• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.105-111
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• 2005

Objective: Tremor, either essential tremor or Parkinsonian tremor, has been effectively and safely treated by lesioning the ventral intermediate(Vim) nucleus of the thalamus with or without mircroelectrode recording. The authors evaluate the treatment outcome of sixteen tremor patients who had been treated with thalamotomy without microelectrode. Methods: Between September, 2001, and December, 2003, sixteen tremor patients were treated with thalamotomy without microelectrode recording. Twelve patients suffered from Parkinsonian tremor and four patients were essential tremor patients. The male to female ratio was 1.6 to 1 with median age of 59.6 years (range; 39-74 years). Under local anesthesia, a 3mm hole was made using a hand-held twist drill, and the dura mater was penetrated with a 1.2mm sharp drill beat. Radiofrequency(RF) electrode was placed in the Vim nucleus of thalamus. With intraoperative macrostimulation, RF lesion was made. Postoperative CT scan and/or MR imaging was performed to confirm the localization of the target lesioned. Preoperative and postoperative tremor was evaluated with simple tremor severity scale and the development of complications related with the procedure was closely reviewed at the immediate postoperative period and the last follow-up. Results: It produces immediate relief in up to 98.4% of the patients. There were no development of complications related with procedure, all patients discharged one or two days after surgery. Conclusion: Vim thalamotomy without microelectrode recording is a safe and effective procedure to control the tremor with minimal morbidity. Intraoperative macroelectrode stimulation safely localizes the Vim nucleus target of the thalamus for the treatment of patients with tremor.

• 혜화의학회지
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• 제10권1호
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• pp.437-451
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• 2001

The clinical study was carried out the 30 patients with tremor who were treated in Daejeon University Oriental Hospital from 1 April 1997 to 31 March 2001. The results were summarized as follows. 1. The ratio of female was higher, especially in the psychosomatic tremor, the ratio of female was higher and in the age distribution the aged over 50 were higher frequence. 2. The case without past history was most, the most ordinary preceding disease was hypertention and the next was diabetes, drinking history had no concern with tremor, first visit was most, in the psychosomatic tremor complication by relation was the most inducing factor and both parkinson tremor and essential tremor were no inducing factor. 3. Tremor appeared to be busy in extremities, parkinson tremor appeared to be accompanied with musculoskeletal system symptoms and they were in descending order lower limb weakness, extremities numbness, general body weakness e.t.c. both essential tremor and psychosomatic tremor appeared to be accompanied with psychosomatic symptoms and they were in descending order dizziness, headache e.t.c. 4. In classification of Four Human coporeal constitution the number of patients, Tae-Eum-In(太陰人) was most, the prescription drugs of tranquillizing the liver and relieving anxiety such as GYEJIYONGGOLMORYETANG(桂枝加龍骨牡蠣湯) and nourishing Yin, blood and relieving anxiety such as SAMULANSINTANG(四物安神湯) were used to be busy. 5. The rate of treatment was collectively improved and was higher in the yaung age than in the old age, the period of the clinical history was the shorter within one month, the rate of improvement was the better.

• 대한한방내과학회지
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• 제39권5호
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• pp.984-993
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• 2018

Objectives: This report describes the case of a patient suffering tremor of the hands and feet, which was improved by Gamigyejak-tang-gamibang. Methods: For relieving symptoms, Korean medicine treatments, including herbal medicine, acupuncture, and moxibustion, were performed. To evaluate the effects of treatments, effective rate, visual analog scale, and patient's condition scale were used. Results: After treatment for 3 months, the clinical symptoms of the patient were improved. Effective rate increased from 10% to 95%. Both visual analog scale and patient's condition scale scores decreased from 8 to 1. Conclusions: This report suggests that Gamigyejak-tang-gamibang is effective for treating essential tremor.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.188-195
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• 2000

Objective : Essential tremor(ET) is the most common movement disorder, however, there has been little agreement in the neurologic literature regarding diagnostic criteria for ET. Familial ET is an autosomal dominant disorder presenting as an isolated postural tremor. The main feature of ET is postural tremor of the arms with later involvement of the head, voice, or legs. In previous studies, it was reported that ET susceptibility was inherited in an autosomal dominant inheritance. As previous results, it would suggest that ET might be associated with defect of mitochondrial or nuclear DNA. Recent studies are focusing on molecular genetic detection of movement disorders, such as essential tremor and restless legs syndrome. Moreover, authors have analysed mitochondrial DNA(mtDNA) from the blood cell of positive control(PC) and ET patients via long and accurate polymerase chain reaction(LA PCR). Materials & Methods : Blood samples were collected from PC and 9 ET patients. Total DNA was extracted twice with phenol followed by chloroform : isoamylalcohol. For the analysis of mtDNA, LA PCR was performed by mitochondrial specific primers. Results : With this technique, deletions of large quantities were detected within several regions of mtDNA in ET patients except for D-loop and CO I regions. Conclusion : The authors believe that ET is a genentic disorder with deficiency of mitochondrial DNA multicomplexes and mitochondiral dysfunction could be one of major causative factors of ET. Mitochondrial dysfunction may play an important role in the pathogenesis and possibility of disease progression among familial group with ET patients.

• 대한한방내과학회지
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• 제25권4호
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• pp.391-400
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• 2004

Tremor is a rhythmic and involuntary muscular contraction characterized by oscillations of a part of the body. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. The appropriate treatment of tremor depends on accurate diagnosis of it's cause. Some tremors respond to treatment of underlying conditions. Senile tremor and Parkinson's tremor are more common in aged people. Yanghyulgupung-tang is effective herbal medication in blood deficiency-type senile tremor. Four cases of senile tremor and Parkinson's tremor are reported. All four patient were treated with Yanghyulgupungtang-gamibang and improvement was seen in all four.

• 대한한방내과학회지
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• 제38권6호
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• pp.1096-1100
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• 2017

The carotid artery is one of the main vessels supplying blood to the brain. Carotid artery stenosis is mostly caused by atherosclerosis, a disease where cholesterol is deposited in the arterial blood vessels. Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many diseases, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy, and alcohol withdrawal. Tremors may be classified as postural, rest, and action tremors. Tremor of a patient with stenosis of the left carotid artery decreased with acupuncture treatment. The acupoints were GB20, TE17, GV8 and GV11. This case shows that the acupuncture treatment is effective against tremor.

• 대한후두음성언어의학회지
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• 제32권1호
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• pp.9-14
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• 2021

Spasmodic dysphonia, essential tremor, and vocal tremor related with Parkinson's disease are different disorders showing fairly similar symptoms such as difficulty in the speech onset, and tremble in the voice. However, the cause and the resulting treatment of these diseases are different. Spasmodic dysphonia is a vocal disorder characterized by spasms of the laryngeal muscles during a speech, invoking broken, tense, forced, and strangled voice patterns. Such difficult-to-treat dysphonia disease is classified as central-origin-focal dystonia, of a yet unknown etiology. Its symptoms arise because of intermittent and involuntary muscle contractions during speech. Essential tremor, on the other hand, is characterized by a rhythmic laryngeal movement, resulting in alterations of rhythmic pitch and loudness during speech or even at rest. Severe cases of tremor may cause speech breaks like those of adductor spasmodic dysphonia. In the case of hyper-functional tension of vocal folds and accompanying tremors, it is necessary to distinguish these disorders from muscular dysfunction. A diversified assessment through the performance of specific speech tasks and a thorough understanding for the identification of the disorder is necessary for accurate diagnosis and effective treatment of patients with vocal tremors.

• 동의생리병리학회지
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• 제26권5호
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• pp.760-764
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• 2012

The purpose of this study was to report the effect of GwiBiTang and gagambang, acupuncture and moxibustion on essential tremor. This study was made on 6 cases that were treated in the OO University Oriental Medicine hospital and evaluated tremor using Visual Analogue Scale(VAS). GwiBiTang was one of the most generally used herbal medication, diagnosed as dual deficiency of the heart-spleen. In five patients out of six, VAS scores decreased. Two patients's scores decreased to 0 point. Three patients's score decreased to 2, 5 and 6 point, respectively. One patient was maintained on these Korean medical treatment for 26 days with no decrease of VAS score in tremor. The overall therapeutic effect was "markedly improved" in 2 (33.3%), "moderately improved" in 3 (50%), "poor" in 1 (16.7%). The results obtained this study suggest that GwiBiTang and gagambang, acupuncture and moxibustion might be effective in the treatment of tremors. Future studies will be required to ascertain the effect of GwiBiTang.

• 동의신경정신과학회지
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• 제28권2호
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• pp.95-107
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• 2017

Objectives: This study was performed to review studies on Essential Tremor (ET) in Traditional Chinese medicine (TCM). Methods: We reviewed papers in the China National Knowledge Infrastructure (CNKI) from 2007~2016. Search keywords were 原发性震颤, 特发性震颤, essential tremor and idiopathic tremor, and excluded non-clinical studies, non-related to ET or TCM studies, theses for degrees and non-Randomized Controlled Trial (RCT). The quality of the articles was assessed by Jadad scale and the Risk of Bias (RoB). Results: Thirteen studies were selected. 'Criteria for the diagnosis of ET' was most frequently used as diagnostic criteria. 'Tremor rating scale' was primarily used for outcome measurement. Meta-analysis of nine trials revealed the effective rate of acupuncture and Western medicine (WM+Acu) groups was significantly higher compared to the WM group (RR: 1.48, 95 percent CI: 1.20 to 1.82, p=0.0002, $I^2=0$ percent) and tremor rating scale was also significantly decreased in the treatment group (MD: -1.35, 95 percent CI: -2.17 to -0.54, p=0.001, $I^2=0$ percent). Also, effective rates of Electro-acupuncture (EA) and Chinese herbal medicine (CHM) groups were significantly higher than that of the WM group {(RR: 1.53, 95 percent CI: 1.22 to 1.92, p=0.0003, $I^2=0$ percent) in EA vs. WM and (RR: 1.35, 95 percent CI: 1.16 to 1.57, p<0.0001, $I^2=0$ percent) in CHM vs. WM}. However, the quality of selected clinical studies was poor. Conclusions: Treatment of ET in TCM may be more effective and safe than in Western medicine. Therefore, we hope this study will lead to further clinical research on treatment of ET in Korean medicine.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.112-115
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• 2005

Objective: Thalamic lesioning and deep brain stimulation(DBS) have proved to be beneficial to the treatment of essential tremor(ET). The authors compared the effects and complications of two modalities. Methods: A total of 34 patients with ET were treated with ventral intermediate(Vim) nucleus thalamotomy or Vim DBS from May 1999 to May 2003. The procedure of lesioning or stimulation were performed as usual manner with or without microelectrode recording. Postoperatively, utilizing the various combinations of frequency, voltage and pulse width optimized the stimulation. The degree of improvements of tremor and the occurrence of the complications were evaluated postoperatively and at follow-up. Results: There were 38 procedures, including 27 with Vim thalamotomy and 11 with DBS, in 34 patients. Of the thalamotomy group, left Vim lesioning is 25 and right one is 2. Follow-up duration ranged from 12 to 57 months. In the thalamotomy group, the rate of overall good outcome was 88.9% but 12 patients (44.4%) showed permanent adverse effects. In the cases of stimulation, the rate of overall good outcome was 90.9% and two patients had acceptable dysarthria. Conclusion: Both Vim thalamotomy and Vim DBS were effective for the treatment of ET, although perioperative adverse effects tended to be higher in patients who had thalamotomy. In cases of DBS, adjustments of stimulation parameters enabled an acceptable position to be achieved with tremor control and unwanted effects.