Transcutaneous electrical acupoint stimulation based on electro-oculogram signal regulation for children with mental retardation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of transcutaneous electrical acupoint stimulation (TEAS) at Changqiang (GV 1) based on the modulation of electro-oculogram (EOG) signal for children with mental retardation, and explore the evaluation effect of the goal attainment scale (GAS) in children with mental retardation.@*METHODS@#Sixty children with mental retardation were randomly divided into a treatment group and a control group, with 30 cases in each one. The children in the control group were treated with conventional rehabilitation, 5 times a week. On the basis of the control group, TEAS at Changqiang (GV 1) under the modulation of EOG signal was adopted in the treatment group. When the similarity between the collected EOG signal and the template was within the range of EOG threshold, one electric stimulation was triggered at Changqiang (GV 1) for 20 s (continuous wave, 70-100 Hz in frequency, 0.1-0.2 ms in pulse width), lasting 30 min in each treatment, the intervention was given twice a week. One course of treatment was composed of 4 weeks, and 3 courses were required in total in the two groups. The infant-junior high school student's social living ability scale (S-M) and GAS were scored and compared before and after treatment in the two groups.@*RESULTS@#After treatment, the scores of self-living ability in the treatment group and communication ability in the control group were higher than those before treatment (P<0.01, P<0.05). The scores of collective activity and motor ability in the treatment group were higher than those in the control group (P<0.05). After treatment, GAS scores were higher than before treatment in both groups (P<0.001), and the score in the treatment group was higher than the control group (P<0.05).@*CONCLUSION@#TEAS under the modulation of EOG signal is conductive to improving the collective, motor and self-living abilities of the children with mental retardation and promoting children's individual goals. Compared with the standard score of S-M, the T value of GAS can better reflect the subtle progress of individual.

The Effect of Wearing Prism in Infantile Nystagmus

In infantile nystagmus, we evaluated the changes in visual acuity, nystagmus intensity and face turning between with prism and without prism. 4 patients chosen in our study had a fusional ability examined by Worth-4Dot test and were not accompanied with strabismus. It was confirmed by the inspection of eyes and electro-oculogram that visual acuity at near fixation was better than that at distant fixation and the nystagmus intensity was decreased by convergence. The age distribution of the patients was between 6 and 20 years old. The period of wearing prism ranged from 2.5 to 8.5 months. Improvement in binocular visual acuity at distant fixation with prism was noted relatively from 4 lines to 1 line, the nystagmus intensity (Amplitude x Frequency) calculated by analyzing eletro-oculogram records resulted in the decrease with prism in comparison with that without prism (p<0.05). And the main cause of decrease in nystagmus intensity was determined by that in amplitude rather than frequency. The ranges of correction of face turning at distant fixation wer between 10 degrees and 20 degrees. As the result of this study, in case that nystagmus intensity can be decreaed by convergence and prism is worn succeedingly without any trouble, we assume that the use of bilateral base-out prism will be one of the effective methods for decrease in nystagmus intensity, improvement in visual acuity and face turning.

Clinical Analysis of Vogt- Koyanagi-Harada Disease

Clinical records of 41 patients with Vogt-Koyanagi-Harada disease (VKH disease) who had visited Seoul National University Hospital from 1986 to 1990 were reviewed. Twenty one patients were men and twenty patients were women. Extraocular manifestations included headache (64%), alopecia (34%), poliosis (24%), vitligo (12%), tinnitus (14%), and dysacousia (14%). Arden ratios in electro-oculogram (EOG) were low in the early stages of disease, and became improved with regaining vision. The amplitudes of electroretinogram (ERG), which were low in the early stage, recovered during medication in many cases. Visual prognosis was better if patients were treated with systemic steroid from the beginning. Factors contributing to recurrent or persistent inflammation despite of treatment included numerous extraocular manifestations and delayed treatment.

Periodic Alternating Nystagmus

Periodic alternating nystagmus is a horizontal jerk nystagmus that periodically changes in amplitude and directions every 3 or 4 minutes. Usually the eyes beat in one direction for approximately 90 seconds and then go into a null phase for 10 to 20 seconds before beginning to move in the opposite direction and continued about 90 seconds. The exact mechanism is unknown but the rhythmic alteration of the null zone of horizontal jerk nystagmus is taken as a possible mechanism. These patients periodically show alternating head turning. The authors report 6 cases of congenital periodic alternating nystagmus which show horizontal jerk nystagmus of rhythmic direction change and confirmed by electro-oculogram.