BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder that often resolves spontaneously. It was long believed that the condition was caused by inorganic particles in the cupula of the posterior semicircular canal. Management of this condition includes medication, surgery, physical exercise and more recently particle repositioning maneuvers. Among the various therapies, exercise therapy (ET) reported by Brandt-Daroff was based on the theory of cupulolithiasis and is designed to treat BPPV through dispersion of the debris from the cupula. METHODS: Fifty four patients with BPPV were treated with ET to determine the effectiveness. Fifteen additional patients with BPPV were treated with only medication and served as a control group. RESULT: Forty eight of 54 cases (88.9%) treated with ET showed improvement after 2 weeks. With medication alone, 8 of the 15 cases (53.4%) showed improvement after 2 weeks. CONCLUSIONS: The most important benefit of this maneuver seemed to be more expedient recovery than that with medication alone.
Exercise ; Exercise Therapy* ; Humans ; Semicircular Canals ; Vertigo*

This study was done in order to obtain normal data and normal wave form variations of brainstem auditory evoked potential (BAEP) on various click stimulations of intensities of intensities and frequencies. Observations were made on 50 normal Korean volunteers (32 males and 18 females) ranging in age from 8 to 56 years. Silver disc electrodes 7mm in diameter were placed over the right and left ear lobes and vertex. Earphone rarefaction click stimulations were given with 10 click/sec 70 dB, 50 click/sec 70 dB and 10 click/sec 50 dB, and contralateral 40 dB masking noise. Using Medelec Sensor, input from recording electrode was led to differential amplifiers and the output was summated by average system and then recorded by X-Y plotter. Analysis time, low filter and high filter are adjusted to 10 msec, 100 Hz and 3,000 Hz, respectively, and 2,048 responses were summated. Normal data on various click stimulations and wave form variations of BAEPs were obtained. Increased intensity of click stimulation produced decreased latency and increased amplitude of each BAEP more discrete BAEP waves cound be obtained at 10 click/sec 70 dB than other type of stimulations. Absolute latency of each BAEP wave and interpeak latency were not significantly different from those of the normal data of the other laboratories.
Brain Stem* ; Ear ; Electrodes ; Evoked Potentials, Auditory, Brain Stem* ; Humans ; Male ; Masks ; Noise ; Silver ; Volunteers

Redundant nerve root syndrome(RNRS) is a rare case. It was first reported by Verbiest in 1951. Thereafter a few cases were reported in neurosurgical field, but they were not reported in neurological field. We report a case of RNRS of the cauda equina. The clinical featuresl of the patient were chronic lumbago, radicular pain, leg weakness & atrophy, and intermittent neurogenic claudication. Myelography revealed characteristic serpentine filling defects in the cauda equina.
Atrophy ; Cauda Equina* ; Humans ; Leg ; Low Back Pain ; Myelography

Tuberous sclerosis (TS) is a complex genetic disorder characterized by the formation of multiple hamartomas. It was first described by von Recklinghausen in 1862. In 1880, Boumeville coined the term sclerose tubererse. In 1908, Vogt emphasized the classic triad of seizures, mental retardation, and adenoma sebaceum. TS is inherited as an autosomal dominant trait with a high incidence of sporadic cases. TS might be a relatively common disease, but familial cases were not reported commonly in neurological field. We reported a familial TS in brothers with protean clinical expressivity.
Hamartoma ; Humans ; Incidence ; Intellectual Disability ; Numismatics ; Seizures ; Siblings ; Tuberous Sclerosis*

Leprosy, one of the oldest diseases known to humans, still affects almost 10-15 million people throughout the world. Neuropathy affects 15-20% of infected individuals. Therefore leprous neuropathy is still one of the most common neuropathy in the world. It is due to infection with Mycobacterium leprae and occurs primarily in Asia and Africa. The cardinal symptom of leprosy is sensory loss caused by superficial neuropathy. Anesthetic depigmented skin lesions are an important finding and should be sought. Nerve involvement is a hallmark of leprosy. Nerve involvement is rare in other diseases, so the finding of skin lesions with enlarged nerves should raise the possibility of leprosy. Nerve involvement tends to occur with skin lesions, and the pattern of nerve involvement parrellels the skin disease. In the tuberculoid form, mononeuropathy multiplex is typical pattern, whereas asymmetrical or symmetrical polyneuropathy is most common in the lepromatous form. Motor involvement occurs in a predictable sequence as a result of nerve trunk damage to those nerves that course close to the skin surface and hence are locally cool. Nerve involved include the ulnar nerve at the elbow, the deep peroneal branch at the ankle, superficial branches of the facial nerve, and the median nerve at the wrist, and especially the greater auricular nerve. Nerve involvement without skin lesions, called pure neural leprosy, can occur. Other characteristic findings are thickened nerve, trophic ulcers, mutilated digits, and Charcot joint. In clinically affected nerves, the motor nerve conduction velocities are minimally slow. The terminal latency is often prolonged and the compound muscle action potentials are temporally dispersed and decreased in amplitude. Sensory and mixed compound nerve action potentials are often difficult to obtain or else a reduced amplitude. The facial nerve is commonly involved in leprosy. Improvement in motor nerve conduction was reported in leprosy patients under sulfone treatment. Nerve biopsy reveals subperineurial edema and various amounts of loss of myelinated and unmyelinated fibers. Teased fiber studies reveal paranodal demyelination affecting successive internodes. Therefore segmental demyelination is the main pathology in leprous neuropathy.
Action Potentials ; Africa ; Ankle ; Arthropathy, Neurogenic ; Asia ; Biopsy ; Demyelinating Diseases ; Edema ; Elbow ; Facial Nerve ; Humans ; Leprosy ; Leprosy, Tuberculoid ; Median Nerve ; Mononeuropathies ; Mycobacterium leprae ; Myelin Sheath ; Neural Conduction ; Pathology ; Polyneuropathies ; Skin ; Skin Diseases ; Ulcer ; Ulnar Nerve ; Wrist

Niopam is a newer, nonionic, watersoluble contrast medium used predominately in cisternographic and myelographic studies with metrizamide lately. The former has fewer, less severe and shorter adverse reactions than the latter. Until now there were no reports on meningitis complicating Niopam CT cisternography or myelography. Now we present a case of aseptic purulent meningitis complicating Niopam CT cisternography.
Iopamidol* ; Meningitis* ; Metrizamide ; Myelography

Creutzfeldt-Jakob disease (CJD) is a rare dementing illness that usually affects older adults and is characterized by a rapidly progressive dementia, ataxia, and myoclonus. The disease is due to an unusual transmissible protein called a prion. The diagnosis is often suspected on the basis of electroencephalographic (EEG) and clinical findings. Our case was 62-year-old woman, who presented acute onset rapid progressive dementia, myoclonus, heightened startle reaction, extrapyramidal symptoms, and died about 2.5 months after onset of disease. We diagnosed this case as CJD with typical EEG pattern and clinical features.
Adult ; Ataxia ; Creutzfeldt-Jakob Syndrome* ; Dementia* ; Diagnosis ; Electroencephalography ; Female ; Humans ; Middle Aged ; Myoclonus ; Startle Reaction

This study was conducted to observe complications of the nervous system in chronic renal failure (CRF) and to observe the time of recovery of the nervous complications after successful renal transplantation. Median nerve somatosensory evoked potentials(MN-SEP), tibial nerve somatosensory evoked potentials(TN-SEP), brainstem auditory evoked potentials(BAEP) and visual evoked potentials (VEP) were recorded by using a Medelec ST10 Sensor EP apparatus before renal transplantation and subsequently 2, 4 and 12 weeks after renal transplantation in 40 CRF patients (32 men and 8 women). Results were then compared with normal data from age, sex and height matched controls. . At the same time of EP testing, BUN, serum creatinine, hemoglobin, hematocrit and parathyroid hormone of CRF patients were checked, and these changes were compared with the alterations of multimodal EP. In pre-renal transplantation states, the values of all of the absolute latencies and most d the interpeak latencies of MN-SEP,TN-SEP and BAEP were more prolonged than those of normal controls, but absolute latencies of VEP were not prolonged significantly. Multimodal EP responses except VEP showed improvement toward normal for 2 weeks, a steady state until 4 weeks, and then further improvement until 12 weeks after renal transplantation. In general, multimodal EP responses except BAEP showed more significant improvement in 12 weeks than did those of 2 weeks after renal transplantation MNSEP did not recover to normal control levels even by 12 weeks after renal transplantation, whereas some of the TN-SEP components had recovered to normal control levels in 2 weeks after renal transplantation, but VEP showed no significant alterations compared with normal controls before and after renal transplantation. In pre-renal transplantation states, most frequent abnormalities were found in MN-SEP (51.3%) whereas least frequent abnormalities were in VEP (5%). BAEP showed only peripheral nervous system dysfunction, whereas the other EP showed central and peripheral.
Brain Stem ; Creatinine ; Evoked Potentials* ; Evoked Potentials, Visual ; Hematocrit ; Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Male ; Median Nerve ; Nervous System ; Parathyroid Hormone ; Peripheral Nervous System ; Tibial Nerve

This study was performed to observe the effectiveness of thymectomy in the management of myasthenia gravis. Twenty-seven myasthenic patients were undergone thymectomy at Keimyung University Dongsan Hospital between January 1981 and December 1990. The most prevalent age group was the 3rd decade and the myasthenic syrnptom developed below thirty in most. Seven patients had remission and 10 patients fared better after thymectomy. There was no significant effect with age and duration of the disease in the result of thymectomy. Those with less severe group had better response than more severe group and non-thymoma group had higher remission rate without statistical significance than thymoma group. There were better response and more complications in the group with maximal thymectomy than simple thymectomy. This study demonstrated that the effect of thymectomy was better in less severe, nontymoma and maximal thymectomy group in myasthenia gravis.
Humans ; Myasthenia Gravis* ; Thymectomy* ; Thymoma

Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. Fever, headache and vomiting are common clinical presentations of the cryptococcal meningitis. But ischemic stroke and cranial nerve impairment are rare neurologic complications. We report a case of cryptococcal meningoencephalitis presenting as cerebral infarction and multiple cranial nerve palsies.
Cerebral Infarction ; Cranial Nerve Diseases ; Cranial Nerves ; Cryptococcosis ; Fever ; Headache ; Meningitis, Cryptococcal ; Meningoencephalitis ; Stroke ; Vomiting