Spontaneous spinal subarachnoid hemorrhage is unusual, accounting for less than 1% of all cases of subarachnoid hemorrhge. Very rare cases have been reported that they had no definitive etiology of spontaneuos spinal subarachnoid hemorrhage. One patient with spontaneous spinal subarachnoid hemorrhage is presented to emphasize the clinical and radiological features of this uncommon illness. The patient had severe back pain at the onset and was unable to walk. The s!mtoms improved slowly with conservative treatments. Complete blood work up CSF culture and spinal angiogrphy failed to reveal a cause for the hemorrhage. This is believed to be the first case report of spontaneous spinal subarachnoid hemorrhage of unknown cause in Korea.
Back Pain ; Hemorrhage ; Humans ; Korea ; Subarachnoid Hemorrhage*

OBJECTIVE: The aim of this study was to investigate frontal N30 status in Parkinson's disease (PD) and to examine the correlation between the amplitude of frontal N30 and the severity of motor deficits. METHODS: The frontal N30 was compared between 17 PD patients and 18 healthy volunteers. Correlations between the amplitude of frontal N30 and the Unified Parkinson's Disease Rating Scale (UPDRS) motor score of the more severely affected side was examined. RESULTS: The mean latency of the N30 was not significantly different between patients and healthy volunteers (p = 0.981), but the mean amplitude was lower in PD patients (p < 0.025). There was a significant negative correlation between the amplitude of N30 and the UPDRS motor score (r = -0.715, p = 0.013). CONCLUSIONS: The frontal N30 status indicates the motor severity of PD. It can be a useful biomarker reflecting dopaminergic deficits and an objective measurement for monitoring the clinical severity of PD.
Evoked Potentials ; Evoked Potentials, Somatosensory* ; Healthy Volunteers ; Humans ; Parkinson Disease*

A 57-year-old female was hospitalized for visual disturbance and right hemiparesis. MRI revealed cortical and sub-cortical infarcts in the left occipito-parietal area. One week later, she experienced paroxysmal electric shock like pain on the dorsum of her right hand. All analgesics failed to relieve her pain, but an antiepileptic drug eradicated the pain completely. This unusual seizure could have been misdiagnosed as a thalamic or pseudothalamic pain syndrome had an ictal EEG not been performed. We report the post-stroke somatosensory seizure, only with unilateral ictal pain. (J Korean Neurol Assoc 19(1):49~51, 2001
Analgesics ; Electroencephalography ; Female ; Hand ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Paresis ; Seizures* ; Shock ; Stroke

Acute infarcts of the anterior inferior cerebellar artery (AICA) territory are unusual. Furthermore incomplete AICA infarcts are perplexing because of its variations of vascular anatomy and inconsistent clinical features. We present a case with clinical features of AICA infarction, which consist of ipsilateral peripheral-type facial palsy, vertigo, and contralateral facial and upper limb sensory changes without motor weakness. The patient had hypertension and was a current smoker. The high signal intensity on inferior pontine tegmental area was found on MRI and the R2 interneuronal dysfunction was note on Blink reflex. The angiographic findings didn't show any focal vascular lesions, which is contrary to the pathogenesis of AICA infarction published previously. On the clinical ground, the present case reserves to attention in that patients with peripheral-type facial palsy should be properly evaluated and with thorough neurological examination and we could differentiate between the incomplete AICA infarcts such as Gasperini syndrome and Bell's palsy.
Arteries ; Bell Palsy ; Blinking ; Facial Paralysis* ; Humans ; Hypertension ; Infarction ; Interneurons ; Magnetic Resonance Imaging ; Neurologic Examination ; Upper Extremity ; Vertigo

BACKGROUND & OBJECTIVES: Severe hemispheric infarction(SHI) reportedly has various range of high mortality. Recently it has been reported that more aggressive therapeutic intervention, such as decompressive hemicraniectomy or mild hypothermia might has potential benefits in the management of SHI. However, the mortality and the prognosis of Sill under the conservative treatment were rarely studied yet in Korea. METHODS: Sixty-six patients with CT proven SHI were subjected among 1649 acute stroke patients registered at the Hallym Stroke Data Bank since Jan. 1993. We analyzed the computerized databases for the mortality and compared inclusively demographic features, clinical characteristics, etiology, therapy modalities and CT findings of fatal group with those of survivors. RESULTS: Twenty-five patients were expired among 66 SI-il patients(mean age: 64.9+/-11.5, male to female ratio;37:29). The mean time to expire was 160.4 hours. The fatal group had a significantly higher incidence of cardioembolism. uncontrolled BP during the acute stage, and extensive infarction territory(MCA+ACA). Risk factors for ischemic stroke such as hypertension, hyperlipidemia. smoking, previous stroke history, diabetes mellitus. and old age were not related to mortality low densities and hyperdense MCA signs on brain imaging were not different between two groups. CONCLUSIONS: The early mortality rate of Sill under the conservative care was 38% in a referral hospital of Korea. intractable hypertension in the acute stage, cardioembolism and extent of infarct area may have predictable values of early mortality of SHI.
Diabetes Mellitus ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Hypothermia ; Incidence ; Infarction ; Korea ; Male ; Mortality* ; Neuroimaging ; Prognosis ; Referral and Consultation ; Risk Factors ; Smoke ; Smoking ; Stroke ; Survivors

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry; to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome; and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity(NCV). The study group was divided into exposed group(39 cases)and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exist. 1. There are statistically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were confirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram; sensitivity 88.9%, specificity 84.2%. Tinel's sign; sensitivity 55.6%, specificity 72.8%. Phalen's sign; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.
Audiometry ; Carpal Tunnel Syndrome* ; Condoms* ; Diagnosis ; Hand ; Mass Screening ; Median Nerve ; Neural Conduction ; Occupations ; Prevalence ; Risk Factors ; Sensitivity and Specificity ; Ulnar Nerve ; Vibration ; Wrist

The habituation of early (R1) and late response (R2) of blink reflex was investigated in 44 patients with Parkinson's disease (PD) and 19 control subjects. The latency, duration and area of R1 and R2 components of blink reflex in single stimulation, and the percentage recovery of R1 in paired stimulation were not different between patients and control subjects. However, in PD patients, the latency of R2 evoked by test stimuli was shorter than that of conditioning stimuli, and the percentage recovery of R2 habituation was increased as compared to that of control subjects. The degree of early recovery of R2 habituation was slightly more evident in advanced PD patients and nonmedicated patients than that of control subjects. In addition, the early recovery of R2 was present in the test of asymptomatic side of PD patients. Our results suggests that blink reflex may be used as a method of evaluating the clinical status of PD patients.
Blinking* ; Humans ; Parkinson Disease*

We analysed video tapes in 31 patients of 97 seizures who were evaluated for epilepsy surgery at AMC Neurology department between 1992 and 1994. All patients had epilepsy surgery such as temporal lobe resection or gamma knife radiosurgery. They were either seizure free or had a greater than 90% reduction in the number of seizures for at least 12 months following surgery. Oromandibular automatism (74.2%), behavioral arrest/staring (63.9%), and upper extremity automatisms (37 1%) were frequent ictal manifestations of mesial temporal lobe epilepsy in our patients, Initial non-versive head turning was observed in 49 events (ipsilateral 77.8%, contralateral 22.2%), while versive head turning was noticed in 25 events (ipsilateral 7.1%, contralateral 92.9%). Contralateral dystonic posture was observed in 47 events (48.5%). Vocalization was observed in 2 among 12 patients (16.7%) with non-dominant sided lesions, and 9 among 19 patients (47.4%) with dominant sided lesions. Dystonic posture was observed contralaterally (100%), hand automatism ipsilaterally (94.4%) and versive head/eye turning wart observed ipsilaterally (92.3%) in our patients. So we concluded that valuable lateralizing sign in mesial temporal lobe origin seizure are contralateral dystonic posture, ipsilateral hand automatism, and versive contralateral head/eye turning. And also turning and rounding sign may have possible lateralizing value.
Automatism ; Epilepsy ; Epilepsy, Temporal Lobe* ; Hand ; Head ; Humans ; Neurology ; Posture ; Radiosurgery ; Seizures ; Temporal Lobe* ; Upper Extremity ; Warts

Phenylpropanolamine (PPA) is the major ingredient of over-the-counter drugs, including diet pills and nasal decon-gestants. We present a case of ICH induced by PPA in diet pills in a 36-year-old woman. She didn't have any medical concerns when she began taking diet pills, containing PPA, since 10 days before admission. A brain CT showed large ICHs on the right basal ganglia and lateral ventricle. Physicians should be alerted to the potential fatal side effects of PPA, in commonly used OTC drugs. (J Korean Neurol Assoc 19(3):298~301, 2001)
Adult ; Basal Ganglia ; Brain ; Cerebral Hemorrhage* ; Diet ; Female ; Humans ; Lateral Ventricles ; Nonprescription Drugs ; Phenylpropanolamine*

BACKGROUND: Hereditary neuropathy with liability to pressure palsies (HNPP) is a peripheral nerve disorder characterized by autosomal dominant inheritance, recurrent pressure palsies, reduced motor and sensory conduction velocities and sausage-like swellings (tomacula) of myelin sheaths in nerve biopsy. A 1.5-Mb deletion in chromosome 17p11.2- p12 is present in the majority but not all cases of HNPP. The aim of the present study was to evaluate the clinical, electrophysiological and morphological aspects of HNPP patients associated with chromosome 17p11.2-p12 deletion. METHODS: To detect the presence of the deletion, the DNA of the patients was analyzed with pVAW409R3 (D17S122). An electrophysiological study was done in all patients. Sural nerve biopsy with teasing was done in three patients. RESULTS: DNA analysis and electrophysiological tests revealed the deletion in 8 families and 16 patients. Nerve conduction studies demonstrated diffuse mild to moderate slowing of nerve conduction velocities especially worse over the common entrapment sites, regardless of clinical manifestations. The long duration of compound muscle and nerve action potentials without conduction blocks or dispersion is characteristic of patients with HNPP. The tomacula of myelin sheaths was found on sural nerve teasing. CONCLUSIONS: We report the clinical, electrophysiological and morphological aspects of the Korean HNPP patients associated with chromosome 17p11.2-p12 deletion. (J Korean Neurol Assoc 19(3):251~259, 2001)
Action Potentials ; Biopsy ; DNA ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery* ; Myelin Sheath ; Neural Conduction ; Paralysis ; Peripheral Nerves ; Sural Nerve ; Wills