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*

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

We report a case of delayed rupture of an anterior communicating artery (Acom) pseudoaneurysm following mechanical thrombectomy (MT) of a distal artery occlusion using a stent retriever. An elderly patient with right hemiparesis showed left proximal internal cerebral artery and middle cerebral artery occlusions. During MT, a fragmented thrombus moved to the anterior cerebral artery (ACA). A stent retriever was deployed to the occluded ACA, and the Acom and proximal ACA segment were significantly straightened. Additionally, we attempted a blind exchange mini-pinning (BEMP) technique, but a subarachnoid hemorrhage (SAH) occurred. Bleeding was almost entirely absorbed 9 days after the procedure, but the SAH recurred at 20 days, and computed tomography angiography revealed a new pseudoaneurysm formation in the Acom. We suggest that the proposed mechanism of pseudoaneurysm formation was likely due to the dislocation and avulsion of the Acom perforators when the ipsilateral ACA was pushed and pulled during MT.

Herpes zoster is a viral disease that produces inflammatory lesions in the posterior root ganglia and is characterized clinically by pain and a skin eruption in the distribution of the affected ganglia. Involvement of motor roots or the CNS occurs in a small percentage of the patients. There are few reports about multiple cranial and upper cervical nerve involvement. We report a herpes zoster with multiple cranial(VI, VII, VIII, XII) and upper cervical(C2,3) nerves involvement. The patient was a 79-year-old woman who presented with painful vesicular eruption on left side of face and neck. She complained of decreased hearing and hyperacusis of left ear. Neurologic examination showed decreased taste sensation of left anterior tongue, left facial palsy, and tongue deviation to the left side.
Aged ; Ear ; Facial Paralysis ; Female ; Ganglia ; Hearing ; Herpes Zoster* ; Humans ; Hyperacusis ; Neck ; Neurologic Examination ; Sensation ; Skin ; Tongue ; Virus Diseases

Torsion dystonia (TD) is a clinical syndrome characterized by prolonged spasms of muscle contraction, which distort the body into typical dystonic posture. The pathological or biochemical basis of either the familial types or of most sporadic forms of idiopathic or primary TD is unknown. We present a 40-year old man who showed a kinesigenic axial dystonia with ipsilateral upper extremity atrophy for 14 years. The symptoms and signs were spontaneous onset, nonprogrwsive course, and induced by voluntary activity but relieved by rest and sleep and responded to trihexyphenidyl medication.
Adult ; Atrophy* ; Dystonia Musculorum Deformans ; Dystonia* ; Humans ; Muscle Contraction ; Posture ; Spasm ; Trihexyphenidyl ; Upper Extremity*

BACKGROUND: Chronic daily headache(CDH) could be included all of the primary headache disorders with daily or near-daily headache lasting more than 4 hours/day for 15 days/month. Several studies have shown that patients with CDH are difficult to classify using the currently published International Headache Society(HIS) system. Recently, some authors recommended that CDH could be subclassified into transformed migraine(TM), chronic tension-type headache(CTTH), new daily persistent headache(NDPH) and hemicrania continua(HC). METHODS: We analysed 100 patients with CDH who were diagnosed in Taegu-Hyosung Catholic University Hospital from February 1996 to May 1998. To describe clinical features of CDH, we used our CDH protocol. RESULTS: (1) Most of the patients were in their 5th-7th decades, and female was predominantly affected(female to male ratio, 7.3:1). (2) The subclassification of CDH were CTTH in 59 patients, TM in 33 patients, NDPH in 7 patients, and HC in 1 patient. (3) Clinical characteristics of CDH were mostly bilateral location, mild to moderate intensity and dull nature. The mean onset age of CDH was 47.7 years, the onset time of the day was in the afternoon or anytime, the duration was more than 4 hours or 12 hours in 90 patients, and the frequency was near-daily or daily in 80 patients. Common associated symptoms were nausea, dizziness, insomnia, fatigue, photophobia, blurred vision, and scalp tenderness. (4) Daily use of analgesics was reported in 66 patients. CDH was aggravated during premenstrual period in 10 patients. Positive family history was shown in 26 patients. CONCLUSIONS: We present this report because knowledge of clinical characteristics and adequate protocol for CDH in clinical practice is necessary.
Age of Onset ; Analgesics ; Dizziness ; Fatigue ; Female ; Headache ; Headache Disorders* ; Headache Disorders, Primary ; Humans ; Male ; Nausea ; Photophobia ; Scalp ; Sleep Initiation and Maintenance Disorders

Paroxysmal hemicrania (PH) has been recently defined as an uncommon primary headache. PH is characterized by frequent attacks of severe unilateral pain associated with autonomic symptoms. The attack frequency usually ranges from 5 to 40 attacks per day. PH is characterized by its absolute responsiveness to indomethacin. However, indomethacin is not often well tolerated because of its gastric side effects. We report two patients with PH who could not tolerate indomethacin due to its severe gastric side effects but dramatically responded to rofecoxib.
Headache ; Humans ; Hydrogen-Ion Concentration ; Indomethacin ; Paroxysmal Hemicrania*

A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis.
Actins* ; Biopsy ; Conjunctiva ; Diagnosis ; Elastic Tissue ; Estrogens, Conjugated (USP) ; Giant Cell Arteritis* ; Giant Cells ; Granuloma* ; Headache ; Humans ; Jaw ; Middle Aged ; Neck Pain ; Skin ; Temporal Arteries

Acute aseptic meningitis is a rare complication of herpes zoster. It is usually regarded as a complication of the cutaneous infection in patients with impaired cellular immunity. Herpes zoster virus is a rare cause of viral meningitis. In one of three patients with herpes zoster meningitis, varicella-zoster virus DNA was detected by the polymerase chain reaction in the cerebrospinal fluid. We report three cases of acute aseptic meningitis followed by herpes zoster.
Cerebrospinal Fluid ; DNA ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Meningitis ; Meningitis, Aseptic* ; Meningitis, Viral ; Polymerase Chain Reaction