Vertigo, a definite rotational sensation, consists of a variety of syndromes. The purpose of this study was to accumulate information on various aspects of vertigo or dizziness. We performed a retrospective study about vertigo patients, who had admitted to our hospital for recent 2 years. From January 1994 to December 1995, 214 patients with the complaints of 'vertigo' and 'dizziness', who admitted to the department of Neurology, Ewha Womans University Hospital, were accepted for this study. All data were recorded on computer-oriented questionnaires in digital forms. The study forms consisted of five parts; (1) history and associated symptoms, (2) physical, neurologic and bedside examinations, (3) laboratory and brain imaging studies, (4) special tests including brainstem auditory evoked potentials and (5) clinical diagnosis. Of these 214 patients, secure diagnosis could be made in 186 patients or 86.9%. Of these, 92 patients had peripheral causes of vertigo, and 94 had central causes. Vestibular disorders accounted for the largest proportion of complaints of vertigo(48/92 or 52%). Of 94 patients with central causes of vertigo, vertebrobasilar insufficiency was the leading cause(25/94 or 27%). The most common site of the brain lesion proved by MRI was cerebellum(23/94 or 25%). BAEP study revealed abnormal findings in 6 cases of the 16 patients with central causes. This study not only offered a clinical information about vertigo, but also could be beneficial for further researches.
Brain ; Diagnosis ; Dizziness ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Neurology ; Surveys and Questionnaires ; Retrospective Studies ; Sensation ; Vertebrobasilar Insufficiency ; Vertigo

Melkersson-Rosenthal syndrome (MRS) is a rare form of hereditary angioedema characterized by a triad of orofacial swelling, relapsing facial paralysis, and a fissured tongue. However, the classic triad is not frequently seen in its complete form, and monosymptomatic or oligosymptomatic forms are more common. Case: A 20-year-old man presented with recurrent labial swelling 9 months ago and recently with a fissured tongue. The surface of the tongue showed deep furrows characteristic of lingua plicata, and an edematous enlargement was observed on the lower lips. Upon neurologic examination, a left sided facial palsy of a peripheral type was noted without abnormalities in the taste sense or lacrimation. An electromyography of the left frontal muscle showed positive sharp waves and fibrillation potentials. Biopsies performed on the lower lips revealed the congested vessels and perivascular inflammatory cells. We report a 20-year-old man with a classical triad of symptoms of Melkersson-Rosenthal syndrome.
Angioedemas, Hereditary ; Biopsy ; Electromyography ; Estrogens, Conjugated (USP) ; Facial Paralysis ; Humans ; Lip ; Melkersson-Rosenthal Syndrome* ; Neurologic Examination ; Tongue ; Tongue, Fissured ; Young Adult

BACKGROUND AND SIGNIFICANCE: Because of the diverse clinical and radiologic manifestations of Neuro-Behcet disease, it is sometimes difficult to differentiate with multiple sclerosis or tumorous condition. We report two cases of Neuro-Behcet disease underwent by stereotaxic biopsy showing vasculitis without any evidence of malignancy, initially misdiagnosed as solitary tumor and metastatic tumor, respectively. CASE: A 35-year-old male admitted due to right hemiparesis. Brain CT showed low density mass shadow in left thalamus. Under the impression of low grade astrocytoma, stereotaxic biopsy was performed. Dense perivascular lymphocytic infiltration with petechial microhemorrhage mixed with hemosiderin pigment was noted in thalamic region. The other patient (male, 44yrs old) admitted due to seizure. On MRI, there are multiple inhomogenous signals on right occipital and left frontal lobe and left thalamus. Under the impression of metastatic tumor, work-up about the primary tumor was done without any positive findings. To determine the primary focus, stereotaxic biopsy was performed. Only reactive gliosis and mild perivascular lymphocytic infiltration was noted in pathologic specimen. With the retrospective careful history taking and follow-up image study, two patients were confirmed as having a Behcet's disease.
Adult ; Astrocytoma ; Biopsy ; Brain ; Follow-Up Studies ; Frontal Lobe ; Gliosis ; Hemosiderin ; Humans ; Magnetic Resonance Imaging ; Male ; Multiple Sclerosis ; Paresis ; Retrospective Studies ; Seizures ; Thalamus ; Vasculitis

Moyamoya disease is a rare clinical entity, diagnosed by cerebral angiography and characterized by occlusion of the bilateral internal carotid artery system and development of collateral arteries. The etiology of moyamoya disease is unknown but some cases were reported to be associated with many other diseases such as hereditary, infectious, autoimmune, and metabolic disorders. A 16-year-old female was admitted with right side motor weakness, visual dis-turbance, malar rash, and emotional lability. Physical examination showed hair loss on frontal and bitemporal areas. Neurologic examinations revealed right hemiparesis and left homonymous hemianopsia. Brain magnetic resonance image showed high signal lesions in the right occipito-temporal and left high frontal area in T2-weighted image. Cerebral angiography showed focal obstructions of supraclinoid portion of both internal carotid arteries and multiple collateral vessels consistent with Moyamoya disease. The clinical features and serologic test of anti-nuclear antibody, anti-double stranded deoxyribonucleic acid antibody and cryoglobulin confirmed the diagnosis of systemic lupus ery-thematosus. We report a case of Moyamoya disease associated with systemic lupus erythematosus which might con-tribute to the etiological variability of Moyamoya disease.
Adolescent ; Angiography ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Diagnosis ; DNA ; Exanthema ; Female ; Hair ; Hemianopsia ; Humans ; Lupus Erythematosus, Systemic* ; Moyamoya Disease* ; Neurologic Examination ; Paresis ; Physical Examination ; Serologic Tests

BACKGROUND AND OBJECTIVES: To evaluate the brain MR angiography(MRA) as a tool of diagnosis and follow up study in acute ischemic stroke. METHODS: We reviewed 90 patients of acute ischemic stroke who received thrombolytic therapy and underwent brain MRI with MRA from September 1994 to July 1995. They were divided into two groups according to carotid system and vertebrobasilar system and then positive MRA findings were defined as stenosis or occlusion of vessels in relation with MRI lesions. RESULTS: The positive MRA was shown more than 80% in large arteries and lower than 23% in small arteries. And also the MRA was shown the degree stenosis and underlying vessel abnormalities but could not precisely analyze the degree of improvement of vascular patency in this study. CONCLUSIONS: The MRA as a routine method addition to the MRI provides relatively reliable and noninvasive screening test and provides information that can be more complete evaluation and prognosis in patients of acute ischemic stroke.
Angiography* ; Arteries ; Brain ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Prognosis* ; Stroke* ; Thrombolytic Therapy ; Vascular Patency

OBJECTIVE: To assess long term outcomes of aggressive rehabilitative treatment on canalicular sequestered lumbar disc herniations METHOD: Clinical outcomes of twenty four patients with sequestered disc herniation with symptomatic radicular pain were evaluated prospectively and longitudinally for one year. All patients received aggressive rehabilitative treatment including transforaminal epidural steroid injection, pelvic stabilization exercise, physical therapy, and back school. Clinical outcomes were measured by visual analogue scale (VAS) for back and radicular pain, Oswestry Disability Index (ODI) for back pain before treatment, posttreatment one, three, six, and twelve months. After twelve months, we categorized patients' satisfaction. Four patients were dropp RESULTS: The averages of VAS for lower extremity and back pain reduced significantly from 6.6 and 5.8 at pretreatment to 0.7 and 0.9 at 12 months posttreatment, respectively (p<0.001). The averages of ODI reduced significantly from 73.5% at pretreatment to 22.3% at posttreatment 12 months (p<0.001). Sixteen of twenty patients (80.0%) were satisfied with their current status posttreatment 12 months. CONCLUSION: Sequestered disc herniations could be treated successfully by aggressive rehabilitative treatment. Clinical improvement was achieved from posttreatment one month and persisted for twelve months. Operation might be delayed until aggressive rehabilitation treatment fail to treat sequestered disc herniations.
Back Pain ; Exercise ; Follow-Up Studies* ; Humans ; Lower Extremity ; Prospective Studies ; Rehabilitation

PURPOSE: Benign childhood epilepsy with centrotemporal spikes (BCECT) or benign rolandic epilepsy (BRE) is not always benign in clinical or neuroimaging features. Recent studies have reported atypical forms of rolandic epilepsy with abnormal neurologic and/or neuroimaging findings, sometimes, also with poor seizure control. We investigated whether there are any differences in linear and nonlinear EEG analysis in typical and atypical rolandic epilepsies of childhood. METHODS: Ten patients with typical BRE group and seven patients with atypical BRE group were included in this study. We selected artifact-free 10-second epochs from 19 electrodes of 10-20 international EEG system from each patient. The power spectrum was calculated in delta, theta, alpha, beta, and gamma frequency ranges. The fractal dimension was analyzed as a nonlinear EEG analysis. We analyzed both EEGs with interictal spikes and without focal slowing or epileptiform activities. RESULTS: The spectral EEG analysis showed a significant increase of absolute and relative power of delta with decrease of alpha bands in atypical BRE group compared to typical group. There was no statistical difference in fractal dimension between the two groups. CONCLUSION: Atypical BRE group showed enhanced delta and decreased alpha power, suggesting a cortical dysfunction in this group with poor clinical outcome.
Electrodes ; Electroencephalography* ; Epilepsy ; Epilepsy, Rolandic* ; Fractals ; Humans ; Neuroimaging ; Seizures

Paragangliomas are rare and slowly growing pulsating hypervascular tumors arising from neural crest cell derivatives throughout the body. In the head and neck, they originate from the branchiometric family of paraganglioma, neuroendocrine tissue that lies along the carotid artery or aorta. Despite their propensity for locally aggressive behavior, metastases of the tumors are quite rare. We report an unusual case of carotid body paraganglioma showing multiple spinal metastases and demonstrated by spinal angiography.
Angiography ; Aorta ; Carotid Arteries ; Carotid Body Tumor* ; Carotid Body* ; Head ; Humans ; Neck ; Neoplasm Metastasis* ; Neural Crest ; Paraganglioma

Spinal arteriovenous malformation ( AVM ) can be a rare cause of relapsing myelopathy. We recently have the opportunity to study a 20-year-old male patient having spinal epidural AVM confirmed by surgical biopsy. To our knowledge, a case of relapsing and remitting course of spinal epidural AVM has not been reported in Korea. A 20-year-old male was admitted because of sudden paraparesis and disturbance of all sensory modalities below the T5 dermatome, 5 times during 2 years. Cerebrospinal fluid profiles did not reveal any pathologic findings. Until the 4th attack, MR findings were non diagnostic. At the 5th attack, thoracic spine MR revealed epidural hematoma compressing the spinal cord. Diagnostic and therapeutic decompressive surgical procedure was done. On surgical field, solitary and tortuous feeding vessels with hematoma were seen in epidural space. Microscopically, the tissue was compatible with arteriovenous malformation.
Arteriovenous Malformations ; Biopsy ; Cerebrospinal Fluid ; Epidural Space ; Hematoma ; Hematoma, Epidural, Spinal ; Humans ; Korea ; Male ; Methods ; Paraparesis ; Spinal Cord ; Spinal Cord Diseases* ; Spine ; Young Adult

The purpose of this study is to evaluate the sealing effect of several root-end filling materials using spectrophotometric analysis. 180 single root teeth with one canal were instrumented and canal filled. Root resected and root end preparation was made. Teeth were randomly classified to 5 experimental group(MTA, EBA, IRM, TCP, ZOE) and 1 control group according to root-end filling material MTA group used PRO ROOT MTA, EBA group used Super EBA, TCP group used NEW APATITE LINER TYPE II main component of which is alpha-tricalcium phosphate(TCP). According to manufacture's instruction experimental material was mixed and retrfilled. After 2% methylene blue solution penetration absorbance for each test sample was measured with spectrophotometer (JASCO UV-530, Japan). The mean absorbance of control and experimental group was as follows; MTA : 0.092, IRM : 0.226, Super EBA : 0.255, ZOE : 0.374, Control : 0.425, TCP : 0.501 and the result analyzed by Turkey test at P=0.05 level. Conclusions of this study are as follows; 1. The absorbance increase in follwing sequence MTA, IRM, Super EBA, ZOE, Control, TCP. 2. MTA showed the least leakage but was not significant with IRM or Super EBA and was significant with control or TCP(p<0.05). 3. TCP had the most leakage and was not significant with control group.
Methylene Blue ; Tooth ; Turkey ; Pemetrexed