41 research outputs found
Two Cases of Primary SjΓΆgren's Syndrome Presenting as Relapsing-Remitting Multiple Sclerosis
SjΓΆgren's syndrome is a slowly progressive autoimmune disorder that predominantly affects major exocrine glands, and may also involve the central nervous system (CNS). It is sometimes very difficult to differentiate the CNS SjΓΆgren's syndrome from multiple sclerosis. Here, we report two cases of SjΓΆgren's syndrome who developed variable neurological symptoms mimicking the relapsing-remitting form of multiple sclerosis. There had been several relapses during the course of interferon-beta treatment but no relapses have occurred after steroid maintenance therapy.ope
Serial Follow-up of Neuroimaging Findings in a Progression-free Survival Case with Progressive Multifocal Leukoencephalopathy in Nonimmunocompromised Child
Progressive multifocal leukoencephalopathy (PML) is a demyelination disease caused by opportunistic infection of the ubiquitous, usually nonpathogenic neurotropic papovavirus (JC virus). The virus infects and destroys myelin-producing oligodendrocytes, thereby causing patchy areas of demyelination in the cerebral white matter. It is exclusively a disease of immunosuppressed individuals. We report a case of an immunocompetent child patient with pathologically-proven PML and with a survival over 3 years after diagnosis. Serial follow up of neuroimaging study including brain MRI, MRS, SPECT and PET was obtained.ope
Sensory change in pure motor stroke
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μ λμ‘°κ΅°μ λμμΌλ‘ 격μν΄μλ₯μμΉ(grating resolution threshold, GRT)λ₯Ό μΈ‘μ νμ¬ νμκ΅°μ λ§λΉλ μμ§μ μ μμΈ‘ μμ§μμ κ°κ°κΈ°λ₯μ μ μν μ°¨μ΄κ° μλμ§ μμλ³΄κ³ , μ μλμ‘°κ΅°μ κ²°κ³Όμ λΉκ΅νκ³ , μ΄κΈ° λ§λΉμ λ λ° μ₯μ νΈμ κ³Όμ μ°κ΄μ±μ λΆμνμλ€. ν΅κ³νμ λ°©λ²μΌλ‘ SPSS ν΅κ³νλ‘κ·Έλ¨μ μ΄μ©νμ¬ μ¬νκ²μ μΌλ‘ Ο2 κ²μ¬, λμκ³Ό λΉλμνλ³Έ t-κ²μ , λ¨μνκΈ°λΆμ(simple regression analysis) λ° λΆμ°λΆμ(analysis of variance)μ μ±ννμκ³ , μ μμμ€μ p-value<0.05λ₯Ό μ μ©νμλ€. μ΄ μ€νμ κ²°κ³Ό, νμμ λ§λΉλμ§ μλ μμ§μ GRT (2.91Β±0.71 mm) μ μ μ λμ‘°κ΅°μ GRT (2.77Β±0.57 mm) κ°μ ν΅κ³μ μΌλ‘ μ μν μ°¨μ΄λ μλ λ°λ©΄, νμμ λ§λΉλ μμ§μ GRT (2.45Β±0.66 mm) μ λμΌν νμμ λ§λΉλμ§ μμ μμ§μμ μΈ‘μ ν GRT λ° μ μ λμ‘°κ΅°μμ μΈ‘μ ν GRTκ°μλ ν΅κ³μ μΌλ‘ μ μν μ°¨μ΄λ₯Ό λ³΄μ¬ λ§λΉλ μμ§μμ μ μν κ°κ°κΈ°λ₯μ ν₯μμ΄ κ΄μ°°λμλ€. νμμ λ§λΉλ μμ§μμ μΈ‘μ ν GRTκ° National Institutes of Health Stroke Scale (NIHSS) μ μ΄μ©ν μ΄κΈ° λ§λΉμ λμ ν΅κ³μ μΌλ‘ μλ―Έμλ μλΉλ‘ μκ΄κ΄κ³(r=-0.310, p<0.05)λ₯Ό λνλ΄μ΄ μ΄κΈ° μ΄λλ§λΉκ° μ¬ν μλ‘ λμΌν μμ§μ κ°κ°κΈ°λ₯μ ν₯μμ μ¦κ°λλ μμμ 보μμΌλ, μ΄κΈ° GRTμ μ΄λλ§λΉ ν볡μ¬μ΄μ μ μν μκ΄μ±μ κ΄μ°°λμ§ μμλ€. λν λ³λ³μ μμΉμ λ°λ₯Έ GRTλ κΈ°μ ν΅ λ° μμ¬μ λ§ λ³λ³μ΄ 2.49Β±0.63 mm, λκ° λ³λ³μ΄ 2.48Β±0.65 mm, λλλΆμ±μ΄ λ° λλνΌμ§ λ³λ³μ΄ 2.36Β±0.63 mmλ‘ μ΄λ€ λ³λ³μ μμΉμ GRTκ°μ ν΅κ³μ μΌλ‘ μ μν μ°¨μ΄λ κ΄μ°°λμ§ μμλ€. μ΄λ¬ν κ²°κ³Όλ κ°κ°μ κ²½κ³μ λν μ΄λμ κ²½κ³μ μ΅μ κ° μ‘΄μ¬νλ©° μ΄λλ§λΉμ μ΄λ¬ν μν₯μ κ°μλ‘ κ°κ°κΈ°λ₯μ΄ ν₯μλ μ μμμ μμ¬νλ€.
[μλ¬Έ]Sensorimotor integration is an essential mechanism for adequate control of voluntary movement. Activation of the sensory cortex results in suppression of motor cortical excitability, suggesting the presence of inhibitory interconnection between sensory and motor system in human brain. However, the influence of motor activation or deactivation on sensory system has not been documented. We hypothesize that impaired motor activity improves sensory discrimination, if reciprocal inhibition is present between sensory and motor system. To test this hypothesis, we evaluated sensory change in the patients with pure motor stroke using Johnson-VanBoven-Philips dome (JVP dome). Study subjects were 83 consecutive patients with acute pure motor stroke and 75 age-matched healthy volunteers. Exclusion criteria were as follows: (1) patients with transien ischemic attack ; (2) patients with a communication problem or cognitive impairments ; (3) patients with evidence of peripheral neuropathy ; (4) patients with multiple strokes. All volunteers were normal on routine neurological examination without cognitive impairment. Using JVP dome, we measured grating resolution threshold (GRT) in the distal phalanx of the index fingers in both the patients and controls, and checked the severity of motor deficit by National Institutes of Health Stroke Scale (NIHSS). The relationship between GRT and other clinical characteristics, such as degree of initial motor deficit, magnitude of motor improvement, and location of stroke was analyzed. GRT was signifcantly lower in the paretic hand (2.45Β±0.66 mm) than in the non-paretic hand of the patients (2.91Β±0.71 mm) and in the controls (2.77Β±0.57 mm). GRT was significantly and inversely correlated with the severity of initial motor deficit (r=-0.310; p<0.05), but was not correlated with the motor improvements during admission (r=0.065). Location of infarction did not influence GRT in the paretic hand of the patients. The present results demonstrate that sensory discrimination was enhanced in the paretic hand, and support the hypothesis that motor system exerts inhibitory influence on sensory system.ope