3.Sequential Involvement of the Nervous System in Subacute Combined Degeneration.
Yang Ki MINN ; Seung Min KIM ; Se Hoon KIM ; Ki Han KWON ; Il Nam SUNWOO
Yonsei Medical Journal 2012;53(2):276-278
PURPOSE: Subacute combined degeneration (SCD) involves progressive degeneration of the spinal cord, optic nerve, and peripheral nerves. Vitamin B12 (VB12) is a co-factor in myelin synthesis. Because each cell that constitutes the myelin component in the central nervous system and peripheral nervous system is different, it is improbable that these cells undergo simultaneous degeneration. However, the sequence of degeneration in SCD has not been established. MATERIALS AND METHODS: In this study, we analysed medical records and electrophysiological data of patients who showed neurological symptoms and whose serum VB12 levels were lower than 200 pg/mL. RESULTS: We enrolled 49 patients in this study. Their mean VB12 level was 68.3 pg/mL. Somatosensory evoked potential (SEP) study showed abnormal findings in 38 patients. Of the 40 patients who underwent visual evoked potential (VEP) study, 14 showed abnormal responses. Eighteen patients showed abnormal findings on a nerve conduction study (NCS). In this study, abnormal posterior tibial nerve SEPs only were seen in 16 patients, median nerve SEPs only were seen in 3 patients, abnormal VEPs only in two, and abnormal NCS responses in one patient. No patient complained of cognitive symptoms. CONCLUSION: In SCD, degeneration appears to progress in the following order: lower spinal cord, cervical spinal cord, peripheral nerve/optic nerve, and finally, the brain.
Adolescent
;
Adult
;
Aged
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Aged, 80 and over
;
Evoked Potentials, Somatosensory/physiology
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Female
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Humans
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Male
;
Middle Aged
;
Subacute Combined Degeneration/*blood/metabolism/*physiopathology
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Vitamin B 12/blood
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Vitamin B 12 Deficiency/blood/complications
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Young Adult
4.Apical Lung Cancer Associated with Neurofibromatosis Type 1.
Mi Hee LEE ; Jae Hoon YANG ; Sang Don HAN ; Hae Ryoung KIM ; Yeon Kyung JUNG ; Seung Min KIM ; Il Nam SUNWOO
Journal of the Korean Neurological Association 2004;22(5):562-563
No abstract available.
Lung Neoplasms*
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Lung*
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Neurilemmoma
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Neurofibromatoses*
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Neurofibromatosis 1*
5.Serial Follow-up of Neuroimaging Findings in a Progression-free Survival Case with Progressive Multifocal Leukoencephalopathy in Nonimmunocompromised Child.
Won Young DOH ; Yang Je CHO ; Soo Chul PARK ; Jong Doo LEE ; Dong Soo KIM ; Tai Seung KIM ; Il Nam SUNWOO ; Joong Un CHOI
Journal of the Korean Neurological Association 2004;22(5):524-528
Progressive multifocal leukoencephalopathy (PML) is a demyelination disease caused by opportunistic infection of the ubiquitous, usually nonpathogenic neurotropic papovavirus (JC virus). The virus infects and destroys myelin-producing oligodendrocytes, thereby causing patchy areas of demyelination in the cerebral white matter. It is exclusively a disease of immunosuppressed individuals. We report a case of an immunocompetent child patient with pathologically-proven PML and with a survival over 3 years after diagnosis. Serial follow up of neuroimaging study including brain MRI, MRS, SPECT and PET was obtained.
Brain
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Child*
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Demyelinating Diseases
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Diagnosis
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Disease-Free Survival*
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Follow-Up Studies*
;
Humans
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Leukoencephalopathy, Progressive Multifocal*
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Magnetic Resonance Imaging
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Neuroimaging*
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Oligodendroglia
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Opportunistic Infections
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Tomography, Emission-Computed, Single-Photon
6.Two Cases of Delayed Post-radiation Lower Cranial Nerve Palsies.
Hyung Jun PARK ; Ki Han KWON ; Yang Ki MIN ; Bum Chun SUH ; Dong Suk SHIM ; Seung Min KIM ; Il Nam SUNWOO
Journal of the Korean Neurological Association 2008;26(1):55-58
Radiation-induced lower cranial neuropathy shows a clinical presentation similar to tumor recurrence or amyotrophic lateral sclerosis. We experienced two patients with bulbar palsies several years after radiotherapy for nasopharyngeal cancer. Brain magnetic resonance imaging showed no evidence of tumor recurrence. Electrophysiologic studies demonstrated mild denervation changes and myokymic discharges in muscles innervated by cranial nerves. Bulbar palsies progressed for 1 year then became stable. We emphasize the importance of myokymic discharges in the differential diagnosis of radiation-induced cranial neuropathy as radiation plexopathies.
Amyotrophic Lateral Sclerosis
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Brain
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Bulbar Palsy, Progressive
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Cranial Nerve Diseases
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Cranial Nerves
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Denervation
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Diagnosis, Differential
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Humans
;
Magnetic Resonance Imaging
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Muscles
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Myokymia
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Nasopharyngeal Neoplasms
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Recurrence