The time course of recovery in vestibular neuritis varies between individuals. The aim of this study was to identify the predictors for the early or late recovery of vestibular neuritis. The inclusion criteria were patients 1) who had an acute onset of vertigo lasting at least 24 hours, 2) with a horizontal-torsional unidirectional spontaneous nystagmus, and 3) with a canal paresis of 20% or more on the bithermal caloric tests. The primary endpoint for this study was an early or late recovery of vestibular neuritis as a dependent variable. A functional level scale was used to define the late recovery (5 or more points) at seven days after the symptom onset. The secondary endpoint was the duration of hospitalization. One hundred twenty eight patients met the inclusion criteria for this study, and among them, 71 patients had an early recovery. Multiple logistic regression analysis showed that diabetes mellitus was the only independent significant variable for the prediction of a late recovery of vestibular neuritis. In addition, the diabetes mellitus was a predicting variable for long duration of hospitalization. Diabetes mellitus was a predictor for a late recovery of vestibular neuritis.

Movement disorders are primarily associated with the basal ganglia and the thalamus; therefore, movement disorders are more frequently manifest after stroke compared with neurological injuries associated with other structures of the brain. Overall clinical features, such as types of movement disorder, the time of onset and prognosis, are similar with movement disorders after stroke in other structures. Dystonia and chorea are commonly occurring post-stroke movement disorders in basal ganglia circuit, and these disorders rarely present with tremor. Rarer movement disorders, including tic, restless leg syndrome, and blepharospasm, can also develop following a stroke. Although the precise mechanisms underlying the pathogenesis of these conditions have not been fully characterized, disruptions in the crosstalk between the inhibitory and excitatory circuits resulting from vascular insult are proposed to be the underlying cause. The GABA (gamma-aminobutyric acid)ergic and dopaminergic systems play key roles in post-stroke movement disorders. This review summarizes movement disorders induced by basal ganglia and thalamic stroke according to the anatomical regions in which they manifest.
Basal Ganglia* ; Blepharospasm ; Brain ; Cerebrovascular Disorders ; Chorea ; Dystonia ; gamma-Aminobutyric Acid ; Movement Disorders* ; Prognosis ; Restless Legs Syndrome ; Stroke ; Thalamus ; Tics ; Tremor

With developing technology, quantitative analysis of gait and balance has been much interested in last decade. In gait analysis, three-dimensional motions capture and gait analysis using foot pressure is widely used. For measuring balance, posturography with force plate especially dynamic intervention has been developed. Recently wearable device containing accelerometer and gyro-sensor can assess long term monitoring for real living situation beyond lab based environment. Future studies of validity and reliability of quantitative analysis is necessary for clinical implication.
Foot ; Gait* ; Postural Balance ; Reproducibility of Results

BACKGROUND AND PURPOSE: Sudden cardiac death is one of the leading causes of death in patients with myotonic dystrophy type 1 (DM1). It has been proposed that a prolonged QT interval is associated with sudden cardiac death in several neurological diseases, including multiple system atrophy, idiopathic Parkinson's disease, and diabetic autonomic neuropathy. However, analyses of the corrected QT (QTc) interval in DM1 patients are rare in the literature. The purposes of this study were to determine the association between the QT interval and DM1, and the affecting factors. METHODS: Thirty-nine patients diagnosed with DM1 through genetic testing were enrolled. The QTc interval (calculated using Bazett's formula: QTc=QT/radicalRR) was compared between these patients and 39 normal healthy controls. The clinical and laboratory factors affecting QTc interval in the patient group were investigated. RESULTS: The QTc interval was significantly longer in the DM1 group (411.2+/-44.7 msec, mean+/-SD) than in the normal control group (355.6+/-20.6 msec). Intragroup analysis revealed that a prolonged QTc interval in DM1 patients was associated with being female and older, having a longer disease duration, and exhibiting abnormal electrocardiography findings. CONCLUSIONS: The higher incidence of sudden cardiac death in the DM1 population is associated with the observed prolonged QTc interval in those patients.
Cause of Death ; Death, Sudden, Cardiac ; Diabetic Neuropathies ; Electrocardiography ; Female ; Genetic Testing ; Humans ; Incidence ; Multiple System Atrophy ; Myotonic Dystrophy ; Parkinson Disease

Background: and Purpose Screening tests for dementia such as the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment are widely used, but there are drawbacks to their efficient use. There remains a need for a brief and easy method of assessing the activities of daily living (ADL) that can be administered to elderly individuals by healthcare workers. We have therefore developed a new scale named the Simple Observation Checklist for Activities of Daily Living (SOC-ADL). Methods: We developed the SOC-ADL scale as a team of experts engaged in caring for individuals with dementia. This scale comprises eight items and was designed based on the Korean instrumental activities of daily living (K-IADL) scale and the Barthel activities of daily living scale (Barthel Index). The new scale was validated by enrolling 176 patients with cognitive dysfunction across 6 centers. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed. We assessed its concurrent validity by performing comparisons with the Korean-MMSE, Clinical Dementia Rating, Clinical Dementia Rating-Sum of Boxes, K-IADL, and Barthel Index, and its criterion validity by performing comparisons between mild cognitive impairment (MCI) and dementia. We also used Cronbach’s alpha to assess the interitem reliability. The appropriate cutoff values were determined by analyzing receiver operating characteristic curves, including the areas underneath them. Results: EFA extracted one factor and CFA revealed that all of the model fits exceeded the minimum acceptable criteria. The SOC-ADL scores were strongly correlated with those of the other tools for dementia and could be used to differentiate MCI from dementia. Cronbach’s alpha values indicated that the results were reliable. The optimal cutoff value of the SOC-ADL for discriminating dementia from MCI was 3 points, which provided a sensitivity and specificity of 74.5% and 75.7%, respectively. Conclusions Our results demonstrate that the SOC-ADL is a valid and reliable tool for differentiating dementia from MCI based on an assessment of ADL. This new tool can be used for screening ADL in elderly subjects who have difficulty communicating, and to increase the efficiency of dementia screening at the population level.

Background: and Purpose The wearing-off (WO) phenomenon is the most common motor complication in advanced Parkinson’s disease (PD), but its identification remains challenging. The 9- and 19-item Wearing-off Questionnaires (WOQ-9 and WOQ-19) are self-assessment tools for motor and nonmotor symptoms that are widely used for WO screening. We produced Korean versions of the WOQ-19 and WOQ-9 (K-WOQ-19 and K-WOQ-9) and investigated their validity and reliability. Methods: We used the translation–back translation method to produce K-WOQ-19 and KWOQ-9, which were self-administered by 124 patients with PD. We conducted in-depth 10-minute interviews for confirming the presence of the WO phenomenon, and then stratified the participants into groups with and without WO. Diagnostic accuracy was assessed by analyzing receiver operating characteristic curves. Concurrent validity was assessed using the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and the Hoehn and Yahr stage with Spearman’s rank correlation analysis. Reliability was assessed based on test–retest Cohen’s kappa (κ) values and intraclass correlation coefficients (ICCs). Results: The optimal cutoff scores on the K-WOQ-19 and K-WOQ-9 for WO screening were 4 and 2, respectively. The test–retest ICCs of K-WOQ-19 and K-WOQ-9 were 0.943 and 0.938, respectively. Nineteen of the combined 20 items in K-WOQ-19 and K-WOQ-9 showed moderate-to-substantial agreement (κ=0.412–0.771, p<0.001). The scores on the translated scales were significantly correlated with MDS-UPDRS IV scores. Conclusions K-WOQ-19 and K-WOQ-9 are reliable and valid tools for detecting WO, with optimal cutoff scores of 4 and 2, respectively.

BACKGROUND: Neurophysiological Index (NI) is derived from compound muscle action potentials, distal motor latency and F-wave frequency in the ulnar nerve/abductor digiti minimi. Recent studies suggested that NI could be used as a sensitive measure of change during the course of ALS. However, the NI has several limitations which include being derived only from the ulnar nerve territory and is less valuable when atrophic change of the abductor digiti minimi is severe. Thus, this study aimed to evaluate the correlation of NI with the functional status of ALS patients and the availability of NI obtained from median and posterior tibial nerve territory. METHODS: The subjects of the study were 25 patients with ALS. The NI, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) and grip power were obtained during the same period and NI values were compared with ALSFRS-R and grip power. RESULTS: A significant correlation was observed between ALSFRS-R and various NI values. Moreover, NI values derived from the ulnar nerve/abductor digiti minimi and the median nerve/abductor pollicis brevis on the dominant hand were statistically correlated with fine motor function scores in ALSFRS-R, and NI values from posterior tibial nerve/abductor hallucis were significantly correlated with lower limb function scores. CONCLUSIONS: Our results support the previous findings that NI is a useful neurophysiological measurement in ALS patients. Moreover, we might suggest NI values from the median nerve/abductor pollicis brevis and the posterior tibial nerve/abductor hallucis also could be used in measuring the functional status of ALS patients.
Action Potentials ; Amyotrophic Lateral Sclerosis* ; Hand ; Hand Strength ; Humans ; Lower Extremity ; Median Nerve* ; Tibial Nerve ; Ulnar Nerve

Neurological complications associated with Crohn's disease are infrequent and optic neuritis is extremely rare. We report a 20-year-old man showing optic neuritis and Wernicke's encephalopathy as complications of Crohn's disease. We suggest that nutritional deficiency caused Wernicke's encephalopathy and the immunologic abnormality of Crohn's disease induced the complication of optic neuritis. This patient is the first reported case showing optic neuritis and Wernicke's encephalopathy simultaneously as neurological complications of Crohn's disease in Korea.
Crohn Disease* ; Humans ; Korea ; Malnutrition ; Optic Neuritis* ; Wernicke Encephalopathy* ; Young Adult