No abstract available.
Korea* ; Orientia tsutsugamushi* ; Rickettsia*

The most frequently reported neurological complication of a wasp sting is ischemic stroke. We treated a patient with wasp sting with unusual complications. A 52-year-old man was hospitalized for anaphylactic shock after multiple wasp stings. Although the patient recovered consciousness after 2 days, he had global aphasia and right hemiparesis. Brain magnetic resonance imaging and angiography revealed high-intensity signals in the left basal ganglia and cerebral cortex and stenosis of the left middle cerebral artery. After 2 days, the middle cerebral artery stenosis improved. After 5 days, diffusion-weighted imaging showed an enlarged lesion in the left frontal cortex. The infarct in this case was due to a predominantly unilateral vasoconstrictive hypoxic brain injury from wasp stings.
Brain Injuries

No abstract available.
Brain Injuries* ; Brain* ; Dentate Gyrus*

Atherosclerotic lesions at the aortic arch are recognized as critical sources of embolic strokes. However, there have been few case reports of aortic arch thrombus occurring without atherosclerotic changes, especially those related to iron deficiency anemia (IDA). A 44-year-old woman was admitted due to rapid-onset right hemiparesis and aphasia. Etiological investigations for cerebral infarction revealed no abnormality other than IDA. This is a rare case of cerebral embolic infarction caused by an aortic arch thrombus with IDA in a middle-aged woman.
Adult ; Anemia, Iron-Deficiency* ; Aorta, Thoracic* ; Aphasia ; Cerebral Infarction ; Female ; Humans ; Infarction* ; Iron* ; Paresis ; Stroke ; Thrombosis*

The objective is this study is to provide a comprehensive understanding of the clinical implication of transcranial magnetic stimulation (TMS) in Alzheimer's dementia (AD). We collected studies using TMS in patients with AD and reviewed 41 identified articles. Thirty five articles were about measures of cortical reactivity, plasticity, connectivity, and six articles were about the enhancement of cognitive function in AD. Reduced short-latency afferent inhibition and resting motor threshold which reflect cholinergic dysfunction and enhanced cortical excitability respectively are consistent findings of altered cortical reactivity in AD. In addition, cortical plasticity and connectivity have shown impaired results in AD compared with healthy controls. Repetitively delivered TMS can improve several domains of cognitive function impaired in AD. Although the evidence is still preliminary, TMS has a clinical implication as a diagnostic and therapeutic method in AD. Thorough investigation of factors that can affect the results of TMS and further studies to clarify the results are needed.
Dementia* ; Humans ; Plastics ; Transcranial Magnetic Stimulation*

No abstract available.
Neck*

OBJECTIVE: To find the developing features of H reflex by the gradual increase of stimulation intensity, to evaluate the variability of each H reflex latency, and to verify the consistency of the side-to-side difference of bilateral H reflex latencies in normal population. METHOD: Fifty normal persons (100 limbs) were studied. H reflexes were elicited using standardized technique from Braddom and Johnson. RESULT: H reflex developed in the stimulation intensity at which M response was not evoked in 46 of total 100 limbs. The latency difference between the longest and shortest in each ipsilateral evoked potential was 0~2.1 ms (mean 0.65+/-0.44 ms). In the side-to-side latency difference between the variously evoked H waves, the mean value of maximal one was 1.28+/-0.63 ms (0.4~2.6 ms), and the mean value of the minimal one was 0.24+/-0.35 ms (0~1.5 ms). The mean side-to-side latency difference between the H waves of maximal amplitudes was 0.69+/-0.46 ms (0.1~1.6 ms), and the mean side-to-side difference between the shortest latencies was 0.61+/-0.53 ms (0~2.1 ms). Among these findings the latency difference of the maximal amplitude was observed in 47 cases with 0~1.5 ms, in 3 cases with more than 1.5 ms. CONCLUSION: In diagnosing the S1 radiculopathy with the side-to-side latency difference it will be reasonable to use the latency of maximal amplitude or the shortest latency as diagnostic tool, and reevaluation will be needed with the diagnostic criteria of 1.5 ms latency difference.
Evoked Potentials ; Extremities ; H-Reflex* ; Humans ; Radiculopathy

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
Aphasia ; Aphasia, Broca ; Cognition ; Delivery of Health Care ; Hemianopsia ; Hemiplegia ; Humans ; Medicalization ; Neurologic Manifestations ; Rehabilitation ; Stroke

No abstract available.
Epilepsy

Objectives: The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. Methods: Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. Results: After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. Conclusions Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.