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Volume 25(2); October 2023

Review Articles

Recording and interpretation of ocular movements: saccades, smooth pursuit, and optokinetic nystagmus
Jin-Ju Kang, Sun-Uk Lee, Jae-Myung Kim, Sun-Young Oh
Ann Clin Neurophysiol 2023;25(2):55-65.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.55
The ultimate role of ocular movements is to keep the image of an object within the fovea and thereby prevent image slippage on the retina. Accurate evaluations of eye movements provide very useful information for understanding the functions of the oculomotor system and determining abnormalities therein. Such evaluations also play an important role in enabling accurate diagnoses by identifying the location of lesions and discriminating from other diseases. There are various types of ocular movements, and this article focuses on saccades, fast eye movements, smooth pursuit, and slow eye movements, which are the most important types of eye movements used in evaluations performed in clinical practice.

Citations

Citations to this article as recorded by  
  • COMPARISON OF RANDOM SACCADE TEST AND CLINICAL SACCADOMETRY TEST RESULTS OF HEALTHY ELDERLY AND YOUNG INDIVIDUALS
    Gülce KİRAZLI, Gökçe SAYGI UYSAL, Ece ÇINAR, Aykut ÖZDOĞAN, Şüheda BARAN, Fatih TEKİN
    Turkish Journal of Geriatrics.2025;[Epub]     CrossRef
  • Analysis of Eye Movements in Adults with Spinal Muscular Atrophy
    Marek Krivošík, Zuzana Košutzká, Marián Šaling, Veronika Boleková, Rebeka Brauneckerová, Martin Gábor, Peter Valkovič
    Medicina.2025; 61(4): 571.     CrossRef
  • 15,232 View
  • 270 Download
  • 2 Crossref
Diagnosis and management of neurogenic orthostatic hypotension
Woohee Ju, Dong In Sinn
Ann Clin Neurophysiol 2023;25(2):66-77.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.66
Orthostatic hypotension is a sustained and pathological drop in blood pressure upon standing. Orthostatic hypotension can be due to non-neurogenic conditions or autonomic disorders. Impaired baroreflex-mediated vasoconstriction and insufficient release of norepinephrine play key roles in the pathophysiology of neurogenic orthostatic hypotension. Its common symptoms mainly related to inadequate cerebral blood flow include dizziness, lightheadedness, and syncope. It is crucial to differentiate neurogenic orthostatic hypotension from non-neurogenic orthostatic hypotension. For the management of neurogenic orthostatic hypotension, physicians should implement non-pharmacological methods and, if possible, reverse combined non-neurological conditions. Depending on severity of symptoms, pharmacological intervention may be tried after or with non-pharmacological methods. Its management should be individualized based on intensity of symptoms, comorbid conditions, drug side effects, and etiology. In this review, we discuss the definition, pathophysiology, clinical approach, and management of neurogenic orthostatic hypotension.

Citations

Citations to this article as recorded by  
  • Effects of Daily Lifestyle Habits on Non-Neurogenic Orthostatic Hypotension in Older Adults in South Korea: A Cross-Sectional Study
    Nahyun Kim, Hye-Kyung Oh
    Healthcare.2025; 13(6): 674.     CrossRef
  • Knowledge of Orthostatic Hypotension among Doctors Working at a Tertiary Care Hospital in Sri Lanka
    Shehan Silva, Warsha De Zoysa, Udayangani Ramadasa, Jegarajah Indrakumar
    Journal of the Indian Academy of Geriatrics.2025; 21(1): 51.     CrossRef
  • 13,078 View
  • 279 Download
  • 2 Crossref
Nociplastic pain
Jeong Hee Cho
Ann Clin Neurophysiol 2023;25(2):78-83.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.78
Nociplastic pain refers to pain arising from altered nociception without evidence of tissue or somatosensory damage. It encompasses various clinical conditions with shared neurophysiological mechanisms involving different organ systems. Nociplastic pain can occur independently or alongside chronic pain conditions with a nociceptive or neuropathic origin. This review introduces the concept of nociplastic pain, its clinical manifestations and the underlying pathophysiology. Taking a biopsychosocial approach can lead to a better understanding of nociplastic pain and improved treatment outcomes for affected individuals.

Citations

Citations to this article as recorded by  
  • Aktualisierung der DEGAM-S1-Handlungsempfehlung zum chronischen, nichttumorbedingten Schmerz
    Cornelia Straßner, Annette Becker
    Zeitschrift für Allgemeinmedizin.2024; 100(6): 307.     CrossRef
  • 2,870 View
  • 86 Download
  • 1 Crossref

Original Articles

Electrophysiological features and prognosis of peripheral neuropathy associated with IgM monoclonal gammopathy: a single-center analysis in South Korea
Sooyoung Kim, Bit Na Lee, Seung Woo Kim, Ha Young Shin
Ann Clin Neurophysiol 2023;25(2):84-92.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.84
Background
Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG).
Methods
We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups.
Results
Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström’s macroglobulinemia: two and B-cell non-Hodgkin’s lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment.
Conclusions
The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.
  • 3,205 View
  • 45 Download
Are there network differences between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura?
Junseok Jang, Sungyeong Ryu, Dong Ah Lee, Kang Min Park
Ann Clin Neurophysiol 2023;25(2):93-102.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.93
Background
We aimed to identify any differences in the structural covariance network based on structural volume and those in the functional network based on cerebral blood flow between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.
Methods
We prospectively enrolled 27 patients with migraine without aura, all of whom had unilateral migraine pain. We defined the ipsilateral hemisphere as the side of migraine pain. We measured structural volumes on three-dimensional T1-weighted images and cerebral blood flow using arterial spin labeling magnetic resonance imaging. We then analyzed the structural covariance network based on structural volume and the functional network based on cerebral blood flow using graph theory.
Results
There were no significant differences in structural volume or cerebral blood flow between the ipsilateral and contralateral hemispheres. However, there were significant differences between the hemispheres in the structural covariance network and the functional network. In the structural covariance network, the betweenness centrality of the thalamus was lower in the ipsilateral hemisphere than in the contralateral hemisphere. In the functional network, the betweenness centrality of the anterior cingulate and paracingulate gyrus was lower in the ipsilateral hemisphere than in the contralateral hemisphere, while that of the opercular part of the inferior frontal gyrus was higher in the former hemisphere.
Conclusions
The present findings indicate that there are significant differences in the structural covariance network and the functional network between the ipsilateral and contralateral hemispheres of pain in patients with episodic migraine without aura.
  • 2,943 View
  • 32 Download
Case Reports
Recurrent transient amnesia: a case of transient epileptic amnesia misdiagnosed as transient global amnesia
Kihoon Shin, Ki-Hwan Ji
Ann Clin Neurophysiol 2023;25(2):103-105.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.103
Transient epileptic amnesia and transient global amnesia both exhibit temporary memory loss. The lack of clues of epileptic events and the absence of epileptiform abnormalities in electroencephalography, a clear brain lesion, and interictal cognitive decline can make diagnoses challenging. Here we present a middle-aged female who experienced long-term recurrent transient epileptic amnesia with subtle epileptic features over a period of 3 years.
  • 3,226 View
  • 53 Download
Inclusion body myositis accompanied with T-cell large granular lymphocyte leukemia
Dong-Young Jeong, Seung-Hee Lee, Jungmin So, Ji Yon Kim, Young Chul Kim, Miyoung Kim, Eun-Ji Choi, Eun-Jae Lee, Hyung Jun Park, Young-Min Lim, Hyunjin Kim
Ann Clin Neurophysiol 2023;25(2):106-109.   Published online October 31, 2023
DOI: https://doi.org/10.14253/acn.2023.25.2.106
Inclusion body myositis (IBM) is a late-onset myopathy that manifests as distinct muscle weakness in the quadriceps, finger flexors, and ankle dorsiflexors. T-cell large granular lymphocyte (T-LGL) leukemia is a late-onset clonal disorder of CD8+ cytotoxic T-cells that is often accompanied by autoimmune diseases. To date, the association between IBM and T-LGL leukemia has been infrequently reported. Here, we report a case of a patient with T-LGL leukemia who developed IBM, along with in-depth laboratory, electrophysiological, and pathologic findings.
  • 2,302 View
  • 40 Download
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