추골기저동맥 일과성 허혈발작에서 뇌간청각유발전위변화에 영향을 미치는 인자

박영혁,유봉구,김광수,유경무,Park, Young Hyuk,Yoo, Bong Goo,Kim, Kwang Soo,Yoo, Kyung Moo 대한임상신경생리학회 2000 Annals of Clinical Neurophysiology Vol.2 No.2

Background and Purpose : Brainstem auditory evoked potentials(BAEPs) are responses of the brainstem by auditory stimulation. Vertebrobasilar transient ischemic attacks is the disease that occurs by insufficient circulation in the region of brainstem. The purpose of this study is to know the factors influencing the changes of BAEPs in vertebrobasilar transient ischemic attacks. Methods : The subject of study was 96 patients diagnosed as vertebrobasilar transient ischemic attacks. Patients were divided into two groups according to the BAEPs findings. Their age, sex, presence of hypertension, diabetes, hyperlipidemia, heart disease, neurologic findings, previous stroke, previous vertebrobasilar transient ischemic attacks, smoking and alcohol drinking, and time period between symptom onset and testing were compared. Results : There were no significant differences in age, sex, and presence of hypertension, diabetes, hyperlipidemia, heart disease, previous stroke history, previous vertebrobasilar transient ischemic attack, smoking, and alcohol drinking between two groups. The presence of abnormal neurologic findings in the first examination and time period between symptom onset and testing were significantly different between normal BAEPs group and abnormal BAEPs one(P<0.05). Conclusions : The factors influencing the changes of BAEPs were presence of abnormal neurologic findings and time period between symptom onset and testing. These findings suggest that BAEPs test should be performed in acute stage of ischemic attack.

뇌경색에 의한 편측부전마비에서 자기운동유발전위의 변동

이주호,박영혁,김광수,유경무,Lee, Ju Ho,Park, Young Huk,Kim, Kwang Soo,Yoo, Kyung Moo 대한임상신경생리학회 1999 Annals of Clinical Neurophysiology Vol.1 No.2

Background and Objectives : The Motor evoked potentials (MEP) study may be useful in the evaluation of the degree of impairment in the motor nervous system and in the determination of the prognosis. The purpose of this study is to evaluate the status of central nervous system in acute and subacute state of cerebral ischemia by comparing the changes of MEP in the initial and follow-up study. Methods : Twenty patients with hemiparesis caused by ischemic stroke were recruited for this study. We tested MEP within 7 days and followed-up after 14 days after symptom onset. The cerebral motor cortex area, cervical area for upper extremity and lumbar area for lower extremity were stimulated by transmagnetic stimulator. The central motor conduction time(CMCT) was measured with the difference in MEP caused by stimulating the vertical area and spinal area. The CMCT of hemiparetic patients were classified into three groups-normal, delayed, and no evoked MEP groups. Results : The CMCT in hemiparetic side of acute ischemic stroke patients were singnificantly delayed (P < 0.05) compared with the control group. The CMCT of hemiparetic side in the follow-up study showed no sinificantly difference in comparison to the control group. The prognosis of motor improvement was better in the groups of delayed MEP than the groups of no evoked MEP. Conclusion : The CMCT of hemiparetic and contralateral sides were delayed in acute ischemic stroke, compared with control group and were returned to normal boundaries in subacute state. But in the most cases with no MEP response in the initial study, also showed no MEP response in the follow-up study. The recovery occurred in the subacute state in cases with mild hemiparesis, whereas recovery did not occur in the subacute stage in case with severe hemiparesis.

류마티스 관절염환자에 동반된 불현성 말초신경병증

김진구 ( Jin Gu Kim ),정연순 ( Yeon Soon Jung ),유경무 ( Kyung Moo Yoo ),홍관표 ( Kwan Pyo Hong ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.2

Objective: Symptomatic neuropathy is uncommon in rheumatoid arthritis (RA) but, compression neuropathy and vascular neuropathy were reported in longstanding RA. To investigate the occurrence of electrophysiologically evident peripheral nerve involvement in RA patients without a clinical manifestation of peripheral nerve involvement, we studied nerve conduction velocity study (NCV) in RA patients without symptomatic neuropathy. Methods: Twenty-five RA patients were evaluated neurological examination and by NCV. We compared clinical parameters between electrophysiologic positive group and negative group. Results: There was no patient who had neurologic symptoms or signs of peripheral involvement. Eleven patients (44%) of all exhibited NCV findings consistent with distal symmetrical sensorimotor polyneuropathy, 5 patients (20%) had entrapment neuropathy, 2 patients (8%) showed distal symmetrical sensory polyneuropathy, 1 patient (4%) had digital neuropathy, and 6 patients (24%) had normal NCV. Conclusion: Patients with RA may have electrophysiologic peripheral nerve damage, even in the absence of clinical evidence of peripheral nerve involvement. There was no correlation with any clinical parameters. The inclusion of electrophysiologic examination of the RA patients is recommended in routine diagnostic procedures.

운동신경원성질환을 동반한 산발성 크로이츠펠트-야곱병 1예

유봉구,김광수,유경무 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.1

Dementia with motor neuron disease includes frontotemporal dementia with motor neuron disease, amyotrophic Creuzfeldt-Jakob disease, Parkinson-amyotrophic lateral sclerosis-dementia complex, familial amyotrophic lateral sclerosis, and hereditary spastic paraparesis. A 54-years-old man presented with a eight month history of rapidly progressive dementia. Progressively more severe dementia was accompanied by muscle wasting and visible fasciculations. Cerebrospinal fluid showed the 14-3-3 protein. Brain MRI revealed mild diffuse atrophy in both frontal, temporal and parietal lobes. He died 9 months after onset of the disease. We report a patient with sporadic Creuzfeldt-Jakob disease with motor neuron disease.

各種 局部的 神經病變에서의 正中神經 短潛伏期體感覺誘發電位反應

劉京武,李相度,朴永春 啓明大學校 醫科大學 1987 계명의대학술지 Vol.6 No.2

A number of short-latency somatosensory evoked potential (SEP) studies on various localized neurological lesions has been reported recently to delineate neural generators of each SEP waves. However, their localizing value remains to be elucidated since their specific neural origins still have been debated. We studied median SEP abnormalities in 53 patients with well localized neurological lesions which were diagnosed clinically and by laboratory examinations (EMGs or brain CT scans). In 9 patients with polyneuropathy, latencies of N9, N13 and N19 were delayed, and amplitudes of N9 and N13 were decreased. Whereas amplitude of N19 and P23 and latency of P23 were normal. In 5 patients with brachial plexus injury, there were absence of N9 and subsequent SEP waves, or delayed latencies of N9 and N13 with low amplitudes. In 3 patients with cervical cord injury, there was normal N9. Whereas N13, N19 and P23 were absent or low amplitudes with normal latencies. In 3 patients with brainstem lesions (2 infarction and 1 metastatic tumor), there were normal N9 and N13 latencies, low amplitude of N13 and absent contralateral N19 and P23. In 19 patients with thalamic lesions(17 hemorrhage, 1 infarction and 1 metastaic tumor), there were normal N19 and N13,and absent N19 and P23 contralateral to the side of stimulation in cases of sensory deficit, whereas delayed or low amplitude of contralateral N19 and/or P23 in cases of mild sensory deficit. In 6 patients with putaminal hemorrhage. there were normal N9 and N13 and absent contral-ateral N19 and P23 in cases of sensory deficit, whereas low amplitude of N19 and P23 in cases without sensory deficit. And in 8 patient with well localized parietal infarction, there were also normal N9 and N13 , and absent contralateral N19 and P23 or delayed latency of P23 in cases of sensory deficit, whereas were delayed latency of P23 or low amplitude of N19 and P23 in cases without sensory deficit. In above SEP findings in well localized neurological lesions we propose the neural generator of N9 is near brachial plexus, N13 is dorsal column of high cervical cord, N19 is in thalamus and P23 is thalamocortical radiation or parietal sensory cortex.

진행성 치매와 반복되는 뇌졸중을 보인 뇌 아밀로이드 혈관병증 1예

유봉구,곽강호,김태유,김광수,유경무 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.1

Cerebral amyloid angiopathy can cause intracerebral hemorrhage, progressive dementia, seizure and transient ischemic attacks. Dementia is a relatively common manifestation and associated with the presence of recurrent strokes and leukoencephalopathy. A 66-year-old right-handed man with hypertension and recurrent strokes presented with rapidly progressive dementia and sudden onset of dysarthria and dizziness. He showed memory impairment, personality and behavioral changes, and executive dysfunction for one and an half years. These symptoms developed insidiously and quite rapidly without fluctuation. Brain CT showed a small hemorrhage in the right cerebellum. Brain MRI, especially gradient-echo images revealed multiple cortical and cortico-subcortical microbleeds. Four weeks later, right hemiparesis suddenly developed and a repeated MRI showed a new left corona radiata infarction. We learn from this case that gradient-echo MR images should be performed in patients with rapidly progressive dementia and recurrent strokes.

Kainic Acid로 유발된 경련이 백서 해마에서 c-fos 단백의 발현에 미치는 영향

유경무,김광수,조무연,박병채 대한신경과학회 1996 대한신경과학회지 Vol.14 No.1

고혈당과 연관된 편측무도증 1예

장용석,김광수,유경무 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

Hemichorea-hemiballism (HC-HB) is a rare complication of non-ketotic hyperglycemia. Recently, some reports revealed that brain MRI of non-ketotic hyperglycemic patients with HC-HB showed characteristic contralateral striatal signal abnormality. A 60 year-old woman with non-insulin dependent diabetes mellitus presented with sudden involuntary movements in the left extremities. Involuntary ballistic movements with writhing, consisting of repetitive rotation and flexion-extension without apparent muscle weakness, affected her left limbs proximally. Low-amplitude, involuntary, choreiform movements involved the distal portions of these limbs. She was diagnosed diabetes mellitus 10 years ago, taken oral antidiabetic drug intermittently. Venous blood sugar was 545㎎/㎗, serum osmolality was 306 mosmol/Kg, and other serologic tests were negative. A brain MRI revealed high signal intensity on T1WI and low signal intensity on T2WI in right putamen. We report a patient presented with HC-HB associated with hyperglycemia, and improved after controlled blood sugar.

한국판 MMSE를 이용한 간질 환자의 인지기능 평가

민지원,유봉구,김광수,유경무 고신대학교 의학부 2003 高神大學校 醫學部 論文集 Vol.18 No.1

Background & Purpose : Patients with complex partial seizure have impaired cognitive performance. The aim of this study was to evaluate the cognitive function of patients with epilepsy using Korean version of Mini-Mental State Examination (K-MMSE). Methods : We measured the K-MMSE in 23 patients with complex partial seizure and 22 normal controls. Frequency matching was done about age, sex and residence between the two groups. The evaluation of cognitive function was assessed with K-MMSE. Results : Compared with controls, patients with epilepsy showed significantly lower in total score of K-MMSE and attention-calculation item(P=0.008, P=0.014). There were no differences in the score of other items of K-MMSE between the two groups. Conclusions : These results showed that epileptic patients have impaired cognitive function, especially in attention-calculation performance.

일산화탄소 중독에 의한 지연성 무산소성 뇌병증 2예

김민정,김광수,유경무 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

The carbon monoxide (CO) intoxication has occurred not infrequently in the Korea. Presently, it is well known that there are neurological and complications after CO intoxication. The delayed neurological sequelae of CO intoxication may be also occurred for days or weeks after anoxic exposure. Common delayed neurological manifestations include diffuse cortical dysfunction, psychotic behavior, dementia, parkinsonism, and peripheral polyneuropathy. On magnetic resonance imaging, bilateral symmetric confluent high signal intensity in the periventricular white matter and centrum semiovale was seen on long-repetition-time images, and bilateral ischemia or necrosis of the globus pallidus was seen. The outcome of these sequelae relatively good. We report two cases of delayed postanoxic encephalopathy after acute CO intoxication. Their clinical manifestations were decreased mentality, disorientation, memory disturbance, spasticity and mutism.