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Ji Soo Kim

Publications and source records attributed to Ji Soo Kim.

At least 19 recordsLinked to original sources
PubMed2007

Diffusion-weighted imaging of intramural hematoma in vertebral artery dissection.

BACKGROUND AND PURPOSE: Dissections of the carotid and vertebral arteries can be detected by several imaging modalities, but there is yet no consensus on the most efficient and effective choice. METHODS: We performed diffusion-weighted imaging (DWI) in four patients with vertebral artery dissection documented with T2- and T1-weighted axial magnetic resonance imaging (MRI), and conventional angiography. Intervals from the onset of headache to evaluation ranged from one day to two weeks. RESULTS: All the patients showed high signal intensity within the affected vertebral artery on DWI. CONCLUSION: The movements of water molecules are more or less restricted within the clots according to the stage of thrombus formation in arterial dissection. Our study may provide another potential imaging method in the difficult task of proving arterial dissection.

Cerebral Angiography↗
PubMed2006

Embolic internal auditory artery infarction from vertebral artery dissection.

A 51-year-old man developed sudden vertigo, right hearing loss and dysphagia. Examination revealed right Horner syndrome, spontaneous torsional-horizontal nystagmus, right central type facial palsy, dysarthria, reduced soft palate elevation without gag reflex, left hypesthesia, right dysmetria and imbalance. Audiometry and bithermal caloric tests documented right sensorineural hearing loss and canal paresis. Brain MRI and cerebral angiography documented right lateral medullary infarction from vertebral artery dissection, without involvement of other parts of the brainstem supplied by the anterior inferior cerebellar artery (AICA). This case suggests artery-to-artery embolism as a possible mechanism of isolated vertigo or hearing loss from labyrinthine infarction.

Adult↗
PubMed2006

Nystagmus while recumbent in horizontal canal benign paroxysmal positional vertigo.

BACKGROUND: The identification of the affected ear is crucial for the successful treatment of benign paroxysmal positional vertigo involving the horizontal canal (HC-BPPV) by using particle-repositioning maneuvers. OBJECTIVE: To determine the lateralizing value of lying-down nystagmus in HC-BPPV. METHODS: The authors prospectively investigated lying-down nystagmus in 152 consecutive patients with confirmed HC-BPPV (99 geotropic and 53 apogeotropic types). Lying-down nystagmus was induced by placing patients in a supine position. For the geotropic type of HC-BPPV, the affected ear was identified by assuming that nystagmus is more intense when the head is rotated to the affected side while supine. The reverse assumption was adopted for the apogeotropic type. RESULTS: Lying-down nystagmus was observed in 58 patients (38.2%), 36 (36.4%) of the geotropic and 22 (41.5%) of the apogeotropic type. The direction of lying-down nystagmus was mostly away from the affected ear in the geotropic type, but toward the affected ear in the apogeotropic type. Of the 16 geotropic patients in whom the affected ear was not identified initially, 7 with lying-down nystagmus showed resolution of vertigo after particle-repositioning maneuvers when the involved ear was identified by observing lying-down nystagmus. CONCLUSION: Lying-down nystagmus is a valuable sign for determining which ear is affected in benign paroxysmal positional vertigo involving the horizontal canal, especially when patients show symmetric nystagmus on turning the head to either side.

Functional Laterality↗
PubMed2006

Value of lying-down nystagmus in the lateralization of horizontal semicircular canal benign paroxysmal positional vertigo.

BACKGROUND: Horizontal canal benign paroxysmal positional vertigo is characterized by horizontal direction-changing nystagmus induced by lateral head turning in supine position. According to Ewald's second law, the direction of head turning that creates a stronger response represents the affected side in geotropic nystagmus and the healthy side in apogeotropic nystagmus. However, it may not always be possible to lateralize the involved ear only by comparing the intensity of the nystagmus. We studied the values of nystagmus induced by position change from sitting to supine in the lateralization of horizontal canal benign paroxysmal positional vertigo. METHODS: A retrospective study of 54 patients who had been diagnosed as having horizontal canal benign paroxysmal positional vertigo at the Dizziness Clinic of Seoul National University Bundang Hospital from May 2003 to February 2004 was performed. The directions of the nystagmus induced by lying down were compared with those determined by Ewald's second law. RESULTS: Of the 54 patients, 32 (20 apogeotropic and 12 geotropic) showed horizontal nystagmus induced by lying down. The nystagmus tended to be ipsilesional in apogeotropic patients (80%) and contralesional in their geotropic counterparts (75%). CONCLUSION: In horizontal canal benign paroxysmal positional vertigo, lying-down nystagmus mostly beats toward the involved ear in the apogeotropic type and directs to the healthy ear in the geotropic type. The direction of lying-down nystagmus may help lateralizing the involved ear in horizontal canal benign paroxysmal positional vertigo.

Adult↗
PubMed2006

Primary aberrant regeneration and neuromyotonia of the third cranial nerve.

A 52-year-old woman presented with episodic diplopia with a duration of 6 months. Between the episodes, infraduction of the right eye was mildly impaired with retraction of the right upper lid on downgaze. On resuming the primary position after prolonged left gaze, she developed a right esotropia and reduced abduction, supraduction, and infraduction of the right eye. There was no history of cranial radiation or previous diagnosis of a brain lesion. Brain imaging results were negative. The interictal infraduction deficit and lid retraction were interpreted as signs of a mild right third cranial nerve palsy with primary aberrant regeneration. The episodic esotropia and ductional deficits were considered to be signs of neuromyotonia. This combination of findings, rarely described before, suggests a link between primary aberrant regeneration and neuromyotonia. Abnormal and excessive conduction triggered by stimulation of a partially damaged nerve probably underlies ocular neuromyotonia.

Anticonvulsants↗
PubMed2006

Clinical characteristics of benign paroxysmal positional vertigo in Korea: a multicenter study.

Benign paroxysmal positional vertigo (BPPV) is characterized by episodic vertigo and nystagmus provoked by head motions. To study the characteristics of BPPV in a large group of patients in Korea, we retrospectively analyzed clinical features of 1,692 patients (women: 1,146, 67.7%; men: 54.6, 32.3%; mean age: 54.8+/-14.0 yr), who had been diagnosed as BPPV by trained neuro-otologists Dizziness Clinics. The diagnosis of BPPV was based on typical nystagmus elicited by positioning maneuvers. Posterior semicircular canal was involved in 60.9% of the patients, horizontal canal in 31.9%, anterior canal in 2.2%, and mixed canals in 5.0%. The horizontal canal type of BPPV (HC-BPPV) comprised 49.5% of geotropic and 50.5% of apogeotropic types. We could observe significant negative correlation between the proportion of HC-BPPV of each clinic and the mean time interval between the symptom onset and the first visit to the clinics (r=-0.841, p<0.05). Most patients were successfully treated with canalith repositioning maneuvers (86.9%). The high incidence of HC-BPPV in this study may be explained by relatively shorter time interval between the symptom onset and visit to the Dizziness Clinics in Korea, compared with previous studies in other countries.

Aged↗
PubMed2005

Isolated vertical diplopia as the initial manifestation of presumed pretectal and anterior hypothalamic germinomas.

A 21-year-old man with a 5-month history of diplopia caused by isolated vertical ocular misalignment had normal laboratory studies, including brain magnetic resonance imaging (MRI). Eight months after the onset of diplopia, he reported dry mouth, polydipsia, polyuria, and absent sweating. Examination now disclosed light-near dissociation of the pupillary responses, convergence-retraction nystagmus, and upgaze palsy. MRI revealed enhancing suprasellar and pretectal masses presumed to be germinomas. Two years after brain irradiation and systemic chemotherapy, no lesions are apparent on MRI and hypothalamic dysfunction has partially resolved. In a young patient with isolated vertical diplopia and normal brain imaging, one should consider an early pretectal syndrome and inquire after manifestations of hypothalamic dysfunction.

Adult↗
PubMed2005

Harlequin syndrome with crossed sympathetic deficit of the face and arm.

Harlequin syndrome is characterized by unilateral hyperhidrosis and flushing, which are predominantly induced by heat or exercise. Usually, the sympathetic deficits confine to the face. Rarely, the autonomic deficits involve the arm or the parasympathetic neurons in the ciliary ganglia. We report a 43-yr-old woman who presented with facial flushing and sweating in the right side, which were mainly induced by exercise. The facial flushing accompanied relative coldness in the right arm. Valsalva maneuver, cold pressure and 0.125% pilocarpine test, and computed tomography of the chest were normal. The crossed sympathetic deficit in the left face and right arm suggested that the lesions were multifocal. The sympathetic impairment in our patient may lie on a spectrum of pre- and postganglionic autonomic dysfunction, which was observed in Holmes-Adie, Ross, and Guillain-Barre syndromé.

Adult↗
PubMed2004

Specificity of "peering at the tip of the nose" for a diagnosis of thalamic hemorrhage.

BACKGROUND: Tonic inward and downward deviation of the eyes ("peering at the tip of the nose") is regarded as a unique feature of thalamic hemorrhage, but the mechanisms of this ocular finding remain obscure. OBJECTIVES: To describe 4 patients who showed tonic inward and downward deviation of the eyes from brainstem or thalamic lesions and to discuss the possible mechanisms involved. DESIGN: Case report. SETTING: Secondary and tertiary referral hospitals. RESULTS: One patient developed alternating esotropia with downward ocular deviation from thalamic hemorrhage compressing the midbrain. Two patients showed multiple infarctions in the territory of the posterior circulation with or without the involvement of the thalamus. Another patient had lateral pontine hemorrhage extending up to the midbrain tegmentum. Ocular bobbing preceded or accompanied tonic ocular deviation in 3 patients. CONCLUSIONS: Tonic inward and downward deviation of the eyes may develop in thalamic or brainstem lesions. Irritation or destruction of the neural structures involved in the vergence and vertical gaze may cause this ocular sign in mesodiencephalic lesions. Skew deviation and esotropia from abduction deficit may be involved in some patients. Ocular bobbing and tonic downward deviation may share a common pathogenesis.

Aged↗
PubMed2004

Third cranial nerve palsy from midbrain neurocysticercosis: repeated exacerbation on tapering corticosteroids.

Third cranial nerve palsy is rare in neurocysticercosis and is usually caused by supratentorial or sub-arachnoid lesions with accompanying hydrocephalus or meningitis. We report a patient who presented with third cranial nerve palsy caused by neurocysticercosis involving the midbrain. The patient showed repeated exacerbation of symptoms on tapering corticosteroids. The experience with this patient indicates that tapering of corticosteroids should be performed very slowly in such cases.

Animals↗
PubMed2003

Spasmus nutans and congenital ocular motor apraxia with cerebellar vermian hypoplasia.

BACKGROUND: Spasmus nutans and congenital ocular motor apraxia share clinical characteristics. However, their development in a patient with cerebellar vermian hypoplasia has not been previously described. OBJECTIVE: To report spasmus nutans and congenital ocular motor apraxia in a child with cerebellar vermian hypoplasia. DESIGN: Case report. SETTING: Tertiary-care hospital. Patient A 7-year-old boy with a history of spasmus nutans during infancy and developmental delay was referred for the evaluation of abnormal head and eye movements. RESULTS: The patient had impaired voluntary saccades and smooth pursuit in the horizontal plane and showed thrusting movements of the head during attempted gaze shift. Magnetic resonance imaging of the brain demonstrated cerebellar vermian hypoplasia, especially in the inferior portion. CONCLUSIONS: Spasmus nutans and congenital ocular motor apraxia may develop in patients with cerebellar vermian hypoplasia. In patients with congenital ocular motor apraxia, a history of spasmus nutans should be sought, and careful evaluation of the cerebellar vermis is needed during brain imaging.

Apraxias↗
PubMed2002

Midbrain disorders of vertical gaze: a quantitative re-evaluation.

The mesodiencephalic junction is the site of the prenuclear control of vertical eye motion. We measured vertical saccades, smooth pursuit (SP), the vertical vestibulo-ocular reflex (VOR), and its interactions with vision during active head motion in 21 patients with midbrain lesions causing palsy of vertical saccades, upward, downward, or in both directions. Most patients with limited slow or slowed saccades in one direction on clinical examination had slowed saccades in the opposed direction. SP gain was decreased in both directions in most patients, and decreased upward or downward in few. VOR gain was subnormal in both directions in many patients, and upward only in one; phase lead of the VOR was recorded in 33% of them. Subnormal SP and VOR gains were often dissociated. Visually enhanced VOR gains were subnormal in both directions in many patients. Cancellation of the VOR was impaired in many patients, both upward and downward in most and upward in few patients. Gaze (eye plus head) tracking gain was subnormal in 29% of patients. Defective SP and defective cancellation of the VOR during head free tracking were often dissociated. We conclude that VOR and SP gains are usually subnormal in patients with paresis of vertical saccades. Impairment of pursuit and the VOR are often dissociated. Phase lead of the VOR implicates damage to velocity-to-position neural integrator for vertical eye motion. These associations and dissociations of impaired vertical eye motion signify discrete structural and functional effects of supranuclear midbrain damage that are undetected by examination of saccades.

Adult↗