급성순수외측연수경색에서 딸꾹질과 병변의 위치적 연관성
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Background: Intractable hiccup is not a frequent but disabling condition of lateral medullary infarction (LMI). Unlike other symptoms and signs of LMI, the anatomical lesions of intractable hiccup are not well known. Although there were studies about clinical-radiological correlation using MRI, few studies have evaluated the relation between lesional location of LMI and intractable hiccup. Therefore, we performed this study to clarify the lesional correlation with intractable hiccup in LMI. Methods: Between 1997 and 2003, we identified 12 patients with pure LMI (LMI without concomitant midbrain, pontine, cerebellar, or cerebral infarction) who presented with intractable hiccup in addition to typical lateral medullary syndrome. Eighteen patients without hiccup were included as control group. Clinical and radiologic findings were compared between two groups. Results: The patients with intractable hiccup significantly more often had dorsal lesions rather than ventral lesions at horizontal levels (P=0.011). But, there were no rostrocaudal differences at vertical levels. Conclusion: We suggest that pure LMI associated with intractable hiccup often locates in the dorsal medulla at horizontal correlation. This comparative study using MRI helps us to expand the understanding of the neural substrate for intractable hiccup in LMI. (Korean J Stroke 2008;10:30-35)
Abstract
Background: Intractable hiccup is not a frequent but disabling condition of lateral medullary infarction (LMI). Unlike other symptoms and signs of LMI, the anatomical lesions of intractable hiccup are not well known. Although there were studies about clinical-radiological correlation using MRI, few studies have evaluated the relation between lesional location of LMI and intractable hiccup. Therefore, we performed this study to clarify the lesional correlation with intractable hiccup in LMI. Methods: Between 1997 and 2003, we identified 12 patients with pure LMI (LMI without concomitant midbrain, pontine, cerebellar, or cerebral infarction) who presented with intractable hiccup in addition to typical lateral medullary syndrome. Eighteen patients without hiccup were included as control group. Clinical and radiologic findings were compared between two groups. Results: The patients with intractable hiccup significantly more often had dorsal lesions rather than ventral lesions at horizontal levels (P=0.011). But, there were no rostrocaudal differences at vertical levels. Conclusion: We suggest that pure LMI associated with intractable hiccup often locates in the dorsal medulla at horizontal correlation. This comparative study using MRI helps us to expand the understanding of the neural substrate for intractable hiccup in LMI. (Korean J Stroke 2008;10:30-35)
참고문헌 (23)
- Norrving B, "Lateral medullary infarction: prognosis in an unselected series", Neurology, 41, pp.244~248 (1991)
- Norrving B, "Medullary infarcts and hemorrhages, In Stroke Syndromes. 2nd ed", pp.534~539 (2001), Cambridge University Press
- Victor M, "Lateral Medullary Syndrome, In Adams and Victor’s principles of neurology", pp.678~682 (2001), McGraw-Hill
- Sacco RL, "Wallenberg’s lateral medullary syndrome: Clinical-magnetic resonance imaging correlations", Arch Neurol, 50, pp.609~614 (1993)
- Kumar A, "Intractable hiccups during stroke rehabilitation", Arch Phys Med Rehabil, 79, pp.697~699 (1998)
- Kim H, "Aspiration subsequent to a pure medullary infarction: lesion sites, clinical variables, and outcome", Arch Neurol, 57, pp.478~483 (2000)
- Arita H, "Serotonin innervation patterns differ among the various medullary motoneuronal groups involved in upper airway control", Exp Brain Res, 95, pp.100~110 (1993)
- Arita H, "Generation of hiccup by electrical stimulation in medulla of cats", Neurosci Lett, 175, pp.67~70 (1994)
- Oshima T, "GABAergic inhibition of hiccup-like reflex induced by electrical stimulation in medulla of cats", Neurosci Res, 30, pp.287~293 (1998)
- Marsot-Dupuch K, "Intractable hiccups: the role of cerebral MR in cases without systemic cause", ANJR Am J Neuroradiol, 16, pp.2093~2100 (1995)
- Askenasy JJ, "About the mechanism of hiccup", Eur Neurol, 32, pp.159~163 (1992)
- Kwon M, "Dysphagia in unilateral medullary infarction: lateral vs medial lesions", Neurology, 65, pp.714~718 (2005)
- Park MH, "Lesional location of lateral medullary infarction presenting hiccups (singultus)", J Neurol Neurosurg Psychiatry, 76, pp.95~98 (2005)
- Kim JS, "Spectrum of lateral medullary syndrome: correlation between clinical findings and magnetic resonance imaging in 33 subjects", Stroke, 25, pp.1405~1410 (1994)
- Kim JS, "Pure lateral medullary infarction: clinical-radiological correlation of 130 acute, consecutive patients", Brain, 126, pp.1864~1872 (2003)
- Loft LM, "Hiccups. A case presentation and etiologic review", Arch Otolaryngol Head Neck Surg, 118, pp.1115~1119 (1992)
- Launois S, "Hiccup in adults: an overview", Eur Respir J, 6, pp.563~575 (1993)
- Lee SS, "Myung HJ. A Clinical study of 21 patients with lateral medullary syndrome", J Korean Neurol Assoc, 7, pp.42~51 (1989)
- Friedman NL, "Hiccups: a treatment review", Pharmacotherapy, 16, pp.986~995 (1996)
- Musumeci A, "Persistent hiccup as presenting symptom in medulla oblongata cavernoma: a case report and review of the literature", Clin Neurol Neurosurg, 102, pp.13~17 (2000)
- al Deeb SM, "Intractable hiccup induced by brainstem lesion", J Neurol Sci, 103, pp.144~150 (1991)
- McFarling DA, "Hoquet diabolique: intractable hiccups as a manifestation of multiple sclerosis", Neurology, 29, pp.797~801 (1979)
- Kumral E, "Primary medullary haemorrhage with intractable hiccup", J Neurol, 245, pp.620~622 (1998)