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증예(症例) : 급성 파종성 뇌척수염에 동반된 급성 운동 축삭형 신경병증
유성용 ( Seong Yong Yu ),임의성 ( Eui Seong Lim ),신병수 ( Byoung Soo Shin ),서만욱 ( Man Wook Seo ),김영현 ( Young Hyun Kim ) 전북대학교 의과학연구소 2003 全北醫大論文集 Vol.27 No.2
Acute motor axonal neuropathy(AMAN) is a subtype of Guillain-Barre syndrome and characterized by selective involvement of motor fibers. Acute disseminated encephalomyelitis(ADEM) is a demyelinating disease of central nervous system. The coincidence of central and peripheral nervous system involvement has been reported rarely. We described a 37-year-old male patient presented with fever, altered consciousness. The examination of cerebrospinal fluid and brain magnetic resonance imaging was compatible with acute disseminated encephalomyelitis. Several days later, his mentality was improved but he showed quadriparesis and palsy of cranial nerves, areflexia. Electrophysiologic studies suggested axonal form of motor dominant polyneuropathy. We report a caute motor axonal neuropathy combined with ADEM. We consider that this case is an example of simultaneous immunologic process in the common pathogenic epitope of central nervous system and peripheral nervous system.
증례(症例) : 뇌경색, 발작, 인지저하로 발현한 하시모토 뇌병증 1예
오선영 ( Sun Young Oh ),임의성 ( Eui Seong Lim ),서만욱 ( Man Wook Seo ),김영현 ( Young Hyun Kim ) 전북대학교 의과학연구소 2004 全北醫大論文集 Vol.28 No.2
In recent years, encephalopathy has increasingly been recognized as a complication of Hashimoto`s thyroiditis. Patients with Hashimoto`s encephalopathy have variable neurologic symptoms such as stroke-like episodes, stupor, seizures, psychosis, tremor, myoclonus, and even myelopathy. Although they are usually euthyroid, their symptoms are not peculiar, and treatable with corticosteroids. And the symptoms of Hashimoto`s encephalitis resemble to Creutzfeldt-Jakob disease, However, the diagnosis of the patients with unexplained neurologic deterioration is a challenging task. We herewith describe a patient who displayed symptoms of Hashimoto`s thyroiditis associated with acute stroke, seizure attack, and cognitive impairment. The patient was treated with corticosteroids, and the response to steroids was excellent.