• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.103-106
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• 2023

Post-acute coronavirus disease (COVID-19) syndrome is defined as persistent symptoms or delayed complications after COVID-19. Several cases of cranial nerve invasion related to COVID-19 have been reported. However, to our knowledge, no cases of solitary unilateral hypoglossal nerve paralysis after mild COVID-19 without intubation have been reported to date. Herein, we report the case of a 64-year-old man with unilateral hypoglossal nerve palsy as a complication of COVID-19. He complained of dysarthria and tongue discomfort 2 weeks after COVID-19 onset. Brain and neck computed tomography, magnetic resonance imaging, ultrasonography, and blood tests ruled out other possible causes. The patient's nerve palsy was rapidly diagnosed and improved with early rehabilitation. Understanding of the pathology of COVID-19 is still limited. Physicians should focus on patients' symptoms and their relationship to COVID-19, and investigate complications immediately. This case highlights the importance of early detection and rehabilitation of post-acute COVID-19 syndrome.

• The Journal of Internal Korean Medicine
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• v.26 no.3
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• pp.670-676
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• 2005

The purpose of this case study is to present a case of oculolmotor nerve palsy due to midbrain infarction improved by acupuncture and herb medicine. Oculomotor nerve palsy is a disorder associated with dysfunction in the third cranial nerve, which causes eye movement disorder, diplopia and ptosis. The patient, who was diagnosed with Benedikt's Syndrome(Red Nucleus Syndrome), was given oriental medical treatment. Benetikt's Syndrome has the various symptoms of weakness on one side(contralateral) and eye movement disorder, ptosis, diplopia(ipsilateral) etc., but research on Benetikt's Syndrome or midbrain infarction is scant. Results of this study suggest a role for conservative therapy with herb medicine and acupuncture to treat oculomotor nerve palsy(eye movement disorder, ptosis, diplopia, etc., ipsilateral) and right motor weakness(contralateral) due to midbrain infarction. Further research into oriental medical treatment for such disorders will be forthcoming.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.199-202
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• 2013

Epiduroscopic laser discectomy and neural decompression (ELND) is known as an effective treatment for intractable lumbar pain and radiating pain which develop after lumbar surgery, as well as for herniation of the intervertebral disk and spinal stenosis. However, various complications occur due to the invasiveness of this procedure and epidural adhesion, and rarely, cranial nerve damage can occur due to increased intracranial pressure. Here, the authors report case in which double vision occurred after epiduroscopic laser discectomy and neural decompression in a patient with failed back surgery syndrome (FBSS).

• The Journal of the Society of Korean Medicine Diagnostics
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• v.9 no.2
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• pp.72-82
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• 2005

Background and purpose: Bell‘s Palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent. The aim of this study is to be convinced of differences between facial electrodermal activities of paralyzed side and those of normal side in acute stage of Bell's Palsy patients Methods: Electrodermal activity (EDA) was performed within 1 week after the onset of facial palsy and facial nerve electromyography (EMG) at 2 weeks after the onset. The recovery of facial nerve function was documented by House and Brackmann grading. All the patients were followed up weekly until recovery or up to 6 weeks. Results: There was significant differences (conductivity A: t=3.319, p=0.002; conductivity C: t=2.699, p=0.010) between facial electrodermal conductivities of paralyzed side and those of normal side in acute stage of Bell's Palsy patients (N=45). And the result showed that logarithmic scale of electrodermal conductivity A value ratio obviousely decreased with logarithmic scale of EMG zygomatic branch amplitude ratio (r=-0.472, p=0.143); logarithmic scale of capacitance B, logarithmic scale of EMG temporal branch amplitude ratio (r=-0.422, p=0.133); logarithmic scale of conductivity C, logarithmic scale of EMG buccal branch amplitude ratio (r=-0.545, p=0.083) (N=12). Conclusion: Electrodermal conductivities increased in paralyzed facial side in acute stage of Bell's Palsy patients.

• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.167-171
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• 2019

$M\ddot{o}bius$ syndrome is a rare congenital condition, characterized by abducens and facial nerve palsy, resulting in limitation of lateral gaze movement and facial diplegia. However, to our knowledge, there have been few studies on evaluation of cranial nerves, on MR imaging in $M\ddot{o}bius$ syndrome. Herein, we describe a rare case of $M\ddot{o}bius$ syndrome representing limitation of lateral gaze, and weakness of facial expression, since the neonatal period. In this case, high-resolution MR imaging played a key role in diagnosing $M\ddot{o}bius$ syndrome, by direct visualization of corresponding cranial nerves abnormalities.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1345-1351
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• 2000

Objective : Around the sellar area, there are many important structures. But, the optimal radiation dosage for minimal toxicity to surrounding neural tissue has not been firmly established. The purpose of this study is to evaluate the radiosurgical outcome of juxtasellar tumors and to investigate the relationship between radiation dosage and toxicity to neural tissue. Method : Between May 1992 and June 2000, we treated 65 juxtasellar tumors by using the Leksell Gamma Knife. Among them, 52 patients who could be followed more than 1 year were included in this study. The radiosurgical dosage to the optic pathway, cavernous sinus, Meckel's cave, hypothalamus, pituitary gland and stalk, and brain stem was analyzed and correlated with clinical outcome. The mean follow-up period was 33.5 months(range 12.2- 99.0 months). Result : The clinical response rate was 69.2%. The volume response rate was 61.0% and the radiologic control rate was 92.7%. There were 4 complications(7.7%) of 2 trigeminal neuropathy, 1 abducens nerve palsy, and 1 trigeminal and transient abducens nerve palsy. The optic apparatus appeared to tolerate doses greater than 10Gy. The risk of cranial nerve complications in cavernous sinus seemed to be related to doses of more than 16Gy. In 3 of 4 patients who received more than 16Gy to cavernous sinus, the abducens or trigeminal neuropathy occurred. Also, one patient who received more than 15Gy to the Meckel's cave, trigeminal neuropathy developed. The hypothalamus, pituitary gland and stalk, and brain stem were relatively tolerable to radiation. Conclusion : Gamma Knife radiosurgery seems to be an effective method to control the growth of juxtasellar tumors. To avoid injury to surrounding important neural tissue, careful dose planning and further study for radiation toxicity to neural tissue were needed.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.126-136
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• 2007

Objectives : Bell's palsy in an acute peripheral facial nerve paralysis that usually affects only one side of the face. The seventh cranial nerve carries predominantly motor fibers, but also supplies some autonomic innervation, sensation to park of the ear, and taste to the anterior two thirds of the tongue. The aim of this study is to provide evidence of differences between facial skin temperature of the paralyzed side and normal side in Bell's palsy patients. Methods : the author studied 68 patients with Bell's palsy whose facial nerve function had been documented by the House-Brackmann grading system. We measured skin temperature of the forehead, zygoma, lower lip, temple and lower jaw area of the paralyzed side and those of the normal side. Results : there were significant facial skin temperature differences between the forehead area of paralyzed side and that of normal side of GrII(P<0.05) and III(P<0.05). The result also showed that the facial skin temperature difference according to the aflection period vanished when air temperature was calibrated (F=1.700, P=0.178). Conclusions : Thermography is a useful diagnostic tool in Bell's palsy if the air temperature is low enough to cool the facial skin temperature and the forehead area is evaluated as the sampling zone.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.25-28
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• 2012

Background: Bell's palsy is the most common disease of cranial nerve. While most electrodiagnostic tests can detect the abnormality of facial nerve several days later in Bell's palsy, blink reflex usually reveals the abnormality earlier than other tests. Therefore, we investigated the diagnostic usefulness of blink reflex in the early stage of Bell's palsy. Methods: We performed a prospective investigation in patients with facial palsy. We enrolled patients with Bell's palsy who were evaluated within 7 days of symptom onset and excluded patients with secondary causes of facial palsy. We analyzed the findings of blink reflex according to age, sex, evaluation time, and severity of facial palsy. Results: Of 320 consecutive patients with facial palsy, a total of 204 patients were enrolled. Blink reflex was normal for 10 patients and abnormal for 194 patients. The time interval between the symptom onset and the evaluation time was not associated with the result of blink reflex, but House-Brackmann grade was significantly related to the result of blink reflex (P<0.001). Patients with mild Bell's palsy often showed normal blink reflex. Conclusions: Our study shows that blink reflex is useful diagnostic test regardless of evaluation timing in the early stage of Bell's palsy, although it could be normal in patients with mild Bell's palsy.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.181-184
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• 2010

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.14 no.1
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• pp.76-86
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• 2001

Herpes zoster oticus which is called Ramsay Hunt syndrome, geniculate ganglion herpes and otic herpes, is characterized by a viral prodrome with otalgia, vesicular eruptions, facial paralysis, hearing disturbance, tinnitus, vertigo and other symtoms. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster oticus, but on rare occasions 8th, 9th, 10th, 11th, 12th cranial nerves and even the upper cervical nerve are influenced as well.. In general, it has poor prognosis compared with Bell's palsy, leaving permanent facial nerve dysfunction. We report a case of Herpes zoster oticus, which was fully recovered by acupuncture and herbal medication within 12 days. We used $FEMA^{11)}$ and House-Brackmann's grading system to assess the degree of paralysis in each part of face.