A Case on Risperidone-Induced Tardive Dyskinesia

OBJECTIVE: Base on clinical practice, the authors report a case of tardive dyskinesia arising during the course of treatment with resperidal. METHODS: This article was review and analysis of a case on risperidone-induced tardive dyskinea. RESULTS: Mrs K, a 51-year-old women with a 1-year history of schizophrenic disorder, gradually developed tardive dyskinetic movement of the mouth, lip, and tongue over a 4 month period(From July 1996 to June 1997) while taking risperidone. Initially she was treated with haloperidol and alprazolam. However, the haloperidol was subsequently discontinued because of EPS developed. From 11th March 1997, she was observed to have a severe form of tardive dyskinesia involving her tongue, lip, and mouth. After risperidone was withdrawn at 9th May 1997, her tardive dyskinetic movement was disappeared. CONCLUSIONS: This is, to our knowledge, the first report of the onset of tardive dyskinesia in a patient taking risperidone. However, additional controlled studies of specific questions are needed ; e.g., the dose-response curves for produce tardive dyskinesia and the mechanism of producing risperidone-induced tardive dyskinea and so on.

The Impact of Marital Relationship, Conjugal Dynamics and Family Violence on Juvenile Delinquency / 신경정신의학

OBJECT: The family Is one of the major socialization agencies far children. Parents are one of the most important models from whom the child and adolescent acquire a wide variety of behavior patterns, attitudes, values, and norms. The aim of this study was to determine the important factors related to family conflicts on juvenile delinquency and to examine relationship between marital relationship, conjugal dynamics, family violence, character of adolescent and delinquent behavior. METHODS: Data collection was done through questionnaire survey. The subjects for this study consisted of 1,943 adolescents including 707 juvenile delinquents and 1,236 adolescents students in Korea, chosen from Korean student population and adolescent delinquent population confined in juvenile corrective institutions, using proportional stratified random sampling method. sample of 1,863 adolescents aged between 12 and 18 agreed to participate f3r this study, 80 refused to participate. The actual number of cases put into the analysis was 1,863 adolescents including 657 juvenile delinquents and 1,206 adolescents students. Data were analysed by IBM PC using SAS program. In this study, independent variables were marital relationship, conjugal dynamics, sex distinction of adolescent and intermediating variables were family violence and character of adolescent including need satisfaction/frustration, antisocial personality tendency, complaints of psychosomatic symptoms, and dependent variable was delinquent behavior. Statistical methods employed were x2 test, t-test, simple correlation and path analysis. RESULTS: The results of this study were as follows In this study, the two group(delinquent adolescents and student adolescents) of adolescents were seen as quite different with regard to the variables affecting the genesis and consolidation of juvenile delinquent behavior The delinquent adolescents group were reared in the family environment that the significantly higher family violence and the more dysfunctional marital relationship and conjugal dynamic than student adolescents group. And the delinquent adolescent has the high or need frustration and antisocial Personality tendency and the more complaints of psychosomatic symptoms than student adolescents. were antisocial personality tendency(direct effect=0.262, indirect effect=0.103, total effect=0.365) and sex distinction(direct effect=0.336, indirect effect=-0.014, total effect=0.322). Family violence, character of adolescent including the extent of need illustration, complaints of psychosomatic symptoms were assumed a positive influence as direct and/or indirect paths on juvenile delinquent behavior. Marital relationship and conjugal dynamics have indirect influence on delinquent behavior among adolescents and have direct influence on family violence. CONCLUSIONS: The home environment including marital relationship and conjugal dynamics is the basis far genesis and aggravation of delinquent behavior. Maladaptive interactions within the family members and domestic violence will thus have negative consequences on a global scale including character of adolescent and delinquent behavior such as smoking, drinking, substance abuse, physical assaults etc. We suggested the cause-and-effect relationship between familial factors and juvenile delinquency. However, we should mention that this Interaction can occur in di-directions. This implies that therapeutic intervention should deal with the various links in the chain(sociofamilial, personality traits, gender difference etc.) involved in the genesis and consolidation of juvenile delinquent behavior.

Case formulation of psychiatric patients with temporomandibular pain and dysfunction / 신경정신의학

No abstract available.

Family dynamics of juvenile sex violence / 신경정신의학

No abstract available.

A Case of Postpoliomyelitis Muscular Atrophy

A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.

A Case of Primary Midbrain Hemorrhage

Spontaneous, nontraumatic midbrain hemorrhage is rare. The recent advent of CT scanning has led to recognition of smaller non fatal hemorrhage that could not have been diagnosed. About 19 cases of primary midbrrain hemorrhage have been reported in detail on the previous world literature. The authors recently encountered a hypertensive patient with small isolated mesencephalic hemorrhage documented by the CT scanning of brain, who clinically exhibited only bilateral ptosis and nuclear ophthalmoplegia. So we report a case of primary midbrain hemorrhage with the review of literature.

A Study of Topography of Flash VEP in Patients with Cerebrovascular Disease

The author studied the diagnostic usefulness of topography of flash visual evoked potential (FVEP) in evaluation of the patients with cerebrovascular diseases (CVDs) proven by brain CT scans. The patient group of 21 cases were consist of 10 cerebral infarctions and 11 intracerebral hemorrhages, that occurred at various sittes; 2 frontal lesions, 8 temporopariental lesions, 2 occipital lesions, and 8 basal ganglia lesions. As a control group, topographic studies of FVEP were done in 25 patients with no clinical eviddences of central nervous system diorders and visual symptoms. Topographic studies of FVEP with 12 recording electrodes, using Topography system 700 (San-ei), were done by binocular flashlight stimulation at the rate of 2/sec with the eyes closed. Topographic studies of FVEP were evaluated visually and the asymmetry of topography was considered as abnormal. Three types of topography were used; spatial-temporal mapping up to 300 msec of latency, latency mapping of wave II and VII (Cigenek, 1961), and amplitude mapping of wave II and VII. In both control and patient group, FVEP recorded at O1 and O2 were also obtained. The results were as follows: 1. In control group, absolute latencies and amplitudes of wave II and VII were much variable in FVEP recorded at O1and O2. Interhemispheric differences of amplitudes of wave II and VII were also much variable, but those of latencies were the least variable parameters; 1.89+1.24 msec in wave II and 2.65+3.90 msec in wave VII. Interhemispheric differences of latencies and amplitudes in patient group were interpreted as normal within the mean value plus 2 standard deviation of those of control group. 2. In patient group, abnormal FVEP recorded at O1 and O2 were observed only in 11 cases, among which 8 cases (38%) were consistent in lateralization of supratentorial lesions on brain CT scans. 3. Spatial-temporal mapping of FVEP, even in control group, was variable at each latencies, showing shifting asymimetries sidde to side and only suggested the tendency of greater amplitudes in right hemisphere and sequential transition of evoked responses. 4. In patient group, 17 cases showed abnormal latency mapping of wave II an/or wave VII, among which 13 (62%) were consistent in lateralization of supratentorial lesions. This relatively high concordance rate to brain CT findings was thought to be resulted from low variability of interhemispheric differences of latencies, and also suggested that latency mapping is more reliable method than other 2 types of topography of FVEP. 5. Amplitude mapping of wave II and/or wave VII showed 38% (8 cases) of concordance rate to brain CT findings in lateralization of supratentorial lesion. In conclusion, it is thought that topography of FVEP is a useful diagnostic test in evaluation of CVDs, and is also suggested that topography of FVEP can be used in evaluation of various supratentorial cerebral lesions functionally without such sophisticated criteria as in conventional FVEP interpretation.

A Study for Diagnostic Usefulness of Computer Assisted EEG Topography

The authors studied the diagnostic usefulness of the Topographic analysis of EEG, using Topography ststem 700 (San-ei), in evaluation of supratentorial focal cerebral lesions of 27 patients with various etiology, comparing with visual anslysis of EEG. Focal cerebral lesions, which were proven with brain C-T, were 11 cases of cerebral infarction, 6 of intracranial hematoma, 6 of cerebral gliolysis and 4 of others. The topography system displays the spatial distribution of activity in the classic delta, theta, alpha and beta frequency and computed mapping of EEG displays equipotential maps of square of roots of power spectra over each frequency band. For visual analysis of slow waves and background activity changes, Mayo classification system of EEG abnormality was used and for visual evaluation of topographic display, above system was also applied with some modification in order to compare with the data of visual analysis of conventional EEG. The results of the study were as follows; 1. While visual analysis of conventional anlysis of EEGs showed abnormality only in 13 cases (48.1%) of 27, topographic analysis showed abnormality in 22 cases (81.5%). Topographic analysis was more sensitive than than visual analysis of the EEG and topographic analysis was thought to be more sensitive in assessment of local slow waves as well as minor changes, especially slight asymmetry, of background EEG activity. 2. Topographic analysis showed higher concor dance rate (55.6%) to the brain C-T finding in lateralization of supratentorial focal cerbral lesion than that (44.4%) of visual analysis of the conventional EEG.