OBJECTIVES: There was also an observation about the “sleep” in the Greek era, which is called the primordial current of modern medicine, which is interpreted as a phenomenon organized by God and appears in various forms in Greek mythology. METHODS: We used the words ‘Greek mythology,’ ‘Sleep,’ ‘God of Sleep,’ ‘Greece,’ and ‘myth’ in English and Korean on Google site for information on sleep in Greek mythology. RESULTS: In Greek mythology, stories appeared about the sleeping god Hypnos, his wife Pasithea, and the dream gods Oneiroi, to explain the mystery of sleep. The various ideas of ancient Greeks' sleep are reflected in legends about Ceyx and Alcyone, Psyche, Endymion, Ariadne, Argos, and Polyphemus. CONCLUSIONS: The images of sleep in Greek mythology that have continued for decades include observations and experiences of mankind. This can be interpreted from a medical point of view as the important significance of sleep on humans.
Dreams ; History, Modern 1601- ; Humans ; Mythology ; Spouses

BACKGROUND: Parkinson's disease (PD) is one of the most common neurodegenerative diseases. However, the history of PD and famous persons with PD have not been described in detail yet. METHODS: We summarized the history of PD before the first description of James Parkinson's. The four famous patients who were suspected or diagnosed with PD were reviewed through peer-reviewed journals as well as biographies, books, and media. RESULTS: Before the definition of PD was established, there were descriptions of various Parkinsonian symptoms in several literatures. The diagnoses of Adolf Hitler and Na Hyeseok are not certain and we only suspect that they had parkinsonism. The diagnoses of PD of the Pope John Paul II and Muhammad Ali are certain as they had medical records as well as video records that shows progressive deterioration. CONCLUSIONS: Even before James Parkinson, PD have been recognized and described focusing on the bradykinesia and tremor. We should keep in mind that detailed examination as well as transcriptions are important, and that long-term follow-up is needed to document or differentiate PD and its mimics.
Diagnosis ; Famous Persons ; Follow-Up Studies ; Humans ; Hypokinesia ; Medical Records ; Neurodegenerative Diseases ; Parkinson Disease ; Parkinsonian Disorders ; Tremor

No abstract available.
Neuromyelitis Optica

A 36-year-old previously healthy woman developed diplopia and right-sided ptosis. Neurological examinations were normal except for palsy in the right third cranial nerve with pupil involvement. CT and MRI revealed a cavernous hemangioma with recent bleeding in the right midbrain. This case indicates that midbrain cavernous hemangioma can be a rare cause of isolated pupil involving palsy of the third cranial nerve.
Adult ; Caves ; Diplopia ; Female ; Hemangioma, Cavernous ; Hemorrhage ; Humans ; Mesencephalon ; Neurologic Examination ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis ; Pupil

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by sleep interruption or trauma due to abnormal behaviors that occur during REM sleep. The pathophysiology of RBD is known to be a dysfunction of brainstem circuit that causes the loss of skeletal muscle atonia during REM sleep. The diagnosis of RBD is needed to confirm REM sleep without atonia in the polysomnography. The management of RBD includes not only drug treatment, but also to prevent injury from RBD and to follow-up on neurodegenerative diseases that may occur later. RBD is thought to be a prodromal stage of neurodegenerative disease associated with α-synucleoinopathy, such as Parkinson's Disease or multiple system atrophy. This article reviews the symptoms, epidemiology, diagnosis and treatment of RBD, the relevance of neurodegenerative diseases, and recent research trends.
Brain Stem ; Diagnosis ; Epidemiology ; Follow-Up Studies ; Multiple System Atrophy ; Muscle, Skeletal ; Neurodegenerative Diseases ; Parasomnias ; Parkinson Disease ; Polysomnography ; Prodromal Symptoms ; REM Sleep Behavior Disorder ; Sleep, REM

BACKGROUND AND PURPOSE: We investigated the frequency and clinical features of restless legs syndrome (RLS) in patients with Parkinson's disease (PD). METHODS: This study included 74 PD patients. RLS was diagnosed in face-to-face assessments of all of the subjects based on diagnostic criteria of the International Restless Legs Syndrome Study Group revised in 2003. We analyzed the clinical features of PD patients with and without RLS and compared the data to idiopathic RLS. RESULTS: The frequency of RLS in the cohort was 21.6% (n=16). Two (12.5%) of the patients with RLS were not treated with dopaminergic drugs, while 14 (24.1%) of the 58 patients without RLS received treatment with dopaminergic drugs. Anxiety, depression, and quality of life (QoL) were significantly worst in patients with RLS. PD patients with RLS had significantly worse sleep quality (p=0.003) and worse scores on the cardiovascular subscale of the Scales for Outcomes in Parkinson's Disease for Autonomic Symptoms (p=0.031) compared to those without RLS. In the group of PD patients with RLS, RLS preceding PD onset was related to a lower Hoehn and Yahr stage. CONCLUSIONS: We found that the frequency of RLS in the present patients with PD was higher than that in our previous study of a general population of RLS subjects. Compared to the PD patients without RLS, the present PD patients with RLS suffered from worse sleep quality and QoL, depression, anxiety, and autonomic disturbances, especially those with cardiovascular problems.
Anxiety ; Cohort Studies ; Depression ; Dopamine Agents ; Humans ; Parkinson Disease ; Prevalence ; Primary Dysautonomias ; Quality of Life ; Restless Legs Syndrome ; Weights and Measures

OBJECTIVE: To compare the therapeutic and adverse effects of globus pallidus interna (GPi) and subthalamic nucleus (STN) deep brain stimulation (DBS) for the treatment of advanced Parkinson's disease (PD). METHODS: We retrospectively analyzed the clinical data of patients with PD who underwent GPi (n = 14) or STN (n = 28) DBS surgery between April 2002 and May 2014. The subjects were matched for age at surgery and disease duration. The Unified Parkinson's Disease Rating Scale (UPDRS) scores and levodopa equivalent dose (LED) at baseline and 12 months after surgery were used to assess the therapeutic effects of DBS. Adverse effects were also compared between the two groups. RESULTS: At 12 months, the mean changes in the UPDRS total and part I–IV scores did not differ significantly between the two groups. However, the subscores for gait disturbance/postural instability and dyskinesia were significantly more improved after GPi DBS than those after STN DBS (p = 0.024 and 0.016, respectively). The LED was significantly more reduced in patients after STN DBS than that after GPi DBS (p = 0.004). Serious adverse effects did not differ between the two groups (p = 0.697). CONCLUSION: The patients with PD showed greater improvement in gait disturbance/postural instability and dyskinesia after GPi DBS compared with those after STN DBS, although the patients had a greater reduction in LED after STN DBS. These results may provide useful information for optimal target selection for DBS in PD.
Deep Brain Stimulation* ; Dyskinesias ; Gait ; Globus Pallidus ; Humans ; Levodopa ; Parkinson Disease* ; Retrospective Studies ; Subthalamic Nucleus ; Therapeutic Uses

BACKGROUND AND PURPOSE: Hand tremor is one of the most frequent symptoms in movement disorders, and differential diagnoses for hand tremor include Parkinson's disease (PD) and essential tremor (ET). However, accurately differentiating between PD and ET in clinical practice remains challenging in patients presenting with hand tremor. We investigated whether a questionnaire-based survey could be useful as a screening tool in patients with hand tremor. METHODS: A questionnaire related to hand tremor consisting of 12 items was prospectively applied to patients with PD or ET in three movement-disorder clinics. Each question was analyzed, and a query-based scoring system was evaluated for differentiating hand tremors between PD and ET. RESULTS: This study enrolled 24 patients with PD and 25 patients with ET. Nine of the 12 questions differed significantly between PD and ET: 1 about resting tremor, 4 questions about action tremor, and 4 about asymmetry. A receiver operating characteristics curve analysis revealed that the 9-item questionnaire showed a good discrimination ability, with a sensitivity of 88% and a specificity of 84%. CONCLUSIONS: The developed Hand Tremor Questionnaire might be a good screening tool for hand tremors in patients with PD and ET.
Diagnosis, Differential ; Discrimination (Psychology) ; Essential Tremor* ; Hand* ; Humans ; Mass Screening* ; Movement Disorders ; Parkinson Disease* ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tremor*

Objective: The Scales for Outcomes in Parkinson’s Disease–Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson’s disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog). Methods: We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test–retest method with an intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient were used to assess reliability. Spearman’s rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity. Results: The Cronbach’s alpha coefficient was 0.797, and the ICC was 0.887. Spearman’s rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively). Conclusion Our results demonstrate that the K-SCOPA-Cog has good reliability and validity.