The effects of stooped posture on gait and postural sway in Korean patients with Parkinson’s disease

@#Stooped posture, a forward trunk flexion, is a common clinical feature in patients with Parkinson’s disease (PD). However, the exact etiology and effects on gait and balance are not fully understood. In the present study we evaluated the effects of stooping on gait and balance using three-dimensional motion capture and clarified the relationship between the trunk angle and impaired motor function in patients with PD. Thirty-nine patients diagnosed with PD were enrolled in our study. All participants were asked to walk a 6-m tract at their preferred speed, gait parameters and trunk flexion angle were measured using a three-dimensional motion capture system. We analyzed the correlation between trunk angle and gait parameters including gait speed, length, and center of pressure distance for postural sway. Significantly negative correlations were observed between the trunk flexion angle and gait speed (r = -0.407, p = 0.010) and step length (r = -0.561, p < 0.001). Conversely, no correlation was found between trunk flexion angle and postural sway in static standing. We found that stooped posture destabilized gait pattern and did not affect postural sway in PD. Our result showed that stooped posture may not be a compensatory action for stabilizing gait and posture, but rather a symptom of PD.

Internal Capsular Infarction Presented as Monoataxia

No abstract available.

Has Snoring Significance for Predicting Obstructive Sleep Apnea Severity? / 대한임상신경생리학회지

BACKGROUND: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. METHODS: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. RESULTS: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). CONCLUSIONS: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

Comparison of the Demographic and Laboratory Profiles of Patients with Aseptic Meningitis and Encephalitis: Significance of Age and C-reactive Protein / 대한임상신경생리학회지

BACKGROUND: Viruses can cause either meningitis or encephalitis. It is unclear why some people suffer from aseptic meningitis, and others acquire aseptic encephalitis when infected with the same viral pathogens. The aim of this study was to compare demographic and laboratory factors between patients with aseptic meningitis and encephalitis. METHODS: The demographic and laboratory differences were analyzed according to age, sex, diabetes, hypertension, C-reactive protein in the blood, white blood cell and protein in the cerebrospinal fluid, and glucose ratio (cerebrospinal fluid/blood). Additionally, we analyzed the nation-wide differencesin age between the patients with aseptic meningitis and those with encephalitis in Korea. RESULTS: The patients with aseptic encephalitis were older, more likely to have hypertension, and had higher levels of C-reactive protein than did the patients with aseptic meningitis. However, the numbers of white blood cells in the cerebrospinal fluid were significantly higher in the patients with meningitis than in the patients with encephalitis. Multivariable analysis revealed that age >49 years, hypertension and a C-reactive protein level >5.81 mg/dL were independent and significant variables in the prediction of aseptic encephalitis. Additionally, the patients with aseptic encephalitis were older than those with aseptic meningitis in the nation-wide Korean database. CONCLUSIONS: Older age, hypertension, and higher levels of C-reactive protein are useful factors for the prediction of aseptic encephalitis.

Predictors of Excessive Daytime Sleepiness in Korean Snoring Patients

BACKGROUND: Excessive daytime sleepiness is one of the most common symptoms in snoring patients. However, the reason why some individuals complain of daytime sleepiness and others do not is unclear. In this study, we evaluated snoring individuals and examined several demographic and polysomnographic profiles in an attempt to identify predictors of excessive daytime sleepiness. METHODS: The inclusion criteria for patients were the following: 1) patients who underwent an overnight polysomnograph, 2) patients with the chief complaint of snoring, and 3) patients who completed the Korean version of the Epworth sleepiness scale. We used the Epworth sleepiness scale to estimate excessive daytime sleepiness. We quantified correlations between the Epworth sleepiness scale and the demographic/polysomnographic parameters. We also analyzed the parameters affecting excessive daytime sleepiness using multiple linear regression analysis. RESULTS: One hundred nineteen patients met the inclusion criteria for this study. Multiple regression analysis showed that young age was the only independent variable showing statistical significance for predicting excessive daytime sleepiness, and was well-correlated with the Epworth sleepiness scale. However, there were no polysomnographic parameters that were predictive. CONCLUSIONS: Clinicians need to be cautious when using the Epworth sleepiness scale for the diagnosis of obstructive sleep apnea and determining the response to treatment.

Rotational Vertigo and Unsteady Gait Associated with Vestibular Cortical Infarction / 대한임상신경생리학회지

A 77-year-old man developed acute vertigo and unsteady gait. Neurological examination revealed spontaneous left-beating nystagmus in the primary position. He fell to the left when walking without support. Magnetic resonance imaging showed an acute infarction involving the right parieto-temporal lobe. Although the vertigo and unsteady gait are most often associated with vestibular disorders involving the infratentorial structures, those may occur in cerebral infarction of the parieto-temporal lobe.

A Case of Atypical Isolated Nodular Infarction: Nystagmus with a Reverse Direction / 대한뇌졸중학회지

A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.

Primary Diffuse Leptomeningeal Gliomatosis: Report of a Case Presenting with Chronic Meningitis

Neoplastic meningitis occurs in approximately 5% of patients with cancer. Primary diffuse leptomeningeal gliomatosis is a rare condition whereby a glioma arises from heterotopic cell nests in the leptomeninges. We report here a case presenting with clinical features similar to those of chronic infectious meningitis without positive cerebrospinal fluid cytology. Neurological signs in our patient deteriorated progressively without responding to antitubercular, antiviral, or antibiotic therapy. Leptomeningeal biopsy sampling revealed the condition to be primary diffuse leptomeningeal gliomatosis.