Prolonged Comatose State Followed by Rapid Recovery in a Patient with Bickerstaff's Brainstem Encephalitis / 대한임상신경생리학회지

No abstract available.

Timing and Causes of Death of Stroke Patients Died in Hospitalization

OBJECTIVE: To evaluate the frequency distribution and causes of death according to number of days after stroke. METHOD: We reviewed in 158 cases of the stroke patients who had died in hospitalization from January 2000 to June 2002 by medical records retrospectively. We evaluated the correlations between the frequency of death and causes of death by frequency analysis. RESULTS: Mean age was 65.8 11.5 years old and average survival days after stroke were 16.2 24.1 days. The proportion of stroke subtypes were infarct (51.3%), intracranial hemorrhage (36.7%), and subarachnoid hemorrhage (12.0%). The frequency of death at 7 days and 30 days after stroke onset were 52.5% and 89.2%, respectively. The most frequent cause of death was respiratory arrest due to transtentorial herniation or brain stem lesion (48.1%), followed in frequency by pneumonia (22.2%), cardiac origin (10.8%), and vasospasm (6.3%). Within the first 30 days, the leading cause of death was respiratory arrest due to transtentorial herniation or brain stem lesion. After the first 30 days, the most frequent cause of death was pneumonia. CONCLUSION: The results of this study are valuable as basic data of mortality and causes of death after stroke during an acute stroke management and early rehabilitation.

Laryngeal Electromyography: Clinical Application in Vocal Cord Palsy

Vocal cord paralysis is a comlex disorder which may result from numerous causes. It is often associated with trauma, disease in adjacent tissue, or a generalized neuroligical disorder. Laryngeal EMG is a useful technique for vocal cord paralysis. However it has not been used due to the uncertainties of normal human vocal cord physiology and the technical difficulties in performing these studies. We investigated the pathophysiology of vocal cord paralysis with laryngeal electromyography(LEMG). We studied 20 patients with idiopathic vocal cord paralysis. 6 patients were denervated in the cricothyroid(CT) and 6 patients in the thyroarytenoid(TA), and 3 patients in both CT and TA muscles. These indicated superior laryngeal neuropathy, recurrent laryngeal neuropathy, and proximal laryngeal or vagus neuropathy, respectively. LEMG proved to be a safe and effective procedure in the diagnosis of laryngeal neuropathy, and make it possible to use electromyography as a routine procedure in diagnosis laryngeal paralysis.

The Clinical Efficacy of Subcutaneous Sumatriptan (Imigran) for Acute Treatment of Migraine

Sumatripan is a selective agonist at the 5-hydroxytryptamine (5HT,) -like receptor. An open, uncontrolled study was conducted to evaluate the therapeutic response of Korean patients to sumatriptan 6mg using an autoinjector for acute migraine attacks. 38 migraineurs were diagnosed by neurologists and included in the study. However, 7 patients were withdrawn as they failed to have an attack and one more or one additional patient was withdrawn due to syncope immediately after the first injection Patients recorded details of each attack and the response to treatment in a diary card. A total of 64 attacks in 30 patients were finally 'mcluded to evaluate the efficacy of treatment. Sumatriptan was very effective at relieving acute migraine attacks of various severity and the associated symptoms (nausea, vomiting, photophobia and phonophobia). Within two and a half hours after injection, 97% (62/64) showed a significant improvement of symptoms from moderate/severe at baseline to mild/none after treatment. There is no significant statistical difference of response of treatment about each type of migraine (classic migraine vs common migraine, chisquare test, ;? = 3. 84, p = 0. 650). Adverse events occurred 46% (30/65) of attacks. These were usually mild and transient, the most common being chest discomfort, pain at site of injection, nausea/vomiting, neck pain/stiffness, dizziness, sensation of weakness and tingling. In conclusion, sumatriptan taken by subcutaneous injection using an automjector was highly effective, fast acting and well tolerated in the treatment of acute migraine.