We report a 71 years old woman with transient periodic limb movement disorder and myoclonus that appeared after acute gastrointestinal bleeding. The abnormal movements dissolved as the blood loss was restored. The woman was later found to have an asymptomatic spine meningioma. Iron defi ciency due to acute bleeding may be the trigger resulting in the abnormal movements in this patient with subclinical spinal meningioma

BACKGROUND: Sleep disturbance (SD), parasomnia and excessive daytime sleepiness (EDS) are commonly reported in Parkinson disease (PD). But frequencies and etiological factors are not congruent in different studies. METHODS: We studied those patients who had visited our clinic and had been diagnosed as PD using a structured questionnaire. Disease severity was graded according to Hoehn and Yahr stage into 8 stages. Drug history of the patients is reviewed by medical records. SD is defined to be present when one complains of poor sleep regardless of sleep duration. We define sleep benefiter as those who are 'best' and 'on' in the morning. If one has 10 or more scores on the Epworth sleepiness scale, we regard him/her as having EDS. RESULTS: One hundred PD patients are recruited. Thirty-eight of them complain of sleep disturbance. The patients with SD need longer time to get into sleep, and have shorter sleep duration than those without SD. The average number of sleep fragmentation is higher in SD group. Vivid dreams are the most common parasomnia. Sleep benefiters are 61%. They have less amount of levodopa equivalent dose than non-sleep benefiter. Those with EDS have shorter sleep duration. And there are more snorers in them. CONCLUSIONS: We can confirm that SD, parasomnia and sleep benefit is commonly observed in PD patients.
Dreams ; Humans ; Levodopa ; Medical Records ; Parasomnias ; Parkinson Disease ; Surveys and Questionnaires ; Sleep Deprivation

No abstract available.
Delusional Parasitosis ; Delusions ; Humans ; Infarction ; Posterior Cerebral Artery

Neurological manifestations of systemic lupus erythematosus (SLE) can mimic multiple sclerosis (MS) or Devic's syndrome (DS). We report a 16-year-old woman with recurrent myelitis and optic neuritis. She also had an antinuclear antibody, an anti double-stranded DNA antibody and a positive lupus erythematosus cell. Because MS is a diagnosis of exclusion, brainstem involvement is not compatible with DS. We therefore diagnosed her case as a SLE with recurrent myelitis and optic neuritis.
Adolescent ; Antibodies, Antinuclear ; Brain Stem ; Diagnosis ; DNA ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis ; Myelitis* ; Neurologic Manifestations ; Neuromyelitis Optica ; Optic Neuritis*

Specific cutaneous infiltrates in chronic lymphocytic leukemia(CLL) presenting as tumor and large nodule on face, scalp and upper trunk and involvement of oral mucsa is extremly rare. In 7% of cases, leukemic infiltrates of the skin precede the diagnosis of Leuke. We report herein leukemic macrocheilia which occured 3 years before a diagnosis of CLL.
Diagnosis ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Scalp ; Skin

Supernunmerary nipple is a developmental anomaly occuring alon, the course of the embryological milk lines. This entity has receieved little attention in the dermatologic literature and has been confused with a pigmented nevus in some cases. We have experienced two ease of the more unusual form of supern umerary nipple. According to the Kajavas classification, our caes are classified as polithelia pilosa and complete breast with nipple.
Breast ; Classification ; Milk ; Nevus, Pigmented ; Nipples*

BACKGROUND AND PURPOSE: A carboxy-O-methyl transferase inhibitor entacapone has been introduced as an adjuvant drug for Parkinson disease (PD) patients. Although clinical trials reported beneficial role of entacapone, a long-term trial over 3 years failed to show significant effect. The goals of this study were to evaluate the clinical benefit and the efficacy of entacapone in an open clinical practice. METHODS: After the completion of a double-blind placebo-controlled entacapone study, 149 patients from 4 centers were included. Antiparkinsonian medications were optimized by the judgment of the neurologists in charge. The clinical global impression (CGI) scale was obtained at 6 months and 1 year after the initiation of entacapone treatment. RESULTS: Of the 149 patients, 117 patients chose to try entacapone in an open-label fashion. Sixty-nine (59%) patients completed the 1-year trial. Twenty-nine patients discontinued entacpaone before 6 months, and 19 between 6 months and 1 year during trial. Twelve patients out of 48 patients discontinued entacapone because of its poor efficacy. The CGI scale was 3.9 (+/-1.5) at the beginning of the trial, 4.3 (+/-1.1) at 6 month, and 3.8 (+/-1.3) at 1 year, respectively. The CGI scale of those who discontinued between 6 month and 1 year was 3.4 (+/-1.7), which was worse, but insignificantly, than that of the continuer. CONCLUSIONS: The dropout at 1 year of our study was very high at 41%. Even though entacapone is indicated for advanced PD patients with motor fluctuation, the fluctuators commonly have dyskinesia and mental symptoms, which can become more troublesome with entacapone. In the patients with advanced PD, the clinical efficacy and side effects should be carefully considered in a long-term use of entacapone.
Dyskinesias ; Humans ; Judgment ; Parkinson Disease* ; Patient Dropouts ; Transferases

Objectives: To survey daily doses of dopaminergic medications and to draw a posteriori equation of the dose in relation to the various clinical variables in Korean patients with Parkinson disease. Methods: A multi-center cross-sectional survey was conducted over a defi ned period. Information on patient demographics and clinical features including age at Parkinson disease onset, disease duration, treatment duration and Hoehn and Yahr stage, and daily doses of anti-parkinsonian drugs was obtained from the patients’ medical records. Results: A total of 1,762 patients with Parkinson disease were recruited from 6 referral centers. The mean L-dopa equivalent daily dose (LEDD) in the whole population was 608.9 mg/day, which tended to increase linearly depending on the duration of disease and Hoehn and Yahr stage. LEDD was also signifi cantly affected by age and gender. We performed multiple linear regression analyses and devised a posteriori equation of LEDD with clinical variables. Conclusions: This survey provides systematic data for mean LEDD in Korean Parkinson disease patients. In spite of profound individual variations in LEDD, our linear regression model provides an insight about the relationship between daily doses of dopaminergic medications and various clinical features of Parkinson disease.