• Title/Summary/Keyword: lower limbs weakness

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A Case of Amyotrophic Lateral Sclerosis (근위축성 측삭 경화증 1예)

  • Lee, Beom-Jun;Jeon, Jin-Hee;Lew, Jae-Hwan;Kim, Tae-Yun
    • The Journal of Internal Korean Medicine
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    • v.21 no.4
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    • pp.661-665
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    • 2000
  • Amyotrophic Lateral Sclerosis(ALS) is a fatal neuromuscular disease characterized by progressive muscle weakness resulting in paralysis. ALS is characterized by both upper and lower motor neuron damage. Diagnostic tests include magnetic resonance imaging(MRI) electromyogram(EMG), muscle biopsy, and blood tests. In order for a definitive diagnosis of ALS to be made, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We recently experienced one case of ALS, The patients was diagnosed as ALS by EMG and Symptoms. We diagnosed her as Wea jeung and treated by Herbal-medication based on the differentiation of symtoms. we report change of his symptoms through both western medical treatment and oriental medical treatment.

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Clinical Feasibility of Wearable Robot Orthosis on Gait and Balance Ability for Stroke Rehabilitation: A Case Study

  • Shin, Young-Il;Yang, Seong-Hwa;Kim, Jin-Young
    • The Journal of Korean Physical Therapy
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    • v.27 no.2
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    • pp.124-127
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    • 2015
  • Purpose: The emphasis on gait rehabilitation after stroke depends on training support through the lower limbs, balance of body mass over the changing base of support. However, muscle weakness, lack of control of lower limb, and poor balance can interfere with training after stroke. For this case study report, a wearable robot orthosis was applied to stroke patients in order to verify its actual applicability on balance and gait ability in the clinical field. Methods: Two stroke patients participated in the training using the wearable robot orthosis. Wearable robot orthosis provides patient-initiated active assistance contraction during training. Training includes weight shift training, standing up and sitting down, ground walking, and stair up and down Training was applied a total of 20 times, five times a week for 4 weeks, for 30 minutes a day. Gait ability was determined by Stance phase symmetry profile, Swing phase symmetry profile, and velocity using the GAITRite system. Balance ability was measured using the Biodex balance system. Results: Subjects 1, 2 showed improved gait and balance ability with mean individual improvement of 72.4% for velocity, 19.4% for stance phase symmetry profile, 9.6% for swing phase symmetry profile, and 13.6% for balance ability. Conclusion: Training utilizing a wearable robot orthosis can be useful for improvement of the gait and balance ability of stroke patients.

A Case Report of a Guillain-Barre Syndrome Patient Suspected of Having Acute Transverse Myelitis Treated with Korean Medicine (급성 횡단성 척수염으로 의심된 길랑바레증후군 환자에 대한 한방 치료 증례보고 1례)

  • Da-young An;Chae-eun Kim;Mi-kyung Kim;Seung-ho Sun
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1279-1293
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    • 2023
  • A 67-year-old female patient diagnosed with acute transverse myelitis visited our hospital in February 2023. Consultation papers indicated that she was diagnosed with acute transverse myelitis and that she complained of quadriparesis and numbness in both hands and feet. However, her spine magnetic resonance imaging (MRI) did not clearly indicate that she suffered from acute transverse myelitis. She was then sent to a high-level hospital and diagnosed with Guillain-Barre Syndrome through electromyography, cerebrospinal fluid test, and spine MRI. On March 2023, she visited our hospital again, still complaining about weakness in both hands and inability to walk. She was treated with Korean medicine, including acupuncture, electroacupuncture, pharmacopuncture, and herbal medicine such as Yanggyeoksanhwatang and Sipimijihwang-tanggami. After three months, she was discharged on cane walking. The manual muscle test (MMT) grade of her upper limbs increased from 3-/3-/3-/3- (shoulder/elbow/wrist/fingers) to 4/4/4/3+, and the MMT grade of her lower limbs increased from 2/2/2/2 (pelvis/knee/ankle/feet) to 4/4/4-/4-. Her numbness in both feet disappeared, and her numbness in both hands decreased from a numeric rating scale of 7 to 2. No adverse events were reported during treatment. This case implies the therapeutic potential of Korean medicine for Guillain-Barre Syndrome, especially for those who had delayed diagnosis and missed the opportunity to get plasma exchange.

Partial spontaneous remission of small cell lung carcinoma with neurologic symptom (신경계 증상을 동반한 부분적으로 자연완화된 소세포폐암)

  • Yun, Kyung Hyun;Song, Sung Heon;Kim, Chung Hyoun;Hwang, Chan Hee;Lee, Jun Ho;Choi, Je Hyoung;Kim, Sun Young
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.275-278
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    • 2017
  • Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.

Changes in Limb Circumferences among Intensive Care Unit Patients and Related Factors (중환자실 환자의 입원기간에 따른 사지 둘레 변화 및 관련요인)

  • Shin, Hye Eun;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.13-25
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    • 2016
  • Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes.

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A Case Study of a Taeyangin Patient with Vertebrobasilar Insufficient after Mistreat as Taeeumin. (태음인으로 오치(誤治)한 추골뇌저동맥부전증 태양인 환자 치험 1례)

  • Kang, Seok-Hwan;Jeon, Soo-Hyung;Na, Young-Ju;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.4
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    • pp.338-349
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    • 2016
  • Objectives This case study was about a Taeyangin patient with transient ischemic attack(TIA) due to vertebrobasilar insufficiency(VBI). In this study, we report the progress of mistreat with Taeyangin as Taeeumin and the improvement of symptoms after rediagnosis as Taeyangin. Methods Patient's chief complain was weakness of lower limbs, dysarthria and dizziness. Patient first time took Taeeumin prescription such as Chunghyulganggi-tang, Chunsimyonja-tang and Sanyakbopaewon-tang. After occuring side effects we changed the prescription to Taeyangin herbal medicine such as Ogapijangchuk-tang gagam and Mihudeungsikjang-tang gagam. Result and Conclusion Patient suffered from diarrhea by taking Taeeumin prescription and symptom was continue. After changing of prescription to Taeyangin herbal medicine, not only chief symptom but also original symptom was improved.

A Case of Amyotrophic Lateral Sclerosis (근 위축성 측삭 경화증 환자 1례 보고)

  • Kim, Tae-jung;Moon, A-ji;Lee, Seoung-geun;Lee, Key-sang
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.77-85
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    • 2012
  • Amyotrophic lateral sclerosis(ALS) is a progressive disorder that causes degeneration of motor neurons of the brain and spinal cord. It is characterized by loss of motor neurons leading to muscle weakness, and sensation and mental function stay intact during the course of the disease. Diagnostic tests include magnetic response imaging(MRI), electromyogram(EMG), muscle biopsy, and blood tests. In order to a definitive diagnosis of ALS, damage must be evident in both upper and lower motor neurons. When three limbs are sufficiently affected, the diagnosis is ALS. There is no cure for ALS. We experienced one case of ALS, the patients was diagnosed as ALS by EMG and symptoms. We diagnosed her as ShinEumHur(SEH) and treated by Choakwiyeum(左歸飮). We report the change of her symptoms through oriental medical treatment.

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Mechanical Energy Analysis for the Lower Limbs during Sit-to-Walk Movement in Elderly Women (여성 고령자들의 Sit-to-Walk동작 시 역학적 에너지 분석)

  • Moon, Hoon-Kee
    • Korean Journal of Applied Biomechanics
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    • v.19 no.4
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    • pp.697-705
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    • 2009
  • The purpose of this study is to elucidate the possible cause of falling owing to mechanical energy in elderly women as compared to young women when performing the sit-to-walk movement. Two groups participated in this study: 10 elderly women and 10 young women. We used a ProReflex MCU camera (Qualisis, Sweden) and ground reaction force to evaluate the mechanical work. The muscle power (W) showed the same low negative work in both groups in the extension phase of the knee and hip joints while varying the angular velocity and net muscle moment of force. Elderly women, in particular, showed lower negative work. In mechanical work (J), the knee and hip joints of both groups showed the same amount of negative work in the extension phase. In the hip joint, elderly women showed lower negative work results in each phase. These result showed the possible reasons of falling for elderly women according to the weakness of the thigh muscle of the hip joint during the sit-to-walk movement.

A Case of Paraplegia Associated with Epidural Anesthesia -A case report- (산모에서 발생한 경막외 블록 후 하지 마비 -증례보고-)

  • Kim, Hyun Hea;Kim, Doo Hwan;Kim, Sung Hoon;Leem, Jeong Gill;Lee, Cheong;Shin, Jin Woo
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.159-163
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    • 2008
  • Paraplegia is a relatively rare complication of epidural anesthesia. Several possible factors may contribute to the development of paraplegia including arachnoiditis, trauma and ischemia. We experienced a case where paraplegia had developed after epidural anesthesia for cesarean section. So we present the case and consider the possible etiologies. A 30-year-old previously healthy woman was referred to our hospital for postpartum motor weakness of the lower limbs. Six days prior, the patient was admitted at a local obstetric clinic for delivery at 39 weeks gestation. The patient underwent a Cesarean section under epidural anesthesia induced with 20 ml 2% lidocaine and 5 ml 0.5% bupivacaine. In the early morning of the day following the Cesarean section, a motor and sensory deficit in both lower extremities was noted. A lumbar MRI showed diffuse enhancement along the cauda equina and spinal cord surface in the lower lumbar spine, suggesting diffuse arachnoiditis.

A Clinical Case of Oriental Medical Treatment for the Paraplegia after Lumbar Epidural Nerve Block (요추 경막외 차단술 후 발생한 하지마비의 한의학적인 치료 효과 - 증례 보고 -)

  • Yu, Deok-Seon;Kim, So-Yeon;Kim, Dong-Eun;Jung, Il-Min;Yeom, Seung-Ryong;Kwon, Young-Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.4
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    • pp.219-228
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    • 2009
  • Objectives : This study was performed to report the effect of oriental medical treatment in the paraplegia and pain after epidural nerve block. Methods : A 39-year-old woman who underwent epidural nerve block at a local clinic was admitted with motor weakness of lower limbs, severe lower radiating pain and decreased sensation when voiding and defecating. We treated her by acupuncture, a herbal medicine, a bee venom injection, moxibustion and cupping treatment and physical theraphy from 11th July 2008 to 14th October 2008. Results : After treatment, most symptoms decreased, VAS(Visual Analog Scale) score changed from 9 to 2. and examinated muscle power changed from 2-3 to 4-5. Conclusions : Our study suggested that oriental medical treatments are significantly effective in the paralplegia and pain after epidural nerve block. And further studies will be aid to identify underlying mechanism of treatment.