Meta-analysis on randomized controlled trials for scalp acupuncture treatment of stroke: A systematic review.

OBJECTIVE: To conduct a systematic review to assess the clinical effectiveness of scalp acupuncture (SA) for stroke. METHODS: Literature searches were performed in 7 databases up to 16 August 2014, and all the randomized controlled trials (RCTs) in which SA therapy was administered to stroke patients were selected. Methodological quality was assessed using the Jadad score, the Cochrane risk of bias assessment, and the Standards for Reporting Interventions in Clinical Trials of Acupuncture. RESULTS: Of a total of 2086 papers, 21 RCTs were selected. Meta-analysis revealed significant differences in the total efficacy rates of the SA group and the body acupuncture (BA) group vs the medication group (P < 0.002, P < 0.000 001, respectively), the SA plus BA group vs the BA group (P < 0.001); in the motor function of the SA plus BA group vs the BA group (P = 0.077); and in the nerve function of the SA group vs the SA plus BA group (P < 0.0001). CONCLUSION: The results of our systematic review showed that SA therapy may exhibit effects in treatment efficacy and in the recovery of motor and nervous functions in patients with acute to chronic stroke. However, because of the lack of methodological quality, the thoroughly planned clinical studies are still required.

Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

Dural Arteriovenous Fistula on the Brain Stem and Upper Cervical Spinal Cord: A Case Report

A 53-year-old man abruptly developed headache and unconsciousness. Brain computed tomography (CT) and CT angiography showed subarachnoid hemorrhage, intraventricular hemorrhage, and multiple tortuous vascular structures on the brain stem and upper cervical spinal cord. Four-vessel angiography displayed intradural ventral arteriovenous fistula, supplied by the left vertebral and occipital arteries. Drainage was via both sigmoid sinus and cervical venous plexus. He had been treated with transarterial coil embolization of the left vertebral artery. Subsequently, he suffered from left hemiplegia and cognitive problem. Brain magnetic resonance (MR) and MR angiography performed 4 weeks later revealed multiple infarctions on the left cerebellum, left upper cervical spinal cord, and both medial thalamus, as well as occlusion of the left vertebral artery with reduction in varix size. After rehabilitative management, his muscle strength and cognitive function improved. We report a very rare case of dural arteriovenous fistula on the brain stem and upper cervical spinal cord.

Prolotherapy-induced Cervical Spinal Cord Injury: A Case Report

A 49-year-old man received prolotherapy in the upper cervical region at a local medical clinic. Immediately after the procedure, he felt a sensation resembling an electric shock in his right upper and lower extremities, and continuously complained of numbness and discomfort in the right hemibody. He visited our clinic a week later. Upon physical examination, there were no significant abnormal findings. The visual analog scale was 60 points. T2-weight magnetic resonance images of the cervical spine showed a 0.7 cm sized bright oval spot on the right side of the spinal cord at the level of C4-C5 disc, suggesting spinal cord injury. There were no definite electrodiagnostic abnormalities. Digital infrared thermal images showed moderately decreased surface temperature on lateral aspect of the right forearm and dorsum of the right hand compared with the other side. Considering that very rare complications like spinal cord injury may develop after prolotherapy, we suggest that special interventions such as prolotherapy be performed by professional experts.

Rehabilitative Therapeutic Experience in a Juvenile Patient with Secondary Parkinsonism Related to Hypoparathyroidism: A case report

Secondary Parkinsonism caused by hypoparathyroidism in young patients has been rarely reported and the effectiveness of comprehensive rehabilitation management is widely varied. We experienced a case of 16 year old patient with secondary Parkinsonism caused by hypoparathyroidism, who has a chief complaint of progressive resting tremor and gait disturbance. At admission, the tremor subscore was 4 on the unified Parkinson's disease rating scale (UPDRS), the initial score of Korean-modified Barthel index (K-MBI) was 33 points and functional independence measure (FIM) was 52 points. Comprehensive rehabilitation consisted of oral antiparkinsonism drugs, range of motion exercise, motor control and coordination training, gait training with biofeedback, and activity daily living training were performed twice a day, 5 days a week. At one month after admission, she had more improved functional state. The tremor subscore was 2 on UPDRS, K-MBI was 72 points, and FIM was 89 points.

Joubert Syndrome with Severe Hypotonia: A case report

Joubert syndrome first described by Joubert et al. in 1969 is a very rare congenital disorder, characterized by episodic hyperpnea, abnormal eye movement, hypotonia, ataxia, and mental retardation. This syndrome generally represents as autosomal recessive inheritance and main neuropathological finding is agenesis or aplasia of the cerebellar vermis. This patient represents significant generalized muscle hypotonia which is not affected by any other tone-modifying maneuvers. And so there is no significant neuromotor improvement with neurodevelopmental treatment such as Bobath method, Vojta method, or proprioceptive nerve facilitation technique and so on. We report the Joubert syndrome showing typical features with delayed development.