• Title/Summary/Keyword: lower limbs weakness

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Motor Peripheral Neuropathy Involved Bilateral Lower Extremities Following Acute Carbon Monoxide Poisoning: A Case Report (급성 일산화탄소 중독 환자에서 발생한 양하지 말초 운동신경병증 1례)

  • Choi, Jae-Hyung;Lim, Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.46-49
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    • 2015
  • Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

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Study on the 'Pulse Syndrome Complex and Treatment of Blood Paralysis and Weakness Fatigue' in The Synopsis of Golden Chamber (금궤요략.혈비허로병맥증병치제육(血痺虛勞病脈證幷治第六)에 대한 연구)

  • Cheon, Sang-Muk;Han, Sung-Kyu;Yeo, Sung-Won;Lee, Yun-Cheon;So, Yong-Sub;Ro, Seung-Jo;Jeong, Heon-Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.2
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    • pp.333-344
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    • 2006
  • The Blood paralysis(血痺) is infected by a poisonous factor of wind and it disturbs the circulation of meridian. This disease is similar phenomenon to the Blutsaure(血柱) and belongs to the category like the Radial nerve paralysis, the Ulna nerve paralysis and the unstability syndrome of the lower limbs. This dissertation will inquire into symptoms, the way of treatment and the prescriptions of this disease based on the Synopsis of Golden Chamber. The Weakness and fatigue(虛勞) is occurred by several causes. This disease means all the functions of body weakened. This dissertation will inquire into pulse conditions according to the type of the Weakness and fatigue(虛勞), symptoms, the way of treatment and the prescriptions of this disease based on the Synopsis of Golden Chamber.

Lower Motor Weakness and Complex Regional Pain Syndrome of Lower Limb in the Patient of Frontotemporal Dementia: A Case Report (이마관자엽 치매 환자에서 나타난 하지 근력 저하와 복합부위 통증증후군에 대한 증례 보고)

  • Lee, Kwang Min;Noh, Se Eung;Joo, Min Cheol;Hwang, Yong;Kim, Ji Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.352-358
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    • 2017
  • Frontotemporal dementia, the second most common cause of early onset dementia, is a neurodegenerative clinical syndrome characterized by progressive deficits in behavior, executive function and language. Although motor symptoms in frontotemporal dementia are represented by motor neuron disease, parkinsonism and progressive supranuclear palsy syndrome, there have been no reports of motor weakness caused by the direct involvement of central motor nervous systems in frontotemporal dementia. Moreover, no association between clinical dementia groups and complex regional pain syndrome has been reported. We diagnosed a rare case with motor weakness and complex regional pain syndrome of lower limbs due to central nervous system lesion in a patient with frontotemporal dementia by magnetic resonance imaging, electrodiagnostic study and three phase bone scan. Following steroid therapy for complex regional pain syndrome, pain was improved. Functional improvement was noted after rehabilitation therapy, including functional electrical stimulation, muscle strengthening exercise and gait training during hospitalization. This case report suggests that rehabilitation therapy for motor weakness in frontotemporal dementia could be effective for improving overall function.

Risk Factors for Hip Fracture among the Elderly (노인들의 고관절골절 위험요인에 관한 환자-대조군 연구)

  • Kim, Yong-Kwon;Cho, Young-Ha
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.25-36
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    • 2002
  • Objectives: This study was conducted to find out risk factors related to elderly hip fracture, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. Methods: The data were collected from 199 cases hospitalized in 4 university hospitals in Pusan from January, 1996 to December, 1998, 193 healthy controls who visited elderly facilities in Pusan. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed for 2-test and multiple logistic regression. The risk factors were shown with odds ratios and their 95% confidence intervals. Results: In univariate analysis, the odds ratio of hip fracture risk was estimated to be 1.9 for the elderly aged 75 years as compare with those aging less than 65 years; 42 for those with job as compared with those without job; 3.3 for those with more than 6 children as compared with those with one or two children. For the variables related to physical characteristics, small height (p=0.015), light weight (p=0.000), and low BMI (p=0.014) were risk factors for elderly hip fracture. Sane variables related to health, such as previous history of illness (OR=3.3.), abnormal blood pressure (OR=1.6), previous fracture history (OR=22), lower limbs weakness (OR=12.1) and gait disturbance (OR=42.6), were significantly associated with the risk of hip fracture. In multiple logistic regression, risk factors for hip fracture were age, having job, lower limb weakness and previous history of illness. The adjusted odds ratios of hip fracture risk among the elderly were age (OR=1.1), having jobs (OR=11.7), weak lower limb (OR=10.8) and previous history of illnesses (OR=3.3), respectively. Conclusion: This study suggests that the plan for improving the daily living environment for the elderly systematically should be implemented to avoid the chances of fall, and that programs encouraging to practice regular exercise for physical activity and to promote health of the elderly should be developed.

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Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk;Kang, Ji-Hoon;Kang, Sa-Yoon;Lee, Jung Seok;Song, Sook-Keun;Oh, Jung-Hwan;Kim, Joong-Goo;Han, Eun Young;Lee, Ho Kyu;Choi, Jay Chol
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.102-109
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    • 2018
  • Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

A Case of Antisynthetase Syndrome (항 Synthetase 증후군 1예)

  • Kim, Min-Jeong;Kim, Min Ah;Kim, Eung-Gyu;Kim, Chan-Hwan;Kim, Sang-Jin
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.196-198
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    • 2006
  • It has been reported that antisynthetase syndrome belongs to the idiopathic myositis group which includes pulmonary interstitial disease, arthritis, Raynaud's phenomenon, and mechanic's hand, associated with the anti-Jo1 antibody. A 60- year-old man presented with one month history of lower limbs weakness, rapidly progressive exertional dyspnea, and arthralgia. A markedly increased titers of anti-Jo1 antibodies were found. Chest CT showed idiopathic pulmonary fibrosis. Muscle biopsies were consistent with polymyositis. A high dose corticosteroids and cyclosporine were not effective. We report a case of antisynthetase syndrome, in which immunosuppressive agents could not rescue the deteriorating disease course.

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One Family with Hereditary Spastic Paraplegia due to SPG4 Gene Mutation (SPG4 유전자 변이에 의한 유전경직하반신마비를 보인 가족 1예)

  • Cho, Jeong-Seon;Kim, Doo-Eung;Kim, Jung-Mee;Han, Young-Su;Ha, Sang-Won;Park, Sang-Eun;Han, Jeong-Ho;Cho, Eun-Kyoung
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.138-140
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    • 2005
  • Strumpell, in 1880, was the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogeneous in inheritance, age of onset, severity and associated signs. We present one family with autosomal dominant hereditary spastic paraplegia (HSP) due to SPG4 (spastin) gene mutation which is confirmed by genomic DNA isolated from peripheral blood.

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Clinical Study of Oriental-Western collaborative medical treatment on 1 case of patient with Suppurative Arthritis (Suppurative arthritis 환자(患者) 1례(例)의 한(韓)·양방(洋方) 겸치를(兼治)를 통(通)한 임상적(臨床的) 고찰(考察))

  • Ha, Chi-Hong;Cho, Myung-Rae
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.277-285
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    • 2000
  • By process of treatment for a case which diagnosed as suppurative arthritis and admitted from the 5th, October, 1999 to the 15th, November, 1999, the results are as follows. Method & Results : In the earlier days of admission, this patient was diagnosed as damp-heat(濕熱) and medicated Cheongyeolsaseup-tang(qingrexieshi-tang). As the result, heating, pain in both knees and heating in both lmees are improved. In the later days of admission, this patient was diagnosed as impairment of the liver and kidney(肝腎虛損) and medicated Samgi-eum(sanqi-yin). As the reslut, weakness in lower limbs is improved. Conclusion : I consider that the rate of recovery for other infectious diseases including suppurative arthritis can be maximized by accumulation of clinical experiences and continuous research through both western medical treatment and oriental medical treatment.

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Neurolymphomatosis presenting as brachial plexopathy with involvement of cranial nerves

  • Lee, Hye Jung;Kim, Keun Soo;Song, Pamela;Lee, Jae-Jung;Sung, Jung-Joon;Choi, Kyomin;Kim, Bohyun;Cho, Joong-Yang
    • Annals of Clinical Neurophysiology
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    • v.20 no.1
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    • pp.44-48
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    • 2018
  • Neurolymphomatosis (NL) is a rare disease characterized by lymphomatous invasion of the cranial or peripheral nerves by lymphoma. A high suspicion is important due to the various presenting symptoms mandating consideration of many differential diagnoses. We report a case of NL of the cranial nerves and plexus presenting as diplopia, facial palsy, and weakness of the upper and lower limbs in sequence.

A case of spinal muscular atrophy typeⅡ (제 2 형 척수근위축증(SMA type II; Spinal muscular atrophy typeⅡ) 환아 1례에 대한 증례보고)

  • Jo Hyeong-Jun;Lee Jin-Yong;Kim Deok-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.1
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    • pp.197-204
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    • 2000
  • Neuromuscular disorders are common causes of weakness and hypotonia in the infantile period and in childhood. Accurate diagnosis of specific neuromuscular disorders depends first on identification of which aspect of the peripheral neuromuscular system is affected-the motor neuron in the spinal cord, the nerve root or peripheral nerve, the neuromuscular junction, or the muscle-and then on the determination of the etiology and specific clinical entity. Spinal muscular atrophy(SMA) is the most common autosomal-recessive genetic disorder lethal to infants. The three major childhood-onset forms of SMA are now usually called type I, type II and typeⅢ. Progression of the disease is due to loss of anterior horn cells, thought to be caused by apoptosis. Diagnosis is based on the course of the illness, as well as certain changes seen on nerve and muscle biopsy and electrodiagnostic studies. More recently, our understanding of the genetics of this disorder has provided a noninvasive approach to diagnosis. We report on a 3-year-old male patient with spinal muscular atrophy type II. He had progressive muscular weakness since 18 months of age. The upper arms were slightly, and the thighs moderately atrophic. There was muscle weakness of both the upper and lower limbs, being more proximal in distribution. Electromyogram revealed a neurogenic pattern.

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