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나부석,조진환,박관,권순욱,김예슬,김지선,윤진영 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.3
Background and Purpose Hemifacial spasm (HFS) is mostly caused by the compression of the facial nerve by cerebral vessels, but the significance of spasm severity remains unclear. We investigated the clinical significance of spasm severity in patients with HFS who underwent microvascular decompression (MVD). Methods We enrolled 636 patients with HFS who underwent MVD between May 2010 and December 2013 at Samsung Medical Center (SMC), Seoul, Korea. Subjects were divided into two groups based on spasm severity: severe (SMC grade 3 or 4) and mild (SMC grade 1 or 2). We compared demographic, clinical, and surgical data between these two groups. Results The severe-spasm group was older and had a longer disease duration at the time of MVD compared to the mild-spasm group. Additionally, hypertension and diabetes mellitus were more common in the severe-spasm group than in the mild-spasm group. Regarding surgical findings, there were more patients with multiple offending vessels and more-severe indentations in the severe-spasm group than in the mild-spasm group. Even though the surgical outcomes did not differ, the incidence of delayed facial palsy after MVD was higher in the severespasm group than in the mild-spasm group. Logistic regression analysis showed that severespasm was correlated with longer disease duration, hypertension, severe indentation, multiple offending vessels, and delayed facial palsy after MVD. Conclusions Spasm severity does not predict surgical outcomes, but it can be used as a marker of pathologic compression in MVD for HFS, and be considered as a predictor of delayed facial palsy after MVD
나부석,권영남,송수진,송종민,우호걸,이도경,안태범 대한임상신경생리학회 2015 Annals of Clinical Neurophysiology Vol.17 No.1
We reported a 48-year-old man with Behcet disease, who presented with right hemiparesis. His first brain MRI showed multiple enhanced lesions. During the recovery, he had an episode of left 6th nerve palsy without new lesions in a follow-up MRI. Third episode was cervical myelitis, resulting in respiratory difficulty and quadriplegia without any reflexes. The myelitis was not responsive to immunotherapy. He died of respiratory failure complicated with pneumonia. This is a rare case of full-blown neuro-Behcet disease. (Korean J Clin Neurophysiol 2015;17:28-30)
나부석,송수진,송종민,우호걸,권영남,이도경,안태범,Boo Suk Na,Soo Jin Song,Jong Min Song,Ho Geol Woo,Young Nam Kwon,Dokyung Lee,Tae-Beom Ahn 대한소화기암연구학회 2015 Journal of digestive cancer reports Vol.3 No.2
Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.
송수진,나부석,송종민,우호걸,이도경,안태범,Song, Soo Jin,Na, Boo Suk,Song, Jong Min,Woo, Ho Geol,Lee, Dokyung,Ahn, Tae-Beom 대한임상신경생리학회 2015 Annals of Clinical Neurophysiology Vol.17 No.2
A 59-year old man was admitted for drowsiness and stiff neck. CSF examination showed lymphocytic pleocytosis and PCR for herpes simplex virus (HSV)-1 was positive in CSF. Brain MRI revealed enhanced lesions in left temporal lobe. His symptom improved with acyclovir. Follow-up studies showed red blood cells in CSF and a hematoma in the left temporal lobe. There was no additional symptom related to the hematoma. He was discharged after conservative care. Although rare, hematoma can develop in HSV-1 meningoencephalitis.
송종민,권영남,나부석,송수진,신유용,이재홍,이도경,안태범 대한신경과학회 2016 대한신경과학회지 Vol.34 No.4
A 65-year-old female visited us due to gait disturbance. A neurological examination showed cognitive impairment, dystonia, myoclonus, bradykinesia, postural instability, and freezing of gait (FOG). She was diagnosed with extrapontine myelinolysis based on her history of hyponatremia and high signal intensities (HSIs) in both striata on T2-weighted images. Her neurological problems including FOG improved over 25 days. In a follow-up MRI 50 days after the onset, HSIs disappeared in the striata but new ones appeared in the pons. FOG may have been related to striatal dysfunction in this patient.
불면증상이 동반된 폐쇄성 수면 무호흡 환자의 정서적, 성격적 특성 : 미네소타 다면적 인성검사 분석
이지훈,신원철,나부석,이학영,최혜연,김상범,성민지,조한아,차현극 대한수면연구학회 2015 Journal of sleep medicine Vol.12 No.2
Objectives: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and insomnia are two of the most common sleep disorders in the general population. Because OSAHS patients with insomnia may have difficulty in adapting to the sleep breathing medical equipment, it is necessary to pay special attention to the diagnosis and treatment of comorbid insomnia. This study is to investigate the emotion and personality in OSAHS patients with insomnia complaints by using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Methods: We reviewed the results of the standardized questionnaires assessing sleep-related variables, MMPI, and polysomnographic findings of the patients diagnosed as OSAHS. Results: 145 subjects were 49.05±11.83 years of age. The mean Respiratory Disturbance Index was 33.57±19.91 and the mean score of Insomnia Severity Index (ISI) was 11.52±6.49. The mean scores of the Beck Depression Inventory (BDI) and MMPI-2 were within normal ranges. We divided the patients into two groups based on the scores of the ISI, OSAHS with insomnia (n=109) and OSAHS without insomnia (n=36). OSAHS patients with insomnia symptoms had significantly higher scores of hypochondriasis, hysteria, psychasthenia, schizophrenia, paranoia and psychopathic deviate scales and BDI than those without insomnia. Conclusions: Our results suggest that insomnia complaints are very common in OSAHS patients and the psychological problems are more frequently found in OSAHS patients with insomnia symptom than those without it. J Sleep Med 2015;12(2):59-63