SCUBA diving has become increasingly popular, but it is a sport with high risks. It has been widely accepted that the neurologic sequelae of decompression illness (DCI) are confined to the spinal cord. However, cortical blindness is very rare in the central nervous system DCI. We report a case of DCI who showed cortical blindness and MRI abnormalities. The cortical blindness improved after serial hyperbaric oxygenation therapy with the USN table 6A protocol. (J Korean Neurol Assoc 19(4):404~406, 2001)
Blindness, Cortical* ; Central Nervous System ; Decompression Sickness* ; Decompression* ; Diving ; Hyperbaric Oxygenation* ; Magnetic Resonance Imaging ; Spinal Cord ; Sports

The accessory deep peroneal(ADP) nerve is known as a common anatomical variant. It may alter the usual clinical and electrophysiological charateristics of peroneal nerve lesions. The purpose of the study was to investigate the frequency of occurrence and the electrophysiologic characteristics of the ADP nerve. We performed peroneal motor nerve conduction studies in 434 patiets with conventional method. When the CMAP amplitudes evoked by distal peroneal stimulation is smaller than that by proximal stimulation, we searched ADP nerve by stimulation at posterior to the lateral malleolus. In 60 patients, we searched ADP nerve regardless of CMAP amplitude difference. Additionally, we routinely stimulated the region of posterior to the lateral malleolus with recording at the medial and lateral extensor digitorum brevis(EDB) muscles using multi channel EMG in 34 patients. In conventional peroneal nerve conduction study, ADP nerves were detected in 27(8.2%) patients out of 330 studied patients(right 7, left 15, both 5). Mean amplitue of ADP nerve was 1. 52mV (right 1. 90, left 1. 84). In routine ADP stimulation study, ADP nerve was detected in 5(21.7%) out of 23 patients(left 2, both 3). In 4 of them, the distal peroneal amplitudes were greater than the proximal. Mean amplitude was 1.86mV(right 1.38, left 1.65). In conclusion, we confirmed that the accessary deep peroneal nerve is a relatively common variant and its presence may not be predicted by the difference of amplitudes between the distal and proximal peroneal segments in conventional peroneal nerve conduction study. So in cases of suspected peroneal nerve lesions, ADP nerve should be searched.
Adenosine Diphosphate ; Humans ; Muscles ; Neural Conduction ; Peroneal Nerve*

Eosinophilic gastroenteritis (EGE) is known to have a low incidence among the pediatric population, but it can result in serious complications, such as gastric outlet obstruction. In previously published EGE cases with the obstruction in adults, surgeries were often performed. In this report, we present a 14-year-old girl who came to our facility with severe abdominal pain and vomiting. On the initial abdominal physical examination, diffuse tenderness and severe epigastric pain were noted. Computed tomography scan of the abdomen showed the findings of superior mesenteric artery (SMA) syndrome. However, she had no history of recent weight loss, and the medical history was inconsistent with SMA syndrome. We planned upper gastrointestinal series with barium, and then verified gastric outlet obstruction. We performed esophagogastroduodenoscopy and obtained a final diagnosis of EGE through mucosal biopsy specimen. Corticosteroids and anti-inflammatory medications were administered. Dietary modification and education were done as well. The symptoms resolved, and the follow-up esophagogastroduodenoscopy and ultrasonography showed improvements in the obstruction. Our case emphasizes that gastric outlet obstruction due to EGE must be carefully differentiated from SMA syndrome because of their similarities in clinical features and radiologic images. In doing so, we can avoid surgical intervention and perform medical/dietary treatment for gastric outlet obstruction.

BACKGROUND: Motor conduction slowing in diabetic distal symmetrical polyneuropathy (DSP) generally exceeds that in distal axonal polyneuropathy. Additional mechanisms secondary to axonal injury may contribute towards this slowing. However, clinical and pathophysiological significances of motor conduction slowing have been rarely discussed. The purpose of this study is to evaluate the clinical and pathophysiological significance of conduction slowing in DSP. METHODS: We analyzed motor conduction studies of 39 patients with symptomatic painful DSP and 24 patients with asymptomatic painless DSP. Motor conduction studies of 39 patients with amyotrophic lateral sclerosis (ALS) were used as controls for the amplitude-dependent slowing of conduction. Percentages of normal limits were calculated for the compound muscle action potential amplitude (CMAP), distal motor latency (DL), and conduction velocity (CV), and converted to a square root (SQRT) form. The changes of SQRT-DL or SQRT-CV according to SQRT-CMAP changes were plotted and analyzed. RESULTS: Regression analysis showed that DL and CV were amplitude-dependent in both painless DSP and ALS. The changes of DL and CV in painful DSP did not show amplitude-dependency except DL in the lower extremities. CONCLUSIONS: This data supports the hypothesis that the mechanism of slowing is similar in both painless DSP and ALS and results from the loss of large, fast-conducting fibers. Lack of amplitude-dependency of conduction slowing in painful DSP may reflect the combined axonal and demyelinating changes, possibly due to inflammation.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Axons ; Diabetic Neuropathies* ; Electrophysiology ; Humans ; Inflammation ; Lower Extremity ; Neural Conduction ; Polyneuropathies

BACKGROUND: Guillain-Barre syndrome (GBS) is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. Recently, GBS has been classified as a classical demyelinating (acute imflammatory demyelinating polyradiculoneuropathy, AIDP) and two axonal (acute motor axonal neuropathy, AMAN, and acute motor sensory axonal neuropathy, AMSAN) forms. The clinical pattern and prognosis according to type is not clear. METHODS: Forty-one patients clinically diagnosed as GBS were enrolled and classified as AIDP, AMAN, and AMSAN according to electrodiagnostic criteria. We analyzed the clinical data of each subgroup; age, sex, seasonal distribution, history of previous illness, cranial nerve involvement, respiratory involvement, and motor weakness. RESULTS: Forty-one patients with GBS were comprised of 19 patients (46.3%) with AIDP, 12 patients (29.2%) with AMAN, and 10 patients (24.3%) with AMSAN. AIDP was found more frequently in males and in winter (42.1%) while axonal forms of GBS showed neither gender nor seasonal predominance. Frequency of cranial nerve involvement was not different between the sub-groups of GBS, whereas respiratory involvement was more frequent in AMSAN (50%). Upper limbs were weaker in axonal than in demyelinating types of GBS. CONCLUSIONS: Axonal forms of GBS showed some clinical characteristics distinctive from the demyelinating forms, which might be useful in the differential diagnosis of subgroups of GBS. (J Korean Neurol Assoc 19(5):503~508, 2001)
Amantadine ; Axons ; Cranial Nerves ; Diagnosis, Differential ; Extremities ; Guillain-Barre Syndrome* ; Humans ; Male ; Polyradiculoneuropathy ; Prognosis ; Reflex, Stretch ; Seasons ; Upper Extremity

No abstract available.
Colitis, Ulcerative* ; Polyneuropathies ; Ulcer* ; Vasculitis

No abstract available.
Abdominal Wall ; Herpes Zoster

We recently encountered a Korean patient with oculopharyngeal muscular dystrophy (OPMD). His major clinical manifestations were late onset bilateral ptosis, dysarthria, and dysphagia. Direct sequencing analysis of the PABPN1 gene demonstrated a heterozygous insertion of 9 bp sequence [(GCG)(GCA)(GCA); c.28insGCGGCA GCA], resulting in an in-frame insertion of 3 alanines (p. A10insAAA). To our knowledge, this is the first report of a genetically confirmed case of OPMD in Korea.
Deglutition Disorders ; Dysarthria ; Humans ; Korea ; Muscular Dystrophies ; Muscular Dystrophy, Oculopharyngeal*

A 49 year-old woman, who took a high dose of disulfiram for the purpose of suicide, presented with severe hoarseness, quadriparesis, and sensory loss of distal limbs. Laryngeal electromyography showed ample denervation potentials. Nerve conduction study was consistent with severe sensorimotor axonal polyneuropathy. She was diagnosed with an acute palsy of recurrent laryngeal nerve and superimposed severe acute sensorimotor axonal polyneuropathy due to high dose disulfiram intoxication.
Axons ; Denervation ; Disulfiram* ; Electromyography ; Extremities ; Female ; Hoarseness ; Humans ; Middle Aged ; Neural Conduction ; Paralysis ; Polyneuropathies ; Quadriplegia ; Recurrent Laryngeal Nerve ; Suicide ; Vocal Cord Paralysis* ; Vocal Cords*

Dietary fiber improves hyperglycemia in patients with type 2 diabetes through its physicochemical properties and possible modulation of gut hormone secretion, such as glucagon-like peptide 1 (GLP-1). We assessed the effect of dietary fiber-enriched cereal flakes (DC) on postprandial hyperglycemia and gut hormone secretion in patients with type 2 diabetes. Thirteen participants ate isocaloric meals based on either DC or conventional cereal flakes (CC) in a crossover design. DC or CC was provided for dinner, night snack on day 1 and breakfast on day 2, followed by a high-fat lunch. On day 2, the levels of plasma glucose, GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and insulin were measured. Compared to CC, DC intake exhibited a lower post-breakfast 2-hours glucose level (198.5±12.8 vs. 245.9±15.2 mg/dL, P<0.05) and a lower incremental peak of glucose from baseline (101.8±9.1 vs. 140.3±14.3 mg/dL, P<0.001). The incremental area under the curve (iAUC) of glucose after breakfast was lower with DC than with CC (P<0.001). However, there were no differences in the plasma insulin, glucagon, GLP-1, and GIP levels. In conclusion, acute administration of DC attenuates postprandial hyperglycemia without any significant change in the representative glucose-regulating hormones in patients with type 2 diabetes (ClinicalTrials.gov. NCT 01997281).
Adult ; Aged ; Area Under Curve ; Blood Glucose/*analysis ; Cross-Over Studies ; Diabetes Mellitus, Type 2/complications/diagnosis/*diet therapy ; Dietary Fiber/*therapeutic use ; Female ; Gastric Inhibitory Polypeptide/blood ; Glucagon/blood ; Glucagon-Like Peptide 1/*blood ; Hemoglobin A, Glycosylated/analysis ; Humans ; Hyperglycemia/complications/diagnosis ; Insulin/blood ; Intestines/metabolism ; Male ; Middle Aged ; ROC Curve