A 68-year-old man presented with progressive impairment of gait, balance, and memory. He exhibited a slow and unstable gait. Formal neuropsychological evaluation showed a deficit in visuospatial function and memory with frontal dysfunctions. He was diagnosed as idiopathic normal pressure hydrocephalus with an Evans' ratio of 0.35. Four-and-a-half years after ventriculoperitoneal shunt placement, he showed a marked improvement in gait, as well as in visuospatial and frontal lobe functions. He benefited from shunt surgery for at least four-and-a-half years.
Aged ; Follow-Up Studies ; Frontal Lobe ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Memory ; Ventriculoperitoneal Shunt

No abstract available.
Head* ; Parkinson Disease

The cerebrospinal fluid tap test (CSFTT) is recommended as a key step in the diagnosis of idiopathic normal pressure hydrocephalus (iNPH). While there is no generally accepted evaluation period for ascertaining a CSFTT responder, a substantial number of patients are evaluated only once within 24 hours of the test for improvement in gait. We report an iNPH patient with a favorable response to shunt surgery, who was first judged a non-responder by this standard, though subsequently was judged a responder in virtue of repetitively testing gait over 7 days. A 68-year-old man presented with progressive impairment of gait, balance, and memory. He was diagnosed as iNPH with an Evans' ratio of 0.35. At first hospitalization, change in gait was evaluated 24 hours after the CSFTT. He didn't show any significant improvement and was judged as a non-responder. However, at the second CSFTT, we repetitively tested his change in gait over seven days. Forty-eight hours after the tap, he showed significant improvement in his gait. He was then confirmed as a responder. After the operation, the gait difficulties were almost fully resolved. Further studies developing the standard procedure of the CSFTT should be considered.
Aged ; Cerebrospinal Fluid ; Cerebrospinal Fluid Shunts ; Diagnosis ; Gait ; Hospitalization ; Humans ; Hydrocephalus, Normal Pressure* ; Memory ; Predictive Value of Tests ; Virtues

The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

The differential diagnosis of chorea can be challenging in patients without a family history of Huntington's disease or acute-onset hemichorea with stroke. A 50-year-old woman presented with generalized choreic movements and gait disturbance that first appeared 1 month previously. An extensive diagnostic workup including genetic testing, neuroimaging, and various laboratory investigations revealed that this patient had developed chorea as a result of mercury poisoning. She was treated successfully with chelation therapy.
Chelation Therapy ; Chorea ; Diagnosis, Differential ; Female ; Gait ; Genetic Testing ; Humans ; Huntington Disease ; Mercury Poisoning ; Neuroimaging ; Stroke

No abstract available.
Botulinum Toxins* ; Dystonia ; Dystonic Disorders* ; Fingers* ; Humans

BACKGROUND AND PURPOSE: A population-based door-to-door study of cross-sectional methods for assessing the prevalence and factors related to a high risk of obstructive sleep apnea (OSA) was conducted using the Korean version of the Berlin Questionnaire (K-BQ). METHODS: Pooled data collected from Community Health Surveys by the Korea Center for Disease Control and Prevention were analyzed. Of 8,140 respondents from the population, 7,955 were finally included in this study. RESULTS: Of the 7,955 included subjects, 15.7% of the men and 9.8% of the women were at high risk of OSA. Significant differences were found in the following factors between the subjects with a high risk of OSA: gender, age, marital status, educational level, occupation, and presence of smoking, harmful alcohol use, and chronic diseases. Male sex, harmful alcohol use, and the presence of chronic diseases were identified as factors independently associated with a high risk of OSA. CONCLUSIONS: This is the first study to confirm the usefulness of the K-BQ to study the prevalence of OSA in the Korean general population. The findings demonstrate that harmful alcohol use and chronic diseases are very common characteristics among those with a high risk of OSA.
Berlin ; Centers for Disease Control and Prevention (U.S.) ; Chronic Disease ; Surveys and Questionnaires ; Epidemiology ; Female ; Health Surveys ; Humans ; Korea ; Male ; Marital Status ; Methods ; Occupations ; Prevalence* ; Sleep Apnea, Obstructive* ; Smoke ; Smoking ; Surveys and Questionnaires

Syringomyelia rarely accompanies hydrocephalus in the aged person except for the cases with a typical Chiari malformation. A 59-year-old woman developed progressive generalized weakness and gait disturbance for 9 years. MRI demonstrated marked enlargement of the cerebral ventricles and the longitudinal dilatation of central canal involving the entire spinal cord, whereas a typical Chiari malformation was absent. She was successfully treated by ventriculoperitoneal shunting. We report a hydrocephalic patient in her 50's accompanied by syringomyelia without a typical Chiari malformation.
Aged ; Cerebral Ventricles ; Dilatation ; Female ; Gait ; Humans ; Hydrocephalus ; Spinal Cord ; Syringomyelia ; Ventriculoperitoneal Shunt

No abstract available.
Multiple System Atrophy ; Respiratory Sounds*

A 73-year-old man presented with progressive gait impairment. He exhibited slow, shuffling, and unstable gait. A formal neuropsychological evaluation revealed memory deficits with frontal dysfunction. Brain MRI revealed communicating hydrocephalus with an Evans' index of 0.27. After cerebrospinal fluid (CSF) removal by lumbar puncture, the patient exhibited a marked improvement in gait. A CSF tap test after careful clinical examination may need to be considered in the diagnosis of idiopathic hydrocephalus with an Evans' index of <0.3.
Aged ; Brain ; Cerebrospinal Fluid* ; Diagnosis ; Gait ; Humans ; Hydrocephalus* ; Magnetic Resonance Imaging ; Memory Disorders ; Spinal Puncture