OBJECTIVE: To analyze the acupoint selection rules of acupuncture for pseudobulbar palsy dysphagia using data mining technology. METHODS: The literature of acupuncture for pseudobulbar palsy dysphagia published from January 1, 1990 to May 1, 2021 was retrieved from CNKI, SinoMed, Wanfang, VIP, and PubMed databases. Acupuncture prescription database was established. The frequency of acupoint selection was analyzed by Microsoft Excel 2016; Apriori algorithm was used to analyze the association rules and draw the high-frequency acupoint co-occurrence network diagram; SPSS21.0 was used to perform clustering analysis. RESULTS: A total of 87 literature was included, involving 89 acupuncture prescriptions and 71 acupoints. Fengchi (GB 20) was the most frequently-used acupoint; the commonly-selected meridians were gallbladder meridian, conception vessel, governor vessel and stomach meridian; the acupoints located at the neck were the most frequently-used acupoints; the crossing points were commonly selected among the special acupoints. The most commonly-used acupoint combination was Jinjin (EX-HN 12) plus Yuye (EX-HN 13). CONCLUSION The modern acupuncture for pseudobulbar palsy dysphagia usually selects local acupoints, especially the neck acupoints such as Fengchi (GB 20) and Lianquan (CV 23). The acupoints in the front and back are concurrently selected with needles towards the disease location.
Acupuncture Points ; Acupuncture Therapy ; Deglutition Disorders/therapy* ; Humans ; Meridians ; Pseudobulbar Palsy

OBJECTIVE: To observe the clinical effect of fire needling on dysphagia due to pseudobulbar paralysis after stroke and to compare the difference in clinical effect between fire needling and swallowing function rehabilitation training. METHODS: A total of 76 patients with dysphagia due to pseudobulbar paralysis after stroke were randomly divided into an observation group and a control group, 38 cases in each group (1 case dropped out in the control group). The both groups were based on conventional western medication treatment. Fire needle pricking was exerted at Lianquan (CV 23), Fengchi (GB 20), Wangu (GB 12), Shuigou (GV 26), Neiguan (PC 6) and Zusanli (ST 36) without needle retaining every other day in the observation group. The control group was treated with the swallowing function rehabilitation training. In both groups, treatment for 2 weeks was as one course and 2 courses of treatment with 2-day interval were required. After treatment, swallowing scores of Fujishima Ichiro and swallow quality of life questionnaire (SWAL-QOL) scores were observed in both groups, and the clinical effect was compared. Follow-up of swallowing scores of Fujishima Ichiro in 4 weeks after treatment was completed to evaluate the clinical effect. RESULTS: The clinical effective rates after treatment and follow-up were 92.1% (35/38) and 94.7% (36/38) in the observation group, higher than 75.7% (28/37) and 83.8% (31/37) in the control group (<0.05). After treatment, the swallowing scores of Fujishima Ichiro and SWAL-QOL scores were increased in the two groups (<0.05), and those in the observation group were higher than the control group (<0.05). The swallowing scores of Fujishima Ichiro were increased during follow-up in the two groups (<0.05). CONCLUSION Fire needling has a better effect than conventional rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke, which can obviously improve the swallowing function and quality of life in patients with dysphagia.
Acupuncture Points ; Acupuncture Therapy ; methods ; Deglutition Disorders ; etiology ; therapy ; Humans ; Pseudobulbar Palsy ; etiology ; therapy ; Quality of Life ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo compare the therapeutic effects on dysphagia in post-stroke pseudobulbar palsy between the combined treatment with acupuncture and rehabilitation training and the combined treatment with low-frequency electrical therapy and rehabilitation training and to explore its more effective therapy, using the ultrasonographic examination.

METHODSA total of 60 patients of dysphagia in post-stroke pseudobulbar palsy were randomly assigned into an observation group and a control group, 30 cases in each one. The rehabilitation treatment was provided in the two groups. Additionally, in the observation group, acupuncture was used at the three-tongue points [Shanglianquan (Extra), located in the depression between the lingual bone and the border of lower jaw, 1 inferior to the midline of the jaw; and the other two points, located at 0.8 bilateral to Shanglianquan (Extra)], bilateral Fengchi (GB 20) and Fengfu (GV 16). After arrival of , the last two tongue-points were stimulated with electricity, with disperse-dense wave, periodically at 2 Hz, 10 Hz and 100 Hz, at the interval of 3 s, lasting for 30 min. Bilateral Fengchi (GB 20) was stimulated with electricity, with disperse-dense wave and the same frequency as above, lasting for 30 min. In the control group, the low-frequency electrical stimulation was adopted. The electrodes were placed on the bilateral sides of the midline of the throat, 30 min each time. The treatment was for 1 month in the two groups, once a day. The scores of the standardized swallowing assessment (SSA) and the videofluoroscopy swallowing study (VFSS) were observed and the reducing rate of the hyoid-thyroid cartilage distance was determined with ultrasound quantitative measure.

RESULTSAfter treatment, SSA scores of the two groups were all lower than those before treatment and VFSS scores were higher than those before treatment (all <0.05). The above scores in the observation group were better than those in the control group (both <0.05). The reducing rates of the hyoid-thyroid cartilage distance were higher than those before treatment in the two groups (both <0.05). The result in the observation group was higher than that in the control group (<0.05).

CONCLUSIONThe treatments with acupuncture and rehabilitation training or with the low-frequency electrical therapy and rehabilitation obtain the effects on dysphagia in post-stroke pseudobulbar palsy in the patients. The effects of the combined treatment with acupuncture and rehabilitation training are better. The ultrasonographic technology effectively and quantitatively analyzes the changes in the glossopharyngeal complex in the patients of dysphagia.

Acupuncture Points ; Acupuncture Therapy ; Deglutition Disorders ; rehabilitation ; therapy ; Humans ; Pseudobulbar Palsy ; etiology ; rehabilitation ; therapy ; Stroke ; complications ; Treatment Outcome

Bilateral paramedian thalamic infarction is a rare subtype of stroke caused by occlusion of the artery of Percheron, an uncommon variant originating from one of the posterior cerebral arteries. This type of stroke has several major clinical presentations: altered mental status, behavioral amnestic impairment, aphasia or dysarthria, ocular movement disorders, motor deficits, cerebellar signs, and others. Few cases of bilateral paramedian thalamic infarction-related pseudobulbar palsy characterized by dysarthria, dysphagia, and facial and tongue weakness have been reported. We report here a rare case of acute severe pseudobulbar palsy as a manifestation of bilateral paramedian thalamic infarction.
Aphasia ; Arteries ; Deglutition Disorders ; Dysarthria ; Infarction* ; Movement Disorders ; Posterior Cerebral Artery ; Pseudobulbar Palsy* ; Stroke ; Thalamus ; Tongue

OBJECTIVETo compare the therapeutic effect of method for regulating the Governor Vessel and Conception Vessel as well as routine needling method.

METHODSSixty-four cases of pseudobulbar palsy after stroke were randomly divided into an observation group and a control group, 32 cases in each group. The observation group was treated with regulating the Governor Vessel and Conception Vessel, Tiantu (CV 22) through to Danzhong (CV 17), Shanglianquan (Extra), Baihui (GV 20) through to Naohu (GV 17), Fengfu (GV 16) were selected; the control group was treated with routine needling method with acupoints Yamen (GV 15), Lianquan (CV 23), Tongli (HT 5), Guanchong (TE 1). Scores of Watian drinking water test were observed before and after treatment, and therapeutic effects of two groups were compared.

RESULTSThe effective rate of 87.5% (28/32) in the observation group was superior to that of 65.6% (21/32) in the control group (P < 0.05). Scores of Watian drinking water test in both groups were significantly decreased after treatment (both P < 0.01), and the degree of the decrease in the observation group was superior to that of control group (P < 0.01).

CONCLUSIONRegulating the Governor Vessel and Conception Vessel has a significant therapeutic effect for treatment of pseudobulbar palsy after stroke, and superior to that of routine needling.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Blood Vessels ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Pseudobulbar Palsy ; etiology ; physiopathology ; therapy ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo observe the therapeutic effect of acupuncture at different stages on pseudobulbar palsy. Methods Two hundred and forty cases of pseudobulbar palsy were divided into 4 groups according to different courses of disease, i.e. group I, the course within 10 days; group II, between 10-30 days; group III, between 1-3 months; group IV, between 3-6 months. They were treated with acupuncture at Fengchi (GB 20) for 2 courses, and then their therapeutic effects were ohserved.

RESULTSThe effective rate was 100.0% in the group I, 96.7% in the group II, 83.3% in the group III and 76.7% in the group IV, with a significant difference among the 4 groups (P < 0.01).

CONCLUSIONAcupuncture at Fengchi (GB 20) at any stage has therapeutic effect on pseudohulbar paisy, hut the earlier treatments, the better the therapeutic effects.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Pseudobulbar Palsy ; therapy

Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated as well with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with states such as too rapid correction of hyponatremia, alcohol intoxication, malnutrition, liver disease, burn, cancer, addison's disease, dehydrated disease, and electrolyte imbalance. Clinical presentations are nonspecific but are typically characterized by confused mentation, bulbar or pseudobulbar palsy (dysarthria, dysphagia, tetraplegia), rock-in syndrome, and common symptoms such as lethargy and dysarthria. Brain magnetic resonance imaging(MRI) in CPM results in diffuse high signal intensity in the pons on T2-weighted images, and shows slightly decreased signal intensity and no enhancement in the central pons on T1-weighted images. We described a case of a 30-year-old woman presenting with continuous nausea and vomiting in the 16th week of pregnancy. In order to achieve early diagnosis of CPM, We recommend that emergency physicians should consider CPM during differential diagnosis. Prompt diagnosis and management of associated complications are essential for favorable clinical outcomes in CPM.
Addison Disease ; Adult ; Brain ; Burns ; Central Nervous System ; Deglutition Disorders ; Demyelinating Diseases ; Diagnosis ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Emergencies ; Female ; Humans ; Hyponatremia ; Lethargy ; Liver Diseases ; Malnutrition ; Myelinolysis, Central Pontine* ; Nausea* ; Pons ; Pregnancy* ; Pseudobulbar Palsy ; Vomiting

Central pontine myelinolysis (CPM) is a demyelinating disorder that was first described by Adams et al. in 1959 in patients with a history of alcoholism and malnutrition. It is characterized by delirium, quadriparesis, pseudobulbar palsy, and dysarthria. A subgroup of patients at risk for CPM are chronic alcoholics, malnutrition, diabetes, liver transplantation, hepatic disease, advanced age. Although the cause and pathogenesis remains unclear, but many studies have implicated that the rapid correction of hyponatremia is the major factor associated with CPM. But CPM without hyponatremia has been rarely reported. Diagnosis is confirmed by MR image. Here we present one case of CPM without electrolyte disturbance after alcohol withdrawal in a chronic alcoholic with literature reviews.
Alcoholics ; Alcoholism ; Delirium ; Demyelinating Diseases ; Diagnosis ; Dysarthria ; Humans ; Hyponatremia* ; Liver Transplantation ; Malnutrition ; Myelinolysis, Central Pontine* ; Pseudobulbar Palsy ; Quadriplegia

Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) is a rare syndrome that is clinically characterized by quadriparesis, pseudobulbar palsy, and disturbance of consciousness. It commonly occurs in patients with rapid correction of hyponatremia and chronic alcoholism. We report a case of CPM and EPM in a 55-year-old male patient with maintenance hemodialysis. He had type 2 diabetes mellitus for more than 20 years and underwent hemodialysis for the past 7 months. He was admitted for left periorbital cellulitis and uremic symptoms. On the 34th hospital day, he had nausea, vomiting, decreased consciousness, dysarthria and quadriparesis. Laboratory data were revealed as follows:glucose, 117 mg/dL; sodium, 137.1 mEq/L; and serum osmolality, 277 mosm/L. Magnetic resonance imaging (MRI) of the brain revealed increased signal intensity in the pons, upper medulla, cerebellar peduncle and cerebral peduncle in T2 weighted images. This case was considered as primary CPM and EPM occurring in a patient with maintenance hemodialysis. With general supportive care, the patient has been recovered gradually and is being followed up on an outpatient basis.
Alcoholism ; Brain ; Cellulitis ; Consciousness ; Diabetes Mellitus, Type 2 ; Dysarthria ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelinolysis, Central Pontine* ; Nausea ; Osmolar Concentration ; Outpatients ; Pons ; Pseudobulbar Palsy ; Quadriplegia ; Renal Dialysis* ; Sodium ; Tegmentum Mesencephali ; Vomiting

Osmotic myelinolysis syndrome in central nervous system is classified into central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM). The former can cause a spastic quadriplegia, pseudobulbar palsy, and varying degree of mental disorder, but the latter a movement disorder(tremor, dystonia, parkinsonism, and chorea, etc), behavior change(mood instability, personality change, agitated delirium, and disinhibition, etc), and cognitive dysfunction. Although a few cases of asymptomatic CPM have been reported, asymptomatic EPM were rare. A 67-year-old woman with diabetes mellitus and old cerebral infarction has suffered from the common bile duct stone. She had hyponatremia(Na=126mEq/L) on admission and was corrected rapidly. Incidental findings of her brain MRI showed EPM. We experienced a case of bilateral middle cerebellar peduncle myelinolysis incidentally without neurological presentations and report a rare case of asymptomatic EPM recoverd in diabetic woman after rapid correction of hyponatremia.
Aged ; Brain ; Central Nervous System ; Cerebral Infarction ; Chorea ; Common Bile Duct ; Delirium ; Diabetes Mellitus ; Dihydroergotamine ; Dystonia ; Female ; Humans ; Hyponatremia ; Incidental Findings ; Magnetic Resonance Imaging ; Mental Disorders ; Myelinolysis, Central Pontine* ; Parkinsonian Disorders ; Pseudobulbar Palsy ; Quadriplegia