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      급성순수외측연수경색에서 딸꾹질과 병변의 위치적 연관성

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      https://www.riss.kr/link?id=A101607803

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      다국어 초록 (Multilingual Abstract)

      Background: Intractable hiccup is not a frequent but disabling condition of lateral medullary infarction (LMI). Unlike other symptoms and signs of LMI, the anatomical lesions of intractable hiccup are not well known. Although there were studies about clinical-radiological correlation using MRI, few studies have evaluated the relation between lesional location of LMI and intractable hiccup. Therefore, we performed this study to clarify the lesional correlation with intractable hiccup in LMI. Methods: Between 1997 and 2003, we identified 12 patients with pure LMI (LMI without concomitant midbrain, pontine, cerebellar, or cerebral infarction) who presented with intractable hiccup in addition to typical lateral medullary syndrome. Eighteen patients without hiccup were included as control group. Clinical and radiologic findings were compared between two groups. Results: The patients with intractable hiccup significantly more often had dorsal lesions rather than ventral lesions at horizontal levels (P=0.011). But, there were no rostrocaudal differences at vertical levels. Conclusion: We suggest that pure LMI associated with intractable hiccup often locates in the dorsal medulla at horizontal correlation. This comparative study using MRI helps us to expand the understanding of the neural substrate for intractable hiccup in LMI. (Korean J Stroke 2008;10:30-35)
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      Background: Intractable hiccup is not a frequent but disabling condition of lateral medullary infarction (LMI). Unlike other symptoms and signs of LMI, the anatomical lesions of intractable hiccup are not well known. Although there were studies about ...

      Background: Intractable hiccup is not a frequent but disabling condition of lateral medullary infarction (LMI). Unlike other symptoms and signs of LMI, the anatomical lesions of intractable hiccup are not well known. Although there were studies about clinical-radiological correlation using MRI, few studies have evaluated the relation between lesional location of LMI and intractable hiccup. Therefore, we performed this study to clarify the lesional correlation with intractable hiccup in LMI. Methods: Between 1997 and 2003, we identified 12 patients with pure LMI (LMI without concomitant midbrain, pontine, cerebellar, or cerebral infarction) who presented with intractable hiccup in addition to typical lateral medullary syndrome. Eighteen patients without hiccup were included as control group. Clinical and radiologic findings were compared between two groups. Results: The patients with intractable hiccup significantly more often had dorsal lesions rather than ventral lesions at horizontal levels (P=0.011). But, there were no rostrocaudal differences at vertical levels. Conclusion: We suggest that pure LMI associated with intractable hiccup often locates in the dorsal medulla at horizontal correlation. This comparative study using MRI helps us to expand the understanding of the neural substrate for intractable hiccup in LMI. (Korean J Stroke 2008;10:30-35)

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      참고문헌 (Reference)

      1 Sacco RL, "Wallenberg’s lateral medullary syndrome: Clinical-magnetic resonance imaging correlations" 50 : 609-614, 1993

      2 Kim JS, "Spectrum of lateral medullary syndrome: correlation between clinical findings and magnetic resonance imaging in 33 subjects" 25 : 1405-1410, 1994

      3 Arita H, "Serotonin innervation patterns differ among the various medullary motoneuronal groups involved in upper airway control" 95 : 100-110, 1993

      4 Kim JS, "Pure lateral medullary infarction: clinical-radiological correlation of 130 acute, consecutive patients" 126 : 1864-1872, 2003

      5 Kumral E, "Primary medullary haemorrhage with intractable hiccup" 245 : 620-622, 1998

      6 Musumeci A, "Persistent hiccup as presenting symptom in medulla oblongata cavernoma: a case report and review of the literature" 102 : 13-17, 2000

      7 Lee SS, "Myung HJ. A Clinical study of 21 patients with lateral medullary syndrome" 7 : 42-51, 1989

      8 Norrving B, "Medullary infarcts and hemorrhages, In Stroke Syndromes. 2nd ed" Cambridge University Press 534-539, 2001

      9 Park MH, "Lesional location of lateral medullary infarction presenting hiccups (singultus)" 76 : 95-98, 2005

      10 Norrving B, "Lateral medullary infarction: prognosis in an unselected series" 41 : 244-248, 1991

      1 Sacco RL, "Wallenberg’s lateral medullary syndrome: Clinical-magnetic resonance imaging correlations" 50 : 609-614, 1993

      2 Kim JS, "Spectrum of lateral medullary syndrome: correlation between clinical findings and magnetic resonance imaging in 33 subjects" 25 : 1405-1410, 1994

      3 Arita H, "Serotonin innervation patterns differ among the various medullary motoneuronal groups involved in upper airway control" 95 : 100-110, 1993

      4 Kim JS, "Pure lateral medullary infarction: clinical-radiological correlation of 130 acute, consecutive patients" 126 : 1864-1872, 2003

      5 Kumral E, "Primary medullary haemorrhage with intractable hiccup" 245 : 620-622, 1998

      6 Musumeci A, "Persistent hiccup as presenting symptom in medulla oblongata cavernoma: a case report and review of the literature" 102 : 13-17, 2000

      7 Lee SS, "Myung HJ. A Clinical study of 21 patients with lateral medullary syndrome" 7 : 42-51, 1989

      8 Norrving B, "Medullary infarcts and hemorrhages, In Stroke Syndromes. 2nd ed" Cambridge University Press 534-539, 2001

      9 Park MH, "Lesional location of lateral medullary infarction presenting hiccups (singultus)" 76 : 95-98, 2005

      10 Norrving B, "Lateral medullary infarction: prognosis in an unselected series" 41 : 244-248, 1991

      11 Victor M, "Lateral Medullary Syndrome, In Adams and Victor’s principles of neurology" McGraw-Hill 678-682, 2001

      12 Marsot-Dupuch K, "Intractable hiccups: the role of cerebral MR in cases without systemic cause" 16 : 2093-2100, 1995

      13 Kumar A, "Intractable hiccups during stroke rehabilitation" 79 : 697-699, 1998

      14 al Deeb SM, "Intractable hiccup induced by brainstem lesion" 103 : 144-150, 1991

      15 McFarling DA, "Hoquet diabolique: intractable hiccups as a manifestation of multiple sclerosis" 29 : 797-801, 1979

      16 Friedman NL, "Hiccups: a treatment review" 16 : 986-995, 1996

      17 Loft LM, "Hiccups. A case presentation and etiologic review" 118 : 1115-1119, 1992

      18 Launois S, "Hiccup in adults: an overview" 6 : 563-575, 1993

      19 Arita H, "Generation of hiccup by electrical stimulation in medulla of cats" 175 : 67-70, 1994

      20 Oshima T, "GABAergic inhibition of hiccup-like reflex induced by electrical stimulation in medulla of cats" 30 : 287-293, 1998

      21 Kwon M, "Dysphagia in unilateral medullary infarction: lateral vs medial lesions" 65 : 714-718, 2005

      22 Kim H, "Aspiration subsequent to a pure medullary infarction: lesion sites, clinical variables, and outcome" 57 : 478-483, 2000

      23 Askenasy JJ, "About the mechanism of hiccup" 32 : 159-163, 1992

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