1.A Case of Syringomyelia in Cervical and Thoracic Spinal Cord(C2~T10) Associated with Chiari Malformation.
Gye Hune AHN ; Eui Joong YANG ; Choong Hyeon KIM ; Suk Jung JANG ; Ho SHIN
Journal of Korean Neurosurgical Society 1990;19(6):835-839
We have recently managed a case of syringomyelia associated with Chiari I Type malformation. The syrinx was found at C2 level to T10 level. And the patient complained left forearm pain and paresthesia in left shoulder, arm with segmental dissociated sensory loss. The cranio-vertebral decompression(suboccipital craniectomy, cervical laminectomy) and the shunting procedures were performed. Postoperative course was not uneven, the clinical and neurological improvement was observed. M.R.I. permitted rapid, exact diagnosis including localization of syrinx and information of associated anomaly.
Arm
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Diagnosis
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Forearm
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Humans
;
Paresthesia
;
Shoulder
;
Syringomyelia*
2.Lumbar Sympathetic Radiofrequency Neurotomy in Plantar Hyperhidrosis.
Journal of Korean Neurosurgical Society 2007;41(1):27-29
OBJECTIVE: Surgical treatment of focal plantar hyperhidrosis is often unsatisfactory compared to palmar hyperhidrosis. The purpose of this study is to evaluate the effect of lumbar sympathetic radiofrequency neurotomy on plantar hyperhidrosis. METHODS: From February 2004 to December 2005, 10 patients (mean age 24.3 male 1, female 9) with the clinical diagnosis of plantar hyperhidrosis were treated by bilateral lumbar sympathetic radiofrequency neurotomy of L3 and L4. Patients' symptom relief, satisfactory rate and side effects related to the procedure were analyzed. RESULTS: Radiofrequency neurotomy was effective in the treatment of focal plantar hyperhidrosis showing excellent (more than 75% improved) outcome in 70% of the patients and good (more than 50% improved) in 30%. Complications related to the surgical procedure, such as sensory dysesthesia and compensatory hyperhidrosis were not detected in any case. CONCLUSION: The use of radiofrequency neurotomy to ablate the lumbar sympathetic ganglion is a safe and effective treatment option for patients with plantar hyperhidrosis.
Diagnosis
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Female
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Ganglia, Sympathetic
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Humans
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Hyperhidrosis*
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Male
;
Paresthesia
3.Burning mouth syndrome.
International Journal of Oral Science 2010;2(1):1-4
Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the "state of the art" today.
Burning Mouth Syndrome
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diagnosis
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drug therapy
;
etiology
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Candidiasis, Oral
;
diagnosis
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Diagnosis, Differential
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Glossalgia
;
diagnosis
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Humans
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Paresthesia
;
diagnosis
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Xerostomia
;
diagnosis
4.Intradural Extramedullary Epidermoid Cyst: A Case Report.
Kwang Hwan JUNG ; Sung Do CHO ; Sang Hun KO ; Chae Chil LEE ; Yun Suck YEOM ; Sang Woo KIM ; Hang Ki KANG ; Jae Ryong CHA
Journal of Korean Society of Spine Surgery 2015;22(1):26-30
STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of epidermoid cyst in the spinal canal. SUMMARY OF LITERATURE REVIEW: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer. MATERIAL AND METHODS: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6-T8 level. The cystic mass was excised after durotomy using a posterior approach. RESULTS: We confirmed the presence of an epidermoid cyst for histopathology. CONCLUSION: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
Diagnosis
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Diagnosis, Differential
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Epidermal Cyst*
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Female
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Humans
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Laminectomy
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Magnetic Resonance Imaging
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Paresthesia
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Spinal Canal
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Spine
5.Tailgut cyst accompanied with bony defect.
Jae Sang OH ; Jai Joon SHIM ; Kyeong Seok LEE ; Jae Won DOH
Annals of Surgical Treatment and Research 2016;90(4):235-238
Retro-rectal cystic hamartoma (tailgut cyst), is an uncommon congenital developmental lesion, generally located in the retro-rectal space. Its diagnosis and approach is challenging because the retropelvic space is not familiar. We report a 51-year-old woman who presented with paresthesia and pain in perianal area. The magnetic resonance image showed high signal intensity on the T1-weighted image and iso to high signal intensity on the T2-weighted image of the retropelvic space and CT showed sacral bony defect. We chose the posterior approach for removal of the tailgut cyst. Histopathology exam of the retropelvic cyst revealed a multiloculated cyst containing abundant mucoid material lined by both squamous and glandular mucinous epithelium. The patient has recovered nicely with no recurrence. Tailgut cyst needs complete surgical excision for good prognosis. So, a preoperative high-resolution image and co-operation between neurosurgen and general surgeon would help to make safe and feasible diagnosis and surgical access.
Diagnosis
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Epithelium
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Female
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Hamartoma
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Humans
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Middle Aged
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Mucins
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Paresthesia
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Prognosis
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Recurrence
6.Lateral Femoral Cutaneous Nerve SomatosensoryEvoked Potential Study in Normal Adults.
Seung Sik MOON ; Mee Young PARK
Yeungnam University Journal of Medicine 2001;18(1):67-74
BACKGROUND: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thighis produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. MATERIALS AND METHODS: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old(mean+/-SD:42.06+/-15.74) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. RESULTS: The mean values(msec+/-SD) of LPo, SPdegree, LN, and SN1 of all subjects were 35.10(+/-2.42), 33.80(+/-2.4), 43.68(+/-1.88) and 42.16(+/-2.12) and the mean values(msec+/- SD) of DPo, DNl and DA(tw+/-SD) were 1.3O(fi1.14), 1.52(+/-1.38) and 0.32(+/-0.33). CONCLUSION: For the diagnosis of MP, comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results, the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.
Adult*
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Diagnosis
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Evoked Potentials, Somatosensory
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Humans
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Individuality
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Male
;
Paresthesia
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Reference Values
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Somatotypes
;
Thigh
7.The Diagnostic Validity of Samatosensory Evoked Potentials in Meralgia Paresthetica.
Journal of the Korean Neurological Association 1998;16(4):519-523
BACKGROUND: Meralgia paresthetica(MP) is clinically benign entrapment neuropathy which is characterized by paresthesias and sensory impairment in the cutaneous distribution of the lateral femoral cutaneous nerve(LFCN). The diagnosis of MP is mostly based on clinical symptoms. Sensory nerve conduction study of the LFCN have been of limited value because frequently they could not be recorded in able-bodied persons and also because lesions of the nerve may be localized proximally from the segment that is accessible to nerve conduction study. For these reasons, I studied simple bilateral somatosensory evoked potentials(SSEP) of LFCN to evaluate this clinical symptoms objectively. METHODS: 16 MP patients (mean age+/-SE : 50+/-3.21yrs) and 15 disease free adults(49+/-4.47yrs) were studied bilateral SSEP of LFCN. The stimulation site was anterolateral aspect of thigh and the recording site was Cz'. RESULTS: The mean latencies of P0 and N1 were prolonged on the affected side(P<0.05), The mean latency differences of P0 and N1 between two sides were increased in the patients with MP compare with those of controls.(P<0.001) The mean amplitude difference between two sides were increased in the patients with MP compare with that of controls(P<0.05). CONCLUSION: SSEP of LFCN can be used as a objective test to support the diagnosis of MP. I suggest more than 2.4msec difference for P0 latency between affected and unaffected side could be abnormal.
Diagnosis
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Evoked Potentials*
;
Evoked Potentials, Somatosensory
;
Humans
;
Neural Conduction
;
Paresthesia
;
Thigh
8.Ultrasonographic and Clinical Characteristics of Schwannoma of the Hand.
Seoung Joon LEE ; Seok Tae YOON
Clinics in Orthopedic Surgery 2017;9(1):91-95
BACKGROUND: The purpose of this study was to report the ultrasonographic findings and clinical features of schwannoma of the hand. METHODS: We enrolled 8 patients who were initially diagnosed with ganglion by ultrasonography but finally with schwannoma by a tissue biopsy. We retrospectively analyzed the ultrasonographic findings of eight patients including echogenicity, internal homogeneity, posterior enhancement, internal vascularity, and clinical manifestations such as the occurrence site, tenderness, Tinel's sign, and paresthesia before the surgery. RESULTS: The occurrence sites were as follows: two cases on the thenar area, one case on the second web space, three cases on the third web space, one case on the radiovolar aspect of the proximal phalanx of the index finger, and one case on the radiovolar aspect of the proximal phalanx of the middle finger. Four patients suffered from tenderness and pain on presentation, and all patients had pain around the mass before presentation. Tinel's sign was present without paresthesia in one case. Ultrasonography revealed cystic lesions showing clear margins in all cases, and two of them had acoustic enhancement without internal flow. CONCLUSIONS: It may not be easy to diagnosis schwannoma of the hand with ultrasonography alone when the lesion is small because of the similarity to the ultrasonographic findings of ganglion. Therefore, it is necessary to consider the possibility of schwannoma if a mass near the digital nerve or cutaneous nerve branch is accompanied by dull pain and tenderness.
Acoustics
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Biopsy
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Diagnosis
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Fingers
;
Ganglion Cysts
;
Hand*
;
Humans
;
Neurilemmoma*
;
Paresthesia
;
Retrospective Studies
;
Ultrasonography
9.Atypical Guillain-Barre Syndrome Misdiagnosed as Lumbar Spinal Stenosis.
Dae Young JUNG ; Keun Tae CHO ; Seung Chul LEE
Journal of Korean Neurosurgical Society 2013;53(4):245-248
Guillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.
Diagnosis, Differential
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Extremities
;
Guillain-Barre Syndrome
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Humans
;
Hypesthesia
;
Ileus
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Paresthesia
;
Polyradiculopathy
;
Spinal Stenosis
;
Urinary Retention
10.Unusual complications caused by lipoma of the tongue.
Serena COCCA ; Massimo VIVIANO ; Stefano PARRINI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2017;43(Suppl 1):S6-S8
Lipoma is the most common, benign, soft tissue, mesenchymal tumour and is composed of mature adipose tissue. It is infrequent in the oral cavity (approximately 0.3% of all tongue neoplasias). We describe the case of a 68-year-old man with a swelling at the tongue edge and tongue dysesthesia. Medical history, clinical assessment, radiographic images, and cytological analysis enabled specialists to classify this neoplasia as a lipoma. The patient recovered fully after surgical excision of the affected area, and the neuralgic symptoms regressed. Surgical excision is an elective treatment; however, accurate differential diagnosis, histological examination, and follow-up are required.
Adipose Tissue
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Aged
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Diagnosis, Differential
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Follow-Up Studies
;
Humans
;
Hypesthesia
;
Lipoma*
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Macroglossia
;
Mouth
;
Paresthesia
;
Specialization
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Tongue*