Central pontine myelinolysis (CPM) is well-recognized osmotic demyelination syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Acute ataxia as a sole clinical sign in CPM is rare. We report a case of a 59-year-old man with dysarthria, intention tremor, and a significant gait ataxia starting after alcohol withdrawal, with radiological evidence of CPM. CPM should be included in the differential diagnosis of alcoholic patients who develop a sudden ataxia. Chronic alcohol abuse is one of the most commonly encountered predisposing factors. Alcohol withdrawal represents an additional vulnerability factor, being responsible for electrolyte imbalances which are not always demonstrable but are certainly involved in the development of CPM.
Alcoholics* ; Alcoholism ; Ataxia ; Causality ; Demyelinating Diseases ; Diagnosis, Differential ; Dysarthria ; Gait Ataxia ; Humans ; Hyponatremia ; Middle Aged ; Myelinolysis, Central Pontine* ; Tremor

Hemichorea have been reported in patients with nonketotic hyperglycemia. Usually, hemichorea and hyperglycemia are concomitant. A 73-year-old woman was admitted for investigation of an acute hemichorea. T1-weighted brain magnetic resonance imaging showed hyperintensity in the right putamen. Although she was a diabetic patient, she had no hyperglycemia. Interestingly, 4 weeks earlier, the patient was admitted due to nonketotic hyperglycemia. However, there were no hemichorea at that time. Although pathophysiologically controversial, a delayed hemichorea without nonketotic hyperglycemia should be considered as one of many different causes when evaluating acute hemichorea in diabetic patients.
Aged ; Brain ; Chorea ; Female ; Humans ; Hyperglycemia* ; Magnetic Resonance Imaging ; Putamen

No abstract available.
Brain* ; Conus Snail* ; Dermoid Cyst* ; Magnetic Resonance Imaging ; Rupture

BACKGROUND: The pain-screening questionnaire is a self-reported description of the intensity and nature of pain. This study aimed to develop the Korean Neuropathic Pain Questionnaire (KNPQ) and to assess its reliability and validity regarding the diagnosis of neuropathic pain. METHODS: Four screening tools and two rating scales were translated and modified to develop the preliminary KNPQ. Following a development phase and a pilot study, we generated the final 25-item version of the KNPQ. Each item was rated on a numerical scale of 0-10. The validation procedure was performed in 62 patients with neuropathic pain (21 with central pain and 41 with peripheral pain) and in 34 patients with nonneuropathic pain. The internal consistency between items was assessed to determine the reliability of the KNPQ, and its concurrent validity was determined by evaluating the relationship between the Visual Analogue Scale (VAS) and KNPQ scores. RESULTS: The KNPQ was not influenced by age, sex, or pain duration. The 25-item questionnaire demonstrated high internal consistency. The total score of the KNPQ was correlated with the global pain intensity on a VAS. These items were able to differentiate neuropathic pain from nonneuropathic pain with a sensitivity of 84% and a specificity of 44% (when using a cut-off point of 46). CONCLUSIONS: The newly developed KNPQ may be used for the initial screening of neuropathic pain patients. However, it cannot be used to differentiate central neuropathic pain from peripheral neuropathic pain.
Humans ; Mass Screening ; Neuralgia ; Pain Measurement ; Pilot Projects ; Surveys and Questionnaires ; Reproducibility of Results ; Sensitivity and Specificity ; Weights and Measures

No abstract available.
Adult ; Hemoglobins ; Humans ; Male ; Stroke

This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.
Adult ; Aged ; *Counseling ; Demography ; Female ; *Health Behavior ; Health Promotion ; Humans ; Male ; Odds Ratio

We found two errors, title and author affiliation in our published article.

BACKGROUND: The role of glycated hemoglobin (HbA1c) in the prediction of ischemic stroke in non-diabetic subjects is not clear. We performed a study to analyze the role of HbA1c in the risk prediction of ischemic stroke in non-diabetic Korean males adult. METHODS: A total of 307 non-diabetic male patients with ischemic stroke were enrolled, and 253 age-matched control subjects without a history of diabetes, hypertension, or cardiovascular disease were selected from a Health Check-up database. Anthropometric measurement data, fasting glucose level, lipid profile, and HbA1c level were available for all subjects. Associations of the variables and the presence or absence of ischemic stroke were analyzed. RESULTS: The ischemic stroke patient group had significantly higher HbA1c levels (5.8+/-0.5% vs. 5.5+/-0.5%, P<0.01) and mean systolic and diastolic blood pressure compared with the control group. Among the variables, smoking, low high density lipoprotein cholesterol, systolic blood pressure, and HbA1c were the significant determinants for ischemic stroke. The highest quartile of HbA1c showed a 9.6-fold increased odds ratio for ischemic stroke compared with the lowest quartile of HbA1c (odds ratio, 9.596; 95% confidence interval, 3.859 to 23.863, P<0.01). The proportion of ischemic stroke patients showed a significant trend for increment as the deciles of HbA1c increased (P for trend <0.01). CONCLUSION: Higher HbA1c indicated a significantly increased risk for ischemic stroke after adjusting for other confounding variables in non-diabetic Korean adult males. HbA1c might have significance in predicting the risk for ischemic stroke even in the non-diabetic range.
Adult ; Asian Continental Ancestry Group ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Confounding Factors (Epidemiology) ; Fasting ; Glucose ; Hemoglobins ; Humans ; Hypertension ; Lipoproteins ; Male ; Odds Ratio ; Smoke ; Smoking ; Stroke

Ginkgo nuts have been eaten as oriental medicine and food since ancient times in Korea. However, the potential toxicity of the ginkgo nuts is not well-known. It has been reported that 4-O-methoxypyridoxine in ginkgo nuts causes generalized seizures but no status epilepticus. This report describes a 58-year-old male presented with status epilepticus after overconsumption of ginkgo nuts. After treatment with anticonvulsants and pyridoxine, symptoms were resolved. The toxicity of ginkgo nuts should be considered as a cause of status epilepticus.
Anticonvulsants ; Ginkgo biloba ; Humans ; Korea ; Male ; Medicine, East Asian Traditional ; Middle Aged ; Nuts ; Pyridoxine ; Seizures ; Status Epilepticus

Neurological manifestations are commonly observed in systemic lupus erythematosus (SLE). However, cerebellar involvement has rarely been reported. We report a case of SLE presented with cerebellar ataxia as an initial manifestation after influenza vaccination. A 38-year-old woman who had not been diagnosed with SLE presented with dysarthria and gait disturbance after influenza vaccination. On admission, cerebellar ataxia and bilateral sixth cranial nerve palsy were observed. Influenza vaccination may have triggered autoimmunity in the patient with SLE.
Abducens Nerve Diseases ; Adult ; Autoimmunity ; Cerebellar Ataxia ; Dysarthria ; Female ; Gait ; Humans ; Influenza Vaccines ; Influenza, Human ; Lupus Erythematosus, Systemic ; Neurologic Manifestations ; Vaccination