Background Benign paroxysmal positional vertigo (BPPV) is a relatively common disorder, and is characterized by episodic vertigo and nystagmus which was provoked by head motion. However, little is known about the short and long-term outcome and the prognostic factors for recurrence of BPPV. In this pilot study, we tried to identify the prognostic factors of BPPV for short-term outcome.
Methods We analyzed clinical features of 32 patients (men=21, mean age=60.4�±12.6y) with BPPV that was diagnosed by typical nystagmus induced by positioning maneuver. The induced nystagmus was recorded using video-oculography (VOG). According to the semicircular canal involved, BPPV patients were classified into horizontal, posterior, or anterior canal type. Univariate analysis for age, sex, and history of vertigo, and Kaplan-Meier analysis for each canal type were performed.
Results Horizontal (n=21, 65.6%) semicircular canal type BPPV was more common than the posterior one (n=11, 34.4%). Median follow-up period was 113 day (from 34 to 216 days). Four patients with horizontal canal type BPPV had recurrent attacks. Age, history of vertigo, and days prior to diagnosis were not different between canal type. Overall recurrence rate of horizontal canal type BPPV by Kaplan-Meier estimation was 19% at 60 days (p=0.13).
Conclusions Horizontal canal type BPPV was more common and recurred more frequently than posterior canal type in the present study. However, we did not find prognostic factors for recurrence of BPPV.
Background Acute transverse myelitis(ATM) is a group of disorders characterized by focal inflammation of the spinal cord and resultant neural injury. It can be diagnosed by Transverse Myelitis Consortium WorkingGroup(TMCWG) criteria. But there are some cases which were not satisfied with idiopathic ATM criteria, both clinically and radiologically, especially in acute stage. So we analyzed 27 cases retrospectively, which were diagnosed as idiopathic ATM.
Methods All the records of the patients at Gil Medical Center with a diagnosis of idiopathic ATM from 2001 to 2005 were reviewed. And clinical manifestations including neurological examination, radiologic features and cerebrospinal fluid (CSF) findings were analyzed.
Results Among the patients(20 men and 7 women; mean age, 45.3 years), 11 cases could not be diagnosed as idiopathic ATM according to the TMCWG criteria ; 6 cases did not have well marginated upper sensory level and 5 cases were not satisfied with spinal cord inflammation.
Conclusions Although most cases of suspected idiopathic ATM were suitable for TMCWG criteria, some cases were not satisfied with this diagnostic criteria, especially in acute stage. Subsequent study might be needed to evaluate the reliability and clinical application of the criteria.
Sporadic inclusion body myositis (s-IBM) is an aquired slowly progressive inflammatory myopathy with unknown etiology. Although light microscopic abnormalities and characteristic histopathology on muscle biopsy distinguishes from other inflammatory myopathies, vacuolated muscle fibers, intracellular amyloid deposits or tubulofilaments in electromicroscopic findings are not definite in some patients. This review shows the prominently involved muscles in s-IBM and specific or nonspecific electrophysiologic manifestations from reported data for helping the diagnosis of definite-or probable-IBM patients. In lower limbs, the quadriceps is predominantly involved, as is iliopsoas, and tibialis anterior is common. In the upper limbs, the greatest weakness is in forearm finger flexors. Finger extensors, biceps and triceps also are moderately to prominently involved. The majority of patients demonstrate polyphasic MUAPs that are short in duration. An additional striking feature is the concomitant documentation of long-duration, large-amplitude, polyphasic MUAPs. In spite of the frequent mixed myopathic-neurogenic electromyographic findings of IBM, just like that of chronic myositis, asymmetric, slowly progressive weakness of flexor digitorum profundus or quadriceps femoris muscles after age of 50 is very necessary condition for the diagnosis of IBM.
Repetitive nerve stimulation is a simple and widely used technique to demonstrate neuromuscular transmission defect. A significant decremental response for repetitive hypoglossal nerve stimulation was obtained from the surface recordings in the tongue of a patient with dysarthria and dysphagia. Repetitive hypoglossal nerve stimulation test may be useful in diagnosis of myasthenia gravis with bulbar symptoms only. We utilized repetitive hypoglossal nerve stimulation with tongue recordings and diagnosed a case of myasthenia gravis.
Miller-Fisher syndrome, Guillain-Barre syndrome with ophthalmoplegia, Bickerstaff s brainstem encephalitis and acute ophthalmoplegia share some clinical features, and common anti-GQ1b IgG antibody and these are introduced as anti-GQ1b antibody syndrome. These syndromes mostly present with paralysis of extraocular muscles and internal ophthalmoplegia rarely occurs. We report a case of acute isolated bilateral internal ophthalmoplegia associated with anti-GQ1b IgG antibody.
Electroencephalogram (EEG) is an indispensable tool for diagnosis of epilepsy and is the only assisting barometer of complete remission of epilepsy, which means prolonged, persistent suppression of cortical excitement in epileptic focus in addition to the clinical control of epileptic seizure. The specific morphologies or distribution of epileptic form discharges give us good information for the classification of seizure or epilepsy and epileptic syndromes, which consists of