The pudendal SEPs were measured by the following procedures, in which we stimulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity, three times of threshold : stimulus rate, 1-4.7Hz : stimulus duration, 0.1 or 0.2msec), and recorded at the scalp(active electrode, 2cm behind Cz : reference electrode, Fz). The NCV and EMG detected signs of peripheral neuropathies in 79.4% of alcoholics. Among the alcoholics, 64.7% were abnormal on the pudendal SEPs. Among the alcoholics who revealed abnormality on EMG and NCV, 81.4% were abnormal on the pudendal SEPs, in which 51.9% were not responded. The P1 latencies of pudendal SEPs on neuropathic alcoholics were significantly delayed(p<0.05) than non-neuropathic alcoholics. There was a relative correlation between peripheral neuropathies and sexual disorders in the alcoholics. The prevalence of subclinical neuropathies and sexual disorders seemed to be much higher in alcohol dependence than expectation, and these two problems were relatively correlated, and our results suggested that the peripheral polyneuropathies were one of the prerequisites of sexual disorders.

• 대한신경과학회지
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• 제36권4호
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• pp.329-332
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• 2018

Immune checkpoint inhibitor is associated with variety of immune-related adverse events. We present a case of polyneuropathy induced by immune checkpoint inhibitor, which was refractory to steroid and immunoglobulin. While high-dose steroid and immunoglobulin were not effective, we tried rituximab which is effective in other immune-mediated polyneuropathy. After rituximab treatment, patient's clinical symptom and nerve conduction study finding was markedly improved. We suggest rituximab might be effective in polyneuropathy induced by immune checkpoint inhibitor.

• Journal of Medicine and Life Science
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• 제21권1호
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• pp.11-14
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• 2024

Excess of pyridoxine, in contrast to other nutrients, may result in neuropathy. Case reports are sparse, and little is known about the clinical and electrophysiological findings. Eight patients with pyridoxine-induced neuropathy were investigated, and a review of the literature was undertaken. Nerve conduction studies showed axonal sensory or sensorimotor polyneuropathy. And the blood levels of vitamin B6 were markedly elevated. After discontinuation of vitamin supplements, all patients showed no significant improvement in clinical and electrophysiological findings. Supplementation with pyridoxine at doses greater than 50 mg/day for extended durations may be harmful and should be discouraged.

• Annals of Clinical Neurophysiology
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• 제15권1호
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• pp.13-18
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• 2013

It was sometimes difficult to differentiate between acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) and subacute inflammatory demyelinating polyneuropathy (SIDP). The CNS involvement of these polyneuropathies has rarely reported in the literature. We present the case of a 42-year-old man who developed rapidly developing inflammatory demyelinating polyneuropathy followed by right optic neuritis. This case showed progressive motor weakness and sensory dysfunction with time to nadir at 8 weeks, demyelination in nerve conduction study, no other etiology of neuropathy, no relapse during follow-up of 18 months, good response to steroid and complete recovery which favor SIDP more than A-CIDP. We experienced the case of SIDP associated with optic neuritis.

• 한국동물학회지
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• 제33권4호
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• pp.454-460
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• 1990

Acrylamide의 신경독성에 대해 조사하기 위하여 초기운동실조증이 유도된 생쥐의 신경계에 대한 Acrylamide의 영향을 관찰한 결과, 중추 및 말초신경조직에 있어서의 손상이 보여 척수의 전반적 공포현상, 신경원 및 신경교의 세포손상 그리고 말초신경섬유의 퇴행현상들이 보였다. 또한 이들에 대한 미세구조적 관찰에 의하여 신경원에서의 비정상적 미토콘드리아 및 척수전근 섬유에서의 수초의 균혈화 현상등이 야기됨을 알았으며 좌골신경에서의 수초의 부분적 붕괴 및 축삭형질내의 퇴행현상들도 보였다. 위와 같은 실험결과는 Acrylamide로 인한 중독의 영향이 말초신경장애의 증상으로 나타나나 최초의 신경독성효과는 중추 및 말초신경계에 대해 거의 유사한 시기에 작용함을 시사한다.

• 대한한의학회지
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• 제24권4호
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• pp.139-148
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• 2003

Objectives : Polyneuropathies are diseases of multiple peripheral nerves. They are usually characterized by symmetrical, bilateral distal motor and sensory impairment with a graded increase in severity distally. It is generally regarded that the natural courses are poor, so we wanted to study the effects of Oriental medical treatment on a patient with polyneuropathy. Methods : We treated by conservative Oriental medical treatment a woman of 68 years who was diagnosed as a polyneuropathy and was hospitalized at Seoul Oriental Hospital, Kyungwon University, from 12th Mar. to 31st May, 2003. Changes of functional disability were checked by Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS), muscle atrophy was checked by measuring circumference of the thighs, calves, arms, and sensory impairment was checked by a sensory test. Results : 1. Functional disability caused by motor impairment was reduced after the Oriental medical treatment 2. Muscle atrophy was reduced after the Oriental medical treatment 3. Sensory impairment was reduced after the Oriental medical treatment Conclusion : We treated a patient who was diagnosed with polyneuropathy for over 80 days and recorded good effects of Oriental medical treatment on polyneuropathy.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.36-39
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• 2006

Background: Floppy infant syndrome has a number of different etiologies. Methods: One hundred twenty-three consecutive patients of floppy infant syndrome were included in this study. We reviewed all the electrophysiologic tests of these patients and the medical record of patients showing abnormalities in the electrophysiologic studies. Results: Of the 123 patients, twenty-six (21.1%) showed definite abnormalities in electrophysiologic tests; 8 myopathies, 14 neuropathies and 4 unclassified. The neuropathy was further classified as 5 neuronopathies and 9 sensorimotor polyneuropathies. With muscle or sural nerve biopsy and genetic test, a final diagnosis was made of Duchenne muscular dystrophy in 4, Becker muscular dystrophy in 1, spinal muscular atrophy in 2, and metachromatic leukodystrophy in 1. Conclusions: About 21% of patients presented with floppy infant syndrome showed abnormalities in the neuromuscular system. The electrophysiologic test is valuable to guide further investigations in diagnosing the cause of floppy infant syndrome.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.20-25
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• 2004

Background and Objectives: The proximal and distal nerve segments are preferentially involved in acquired demyelinating polyneuropathies (ADP). This study was undertaken in order to assess the usefulness of motor evoked potential (MEP) and somatosensory evoked potential (SSEP) in the detection of the proximal nerve lesion in ADP. Methods: MEP, SSEP and conventional NCS were performed in 6 consecutive patients with ADP (3 AIDP, 3 CIDP). MEP was recorded from abductor pollicis brevis and abductor hallucis using magnetic stimulation of the cortex and the cervical/lumbar spinal roots. SSEP were elicited by stimulating the median and posterior tibial nerves. Latency from cortex and cervical/lumbar roots, central motor conduction time (CMCT), EN1-CN2 interpeak latency were measured for comparison. Results: MEP was recorded in 24 limbs (12 upper and 12 lower limbs) and SSEP in 24 limbs (12 median nerve, 12 posterior tibial nerve). F-wave latency was prolonged in 25 motor nerves (25/34, 73.5%). Prolonged CML and PML were found in 41.7% (10/24) and 45.8% (11/24), respectively. Interside difference (ISD) of CMCT was abnormally increased in the upper extremity, 66.7% (4/6 pairs) in case of CML-PML. EN1-CN2 interpeak latency was abnormally prolonged in one median nerve (1/10) and LN1-P1 interpeak latency was normal in all posterior tibial nerves. Conclusions: MEP and SSEP may provide useful information for the proximal nerve and root lesion in ADP. MEP and SSEP is supplemental examination as well as complementary to conventional NCS.

• 한국콘텐츠학회논문지
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• 제10권10호
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• pp.237-245
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• 2010

신경전도검사는 당뇨병성다발신경병증 및 당뇨병의 불현성 신경병증환자를 진단하기위한 중요한 검사이며 신경의 기능을 정량적으로 측정할 수 있는 검사기법이다. 본 연구에서는 당뇨병성다발신경병증 환자에서 보이는 전기생리학적 특징을 평가하기위하여 당뇨병성다발신경병증으로 진단된 120명과 정상대조군 77명의 운동신경전도검사의 결과를 비교?분석하였다. 상지와 하지의 각 운동신경에서 정상기준치에 대해 비정상 값을 보인 비율의 특징을 신경전도속도, 말단잠복기, 복합근육활동전위의 진폭, No potential의 빈도, 전도차단의 항목으로 나누어 분석하였다. 당뇨병성다발신경병증은 상지에 비해 하지를 더욱 침범하는 전신성 탈수초성 말초다발신경병증의 전기생리학적 특징이 관찰되었고, 특히 비골신경에서 비정상의 정도가 심한 것으로 분석되었다. 하지만 전도차단의 특징은 대조군에 비하여 유의한 차이가 없는 것으로 나타났다. 운동신경전도검사의 결과를 분석하여 당뇨병성다발신경병증의 전기생리학적 특징을 분석한 본 연구의 결과 하지의 비골신경이 중요한 지표가 될 수 있음이 확인되었고, 이는 당뇨병성다발신경병증의 중요한 전기생리학적 소견으로 사료된다.

• Journal of Hospice and Palliative Care
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• 제20권3호
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• pp.159-166
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• 2017

항레트로바이러스제 치료의 확립, 조기치료로 HIV 감염인들의 바이러스의 조절과 면역저하의 개선이 이루어지고 있다. 다수의 환자들이 더 이상 에이즈 관련 합병증으로 사망하지 않고, 심혈관질환, 대사성질환, 간질환, 신장질환, 신경계질환과 같은 만성합병질환을 갖고 고령화되고 있다. 그러나 지금도 여전히 사회적 차별과 낙인이 존재하는 가운데 후기 발현자로 후천면역결핍증 상태로 방문하여 사망하거나 중증의 신경계합병증으로 장애를 갖는 환자들이 있다. 환자의 다양한 증상들에 대해 이른 시기부터의 완화의료적 접근이 필요하다. 원위 대칭성 감각 다발신경병증 등의 환자의 만성 통증은 저평가되어 왔고 이에 대한 적극적인 통증 중재가 필요하다. 이전 호스피스 기준은 현재 시점에서 새롭게 제시한다. 감염인의 약제 지속 등의 의학적 필요, 심리적 상태, 사회적 여건에 대한 이해가 필요하다. 표준주의 감염관리 원칙을 준수한다면 만성질환으로서의 보편적 호스피스 진료의 제공이 가능하겠다. 생의 말기 빠르고 적극적인 호스피스팀의 개입을 통해 환자들이 존엄하게 삶을 마무리하실 수 있도록 임상경험이 늘어나고, 제도가 마련되길 바란다.