• 대한후두음성언어의학회지
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• 제21권1호
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• pp.57-60
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• 2010

Spasmodic dysphonia is a focal dystonia of the larynx and breathy voice is a typical sign of abductor spasmodic dysphonia. A group of patients with abductor spasmodic dysphonia have a number of acoustic characteristics including abnormal fundamental frequency fluctuations and abnormally long word duration. We report a abductor spasmodic dysphonia case have enlongated voice onset time voiceless consonants and breathy voice in wide band spectrogram. The patient have the acoustic characteristics only in telephone speaking at work time. We treated the patient with anticholinergic and anticonvulsant drug and supplementary voice therapy. The breathy voice and enlongated VOT were disappeared after those treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.235-238
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• 2019

Corticobasal degeneration (CBD) is a rare neurodegenerative disease characterized by dystonia, cognitive deficits, and an asymmetric akinetic-rigid syndrome. Little information is available regarding anesthetic management for CBD patients. Our patient was a 55-year-old man with CBD complicated by central sleep apnea (CSA). Due to the risk of perioperative breathing instability associated with anesthetic use, a laryngeal mask airway was used during anesthesia with propofol. Spontaneous respiration was stable under general anesthesia. However, respiratory depression occurred following surgery, necessitating insertion of a nasopharyngeal airway. Since no respiratory depression had occurred during maintenance of the airway using the laryngeal mask, we suspected an upper airway obstruction caused by displacement of the tongue due to residual propofol. Residual anesthetics may cause postoperative respiratory depression in patients with CBD. Therefore, continuous postoperative monitoring of $SpO_2$ and preparations to support postoperative ventilation are necessary.

• 생물정신의학
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• 제5권2호
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• pp.248-252
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• 1998

순천향대학 천안병원 신경정신과에 입원하여 항정신병 약물로 치료 받고 있는 78명의 환자 중 약물로 인한 급성 근긴장 이상증이 나타난 41명의 환자들을 대상군으로 하고 급성 근긴장 이상증이 나타나지 않은 37명의 환자를 대조군으로 하여 약물 투여전과 투여후 혈청 철의 농도를 측정하여 급성 근긴장 이상증과 혈청 철 농도와의 상관관계를 연구하여 다음과 같은 결과를 얻었다. 대상군에서 항정신병 약물을 투여하기 전 혈청 철의 농도는 $104.8{\pm}30.8{\mu}g/dl$, 항정신병 약물에 의한 급성 근긴장 이상증이 발생한 후 혈청 철의 농도는 $87.2{\pm}21.2{\mu}g/dl$이었으며 양 군간에 통게적으로 유의한 차이가 있었다. 대조군의 경우 항정신병 약물을 투여하기 전 혈청 철의 농도는 $92.5{\pm}34.5{\mu}g/dl$, 항정신병약물을 투여한 후 혈청 철의 농도는 $88.3{\pm}35.3{\mu}g/dl$이었으며 양군간에 통계적으로 유의한 차이가 없었다. 이상의 결과는 항정신병 약물을 투여하면 일부의 환자에서는 혈청 철의 농도를 감소시키고, 결국 정상적으로 철을 포함하고 있는 도파민 $D_2$ 수용체의 기능이 저하되어 급성 근긴장 이상증의 발생에 취약하게 된다는 것을 뒷받침 해 주는 소견이다.

• Annals of Clinical Neurophysiology
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• 제13권1호
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• pp.1-12
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• 2011

Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

• 대한후두음성언어의학회지
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• 제23권2호
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• pp.99-103
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• 2012

Spasmodic dysphonia is a chronic, focal, movement-induced, action-specific dystonia of the laryngeal musculature during speech. It can have a profound effect on quality of life, severely limiting people's communication, especially via telephone and in noisy backgrounds. Spasmodic dysphonia (SD) is usually of the adductor type characterized by glottic contractions causing tightness and voice breaks with forced-strangled voice, but it may also be abductor type or, much less commonly, mixed. Treatment options for adductor spasmodic dysphonia (ADSD) include voice therapy, surgical procedures, and botulinum toxin injections (Botox). The use of Botox injected into the laryngeal muscles remains the "gold standard" treatment for reducing the vocal symptoms of ADSD and Botox induces a temporary paresis of the laryngeal muscles and provides short-term relief of symptoms. Repeated injections of the laryngeal muscles, generally every 3-4 months, are required for continuous relief of symptoms. Improvement in vocal function has been reported after use of Botox injections, though a completely normal voice is rarely achieved. In this hospital, 1,030 patients have been enrolled for Botox injection therapy so far (May, 2012). In this review article, I'd like to present my personal experience of management of spasmodic dysphonia mainly by Botox injection.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.132-135
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• 2019

Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.

• 대한약침학회지
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• 제5권2호
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• pp.71-75
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• 2002

Objective : This study was performed to evaluate the treatment of acupuncture therapy including Herbal Acupuncture in Tardive Dyskinesia. Methods & Result : We treated 1 case of Tardive Dyskinesia patient with Acupuncture and herbal Acupuncture, herbal medicine. Acupuncture therapy was taken on acupoints including CV12 (Chungwan:中脘), ST40 (Pungnyung:豊隆), SP3 (Taeback:太白). As the results of this treatments, little change of tongue motion was observed, but general conditions of the patient was improved. Conclusions : Oriental medical treatments was little effective in this disease, but general conditions of the patient was improved. We think that it need the further study and clinical trial for Tardive Dyskinesia.

• 대한한방소아과학회지
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• 제18권2호
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• pp.143-160
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• 2004

Objective: There were few reports on the treatment of Hypoxic ischemic encephalopathy. We treated a hypoxic ischemic encephalopathic patient after accident with Oriental medical approach, and get a significant result. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy, So we are reporting that case. Method : The acupuncture, herb medication. rehabilitation therapy was applied for treting patient's chife symptom(involuntary movement, dystonia, aphasia, dysuria, constipation) Results : 1. Generally patients with Hypoxic ischemic encephalopathy show language impairment and cognition disorder for several weeks to months. After coma stage, first they recover consciousness but have various degree of confusional mentality, visual agnosia, extrapyramidal stiffness and motor disturbance. 2. Consciousness loss in acute stage of Hypoxic ischemic encephalopathy can be considered as Mental Confusion due to Phlegm(Dammisimgyu) in veiw point of Oriental medicine. 3. After oriental medical treatment, patient's chief symptoms were improved. Conclusion: We treated a hypoxic ischemic encephalopathic patient with Oriental medical approach and patient's chief symptoms were improved. this treatment shows the possibility of healing Hypoxic ischemic encephalopathy.

• 대한정형도수물리치료학회지
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• 제19권1호
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• pp.79-83
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• 2013

Background: Spasmodic torticollis is a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. The purpose of this case is to describe the manual therapy for a patient with spasmodic torticollis. Methods: The patient was a 64 years old man with an 3 month history of left side laterocollis spasmodic torticollis. No known genetic history or trauma. Prior to intervention, his score on the Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score was 24, disability score was 20, pain score was 11. There is a noticeable distinction between left and right side cervical range of motion. The intervention consisted of manual therapy (MET, PNF) 3 times per week for the treatment during 4 weeks. Results: After intervention for 4weeks, his TWSTRS score and range of motion was improved quite a bit before therapeutic exercise. But symptoms are not improving sufficiently fast. Conclusions: Manual therapy is that MET and PNF is effective in improving for patient had spasmodic torticollis with laterocollis of neck.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.