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루프스 신염 치료로 Cyclosporine 투여 후 발생한 가역성후백질뇌병증 증후군
라상준,이기욱 대한임상신경생리학회 2009 Annals of Clinical Neurophysiology Vol.11 No.1
Reversible posterior leukoencephalopathy syndrome (RPLS) is an acute encephalopathy, usually characterized by seizures, visual disorder, mental change and reversible posterior white and gray matter lesions on brain magnetic resonance imaging (MRI). Conditions commonly associated with RPLS include acute renal failure, eclampsia, hypertension, immunosuppresion state, and use of intravenous immunoglobulin or chemotherapy, and additional contributing factors. We report the case of RPLS associated with cyclosporine use in lupus nephritis. In this case, it was not clearly elucidated which was main cause of RPLS. We could think RPLS developed maybe due to combined effect of cyclosporine and lupus nephritis
김지훈,김용덕,라상준 대한신경과학회 2012 대한신경과학회지 Vol.30 No.3
Antibodies to cardiolipin and other phospholipid have been associated with recurrent thrombotic events, including ischemic strokes, especially in children and young adults. Recently it has been shown that anti-ß2 -glycoprotein I antibodies may be more specific in predicting thrombosis. We report a case of anterior spinal artery syndrome with elevated titer of antibodies to ß2 -glycoprotein I in young adult.
김지훈,이기욱,라상준 대한신경과학회 2010 대한신경과학회지 Vol.28 No.3
The spectrum of neurological complications that occurs in the setting of HIV-1 infection includes AIDS-dementia complex, progressive multifocal leukoencephalopathy, brain lymphoma, toxoplasma encephalitis, and cryptococcal meningitis. We present a 36-year-old man with subacute multifocal neurologic signs who had a 3-year history of HIV-1infection and a year history of left optic neuritis. The clinical presentation, CSF findings, and neuroradiological features in our patient were compatible with multiple sclerosis (MS), and hence he represented a rare case of HIV-related MS-like illness.
이기욱,김영신,라상준 대한근전도전기진단의학회 2008 대한근전도 전기진단의학회지 Vol.10 No.2
Trigeminal sensory neuropathy (TSN) is an uncommon clinical condition that results in facial numbness in the distribution of the fifth cranial nerve. TSN is commonly associated with connective tissue disease (CTD) such as scleroderma, Sjo¨ gren syndrome, mixed connective tissue disease, rheumatoid arthritis, and dermatomyositis, but the pathogenesis of TSN associated CTD remains obscure. We reported a patient who presented with TSN as an initial manifestation of systemic lupus erythematosus with review of the literatures.
Ipsilateral Radial Neuropathy after COVID-19 mRNA Vaccination in an Immunocompetent Young Man
이선민,홍준영,김시연,라상준 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.10
The global coronavirus disease 2019 (COVID-19) pandemic spurred an urgent need for vaccination and herd immunity. Recently, mRNA vaccines for COVID-19 have been used widely despite reports of several adverse events. Most adverse effects are mild, al though a few are associated with neurological complications. Unfortunately, there is a scarcity of information on peripheral nerve complications after COVID-19 mRNA vaccination. We report the case of an immunocompetent young male patient who suffered from ipsilateral wrist drop with multiple lymphadenopathy in the cervical and axillary region after Pfizer–BioNTech vaccination. He experienced unilateral wrist drop, which significantly improved with corticosteroid treatment. Based on knowledge of this ad verse effect, careful surveillance and increased awareness are needed for early diagnosis. To the best of our knowledge, this is the first reported case in the English literature of radial neuropathy resulting in wrist drop in a recently vaccinated and young immu nocompetent patient.
A Case of Acute Motor and Sensory Axonal Neuropathy Following Hepatitis A Infection
조윤식,한상돈,최진영,김익희,김용덕,라상준 대한의학회 2013 Journal of Korean medical science Vol.28 No.12
Acute motor and sensory axonal neuropathy (AMSAN) are recently described subtypes of Guillain-Barré syndrome characterized by acute onset of distal weakness, loss of deep tendon reflexes, and sensory symptoms. A 21-yr-old male was transferred to our hospital due to respiration difficulties and progressive weakness. In laboratory findings, immunoglobulin M antibodies against hepatitis A were detected in blood and cerebrospinal fluid. The findings of motor nerve conduction studies showed markedly reduced amplitudes of compound muscle action potentials in bilateral peroneal, and posterior tibial nerves, without evidence of demyelination. Based on clinical features, laboratory findings, and electrophysiologic investigation, the patient was diagnosed the AMSAN following acute hepatitis A viral infection. The patient was treated with intravenous immunoglobulin and recovered slowly. Clinicians should consider this rare but a serious case of AMSAN following acute hepatitis A infection.
수근관증후군에서 국소 스테로이드 주사 후 임상적, 전기생리학적 변화
김지훈,이기욱,윤보라,김용덕,정언석,라상준 대한임상신경생리학회 2013 Annals of Clinical Neurophysiology Vol.15 No.1
Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.