Journal of Acupuncture Research

Korean Acupuncture & Moxibustion Medicine Society (대한침구의학회)
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A Case Report of a Right-sided Hemichorea Patient Diagnosed with Chorea Hyperglycemia Basal Ganglia Syndrome : A Combined Western-Korean Medicine Approach

우반신 무도증을 호소하는 Chorea Hyperglycemia Basal Ganglia Syndrome 환자에 대한 증례보고 : 양한방 복합치료적 접근으로

  • Kim, Sung Yoon (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Park, Jun Hyeong (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Ahn, Jae Hyun (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Jo, Jung Jae (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Seung Min (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kang, Jung Won (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Nam, Dong Woo (Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University)
  • 김성윤 (경희대학교 한의과대학 침구의학교실) ;
  • 박준형 (경희대학교 한의과대학 침구의학교실) ;
  • 안재현 (경희대학교 한의과대학 침구의학교실) ;
  • 조정재 (경희대학교 한의과대학 침구의학교실) ;
  • 이승민 (경희대학교 한의과대학 침구의학교실) ;
  • 강중원 (경희대학교 한의과대학 침구의학교실) ;
  • 남동우 (경희대학교 한의과대학 침구의학교실)
  • Received : 2016.02.12
  • Accepted : 2016.03.08
  • Published : 2016.03.18
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Abstract

Objectives : The purpose of this report is to introduce a rare case of a patient with Chorea Hyperglycemia Basal Ganglia syndrome (C-H-BG) whose initial medical interventions were started 2 weeks after the onset, and to suggest the possibility of treatment using a combined Western-Korean medicine approach. Methods : A 75-year-old female C-H-BG patient complaining of persistent right-sided hemichorea was treated with a therapy that combined Korean and Western medicine from April 4, 2015 to April 29, 2015. Improvements of symptoms were measured by a motor assessment of Unified Huntington's Disease Rating Scale (UHDRS), Visual Analog Scale (VAS) and the number of involuntary movements. Results : Motor assessment of UHDRS, VAS and the number of involuntary movements all showed a gradually improving tendency during 26 days of admission treatment. However, the patient's hemichorea persisted. Conclusion : Rapid blood sugar control is the most important treatment for C-H-BG, because pathologic changes of basal ganglia seem to become irreversible as time goes by. A combined Western-Korean medicine approach to treating C-H-BG seems effective not only in reducing hemichorea, but also in the management of accompanying symptoms such as muscle pain and general weakness.

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References

  1. Ahmad A, Paliwal P, Wakerley BR. Vascular contribution to hyperglycaemia-induced hemichorea. Diab Vasc Dis Res. 2013 ; 10(4) : 378-9. https://doi.org/10.1177/1479164112469121
  2. Lee BC, Hwang SH, Chang GY. Hemiballismus- hemichorea in older diabetic women : a clinical syndrome with MRI correlation. Neurology. 1999 ; 52(3) : 646-8. https://doi.org/10.1212/WNL.52.3.646
  3. Guisado R, Arieff AI. Neurological manifestations of diabetic comas : correlation with biochemical alterations in the brain. Metabolism. 1975 ; 24(5) : 665-79. https://doi.org/10.1016/0026-0495(75)90146-8
  4. Oh SH, Lee KY, Im JH, Lee MS. Chorea associated with non-ketotic hyperglycemia and hyperintensity basal ganglia lesion on T1-weighted brain MRI study : a meta-analysis of 53 cases including four present cases. J Neurol Sci. 2002 ; 200(1-2) : 57-62. https://doi.org/10.1016/S0022-510X(02)00133-8
  5. Ohara S, Nakagawa S, Tabata K, Hashimoto T. Hemiballism with hyperglycemia and striatal T1-MRI hyperintensity : an autopsy report. Mov Disord. 2001 ; 16(3) : 521-5. https://doi.org/10.1002/mds.1110
  6. Shan DE, Ho DM, Chang C, Pan HC, Teng MM. Hemichorea- hemiballism : an explanation for MR signal changes. Am J Neuroradiol. 1998 ; 19(5) : 863-70.
  7. Fujioka M, Taoka T, Matsuo Y, Hiramatsu KI, Sakaki T. Novel brain ischemic change on MRI : delayed ischemic hyperintensity on T1-weighted images and selective neuronal death in the caudoputamen of rats after brief focal ischemia. Stroke. 1999 ; 30(5) : 1043-6. https://doi.org/10.1161/01.STR.30.5.1043
  8. Danve A, Kulkarni S, Bhoite G. Non-ketotic hyperglycemia unmasks hemichorea. J Community Hosp Intern Med Perspect. 2015 ; 5(4) : 1-5.
  9. Hyun WC, Lee SR. Studies on the Effect of AntiConvulsion and Analgesic by Ukgansan and Ukgansangami. J. of Oriental Neuropsychiatry. 1994 ; 5(1) : 69-79.
  10. Kim KS, Sung GK, Moon BS. An Experimental Study on the Antiepileptic Effects of Ukgansan. K.I.M.S. 1998 ; 19(1) : 57-72.
  11. Satoh T, Takahashi T, Iwasaki K et al. Traditional Chinese Medicine on four patients with Huntington's disease. Mov Disord. 2009 ; 24(3) : 453-5. https://doi.org/10.1002/mds.22447
  12. Kim WH, Choi DY. Bowels-viscera syndrome differentiation and treatment . Seoul : Seongbosa. 1985 : 161-2.
  13. Kim JW, Hyun JO, Paik JW et al. Clinical Observation on 1 Case Patient of The Myoclunus and Hemiparesis caused by The Pons Infarction. Journal of KIOM. 2004 ; 10(2) : 17-25.