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[이데일리 이순용 기자] Professor Kim Min-beom and resident Hong Jun-pyo of the Department of Otolaryngology at Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital (Director Shin Hyeon-cheol) proposed a new treatment strategy through the differences in vestibular damage patterns depending on the presence or absence of dizziness in sudden hearing loss.

In most cases, the cause of sudden hearing loss is difficult to determine, but viral infection and vascular disorders within the cochlea are presumed to be the main pathogenic mechanisms. To date, the standard treatment for sudden hearing loss is systemic high-dose steroid administration or intratympanic injection. If the cause is a viral infection, the previous treatment may be effective, but if the cause is a vascular disorder, it is difficult to expect a treatment effect, so hyperbaric oxygen treatment or anticoagulant therapy is considered necessary. However, due to the complex structure of the cochlea, it is often difficult to accurately determine whether the cause of hearing loss is a viral infection or a vascular disorder, making it impossible to provide customized treatment depending on the cause.

Accordingly, the research team of Professor Kim Min-beom of the Department of Otolaryngology at Kangbuk Samsung Hospital confirmed the presence of dizziness and patterns of vestibular damage in 165 patients who visited our hospital with sudden hearing loss from 2017 to 2022 through a hierarchical clustering analysis method. In other words, patients with sudden hearing loss were divided into those with and without dizziness, and the results of the hearing, dizziness, and balance function tests were identified and analyzed for correlation.

As a result, in cases of sudden hearing loss accompanied by dizziness and decreased function of the posterior semicircular canal, the prognosis of existing steroid treatment was poor. Therefore, sudden hearing loss accompanied by dizziness and decreased function of the posterior semicircular canal is highly likely to be caused by vascular disorders, so it is necessary to consider treatments that combine hyperbaric oxygen therapy or anticoagulation therapy from the beginning rather than existing steroid treatments.

Professor Kim Min-beom of the Department of Otolaryngology at Kangbuk Samsung Hospital said, “Sudden hearing loss is a representative otolaryngology emergency, with 40 to 50% of cases resulting in permanent hearing loss even if appropriate treatment is administered in the early stages.” He added, “Above all, it is important to quickly find the cause and implement treatment.” “It is important, and this study allows us to consider new treatments at an early stage,” he said, explaining the significance of the study.

This study was published in ‘Otolaryngology-Head and Neck Surgery’, a top academic journal in the field of otolaryngology.

2024-01-07 08:24:01

#sudden #hearing #loss #accompanied #dizziness #recovery #careful

[18편]
If multiple cerebral infarctions occur, the risk of vascular dementia increases.
High blood pressure can be prevented simply by controlling smoking and drinking.

Taejeong Kim, a professor in the Department of Neurology and Critical Care Medicine at Seoul National University Hospital, who received his bachelor’s degree, master’s degree, and doctoral degree from Seoul National University School of Medicine, is currently serving as the public relations director at the Korean Stroke Association. Through the series ‘Overcoming Stroke’, we are actively promoting that stroke is a treatable disease. Getty Images[서울대병원 신경과 김태정 교수] Stroke is a disease that occurs when a cerebral blood vessel becomes blocked or burst. When a stroke occurs, after-effects such as paralysis of limbs, speech problems, and swallowing problems may remain. Approximately 85% of all cerebral infarction patients are discharged from the hospital with aftereffects, even if the condition is mild. So, does dementia occur more often after a stroke?

Where am I? I can barely remember

According to data from the National Statistical Office in 2020, Alzheimer’s dementia accounts for more than 75% of all dementia patients, but vascular dementia patients account for the next 10%. Although the difference in rates is large, vascular dementia ranks second among all dementias. Stroke is directly related to vascular dementia. After a stroke, vascular dementia can occur depending on the location or degree of involvement of the stroke. It is known that vascular dementia can occur in less than 10% of people within a year after a stroke, and in more than 30% of people within 5 years of a stroke. .

There are several types of vascular dementia, including dementia caused by multiple cerebral infarctions, dementia caused by a single cerebral infarction occurring in strategic brain regions related to cognitive function, and dementia caused by subcortical small vessel disease. Simply put, this means that if cerebral infarction occurs multiple times or if cerebral infarction occurs in an area related to cognitive function, the risk of vascular dementia increases.

This risk increases as the severity of stroke increases. Stroke patients are directly related to the occurrence of stroke, but it can also occur as asymptomatic stroke lesions or small vessel disease. For this reason, there are cases where patients visit hospitals due to cognitive decline and then have related lesions confirmed through brain imaging tests.

What are the symptoms of vascular dementia? Symptoms of vascular dementia may vary in type, severity, and timing of symptom occurrence depending on the location or degree of invasion of the cerebral blood vessel causing the stroke. The main symptoms include cognitive decline, such as memory loss, language ability, decreased ability to grasp space and time, judgment, and ability to perform daily activities, as well as apathy, depression, anxiety, delusions, hallucinations, wandering, aggression, hypersensitivity to stimuli, and abnormalities. Psychological and behavioral symptoms such as behavioral and dietary changes and sleep disturbances may also appear. Kim Tae-jeong, Professor, Department of Neurology and Critical Care Medicine, Seoul National University Hospital If dementia symptoms have occurred after a stroke, various stroke-related neurological symptoms such as hemiparesis, hemiparesthesia, visual disturbance, facial paralysis, speech impairment, swallowing impairment, gait disturbance, and limb stiffness may occur. Abnormal symptoms are also accompanied, and in severe cases, physical complications such as fecal and urinary incontinence, falls, bedsores, pneumonia, and urinary tract infections may appear. When looking at Alzheimer’s dementia, Alzheimer’s dementia mainly appears with recent memory impairment in the early stages, and gradually progresses, causing other problems in addition to memory decline. Deterioration of cognitive function and mental and behavioral symptoms become more frequent, and in the later stages, physical symptoms such as stiff limbs, gait disorders, and incontinence appear, showing a relatively consistent progression pattern. On the other hand, in vascular dementia, compared to the level of memory decline, which is a symptom of cognitive decline, the decline in other cognitive functions such as attention and concentration, frontal lobe function, language function, etc. may be more noticeable, and personality changes may be seen in the early stages. However, it is often difficult to distinguish between Alzheimer’s dementia and vascular dementia, and as many patients have various cerebrovascular risk factors as they age, they often develop mixed dementia with both types after several years.

This is how to prevent vascular dementia

So, is there a way to prevent vascular dementia? The most important thing is to prevent stroke, which is an important cause of vascular dementia. It is most important to prevent stroke as much as possible by controlling risk factors for stroke such as high blood pressure, diabetes, hyperlipidemia, atrial fibrillation, smoking, and drinking. Because these risk factors can cause stroke or small vessel disease, the main cause of vascular dementia, controlling these factors is ultimately important.

In addition, when a stroke occurs, the more severe the stroke, the higher the risk of developing dementia later, so if stroke symptoms occur, you must visit the hospital as quickly as possible, receive ultra-acute treatment, and minimize the aftereffects.

Vascular dementia can be said to be a type of dementia whose risk of occurrence can be reduced by controlling vascular risk factors as much as possible. Therefore, if you know that you have risk factors for cardiovascular disease such as high blood pressure, diabetes, hyperlipidemia, etc., you must actively control them and receive consistent management to prevent stroke and vascular dementia at the same time.

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2023-12-30 04:33:33

#Memory #loss #stroke.. #dementia뇌졸중 #극복하기

[이데일리 이순용 기자] Language is a means of communication, and words play the most important role. Children with developmental language disorder are slow in producing early words, have difficulty acquiring verbs, and have difficulty applying newly learned words. Find out about developmental language disorder with the help of Professor Kim Hyun-jeong of the Department of Rehabilitation Medicine at Soonchunhyang University Bucheon Hospital.

Language disorder refers to a communication disorder in which the language acquisition process deviates significantly from the normal process. Normal children begin speaking words as early as 10 months after birth, on average at 12 months, and connect two words by about 18 months of age. Doesn’t babble by 6 months, doesn’t understand what others say when turning, can’t put together two words by 2 years of age, speaks less than 50 words by 3 years of age, or can’t play or talk with peers by age 4 If you have difficulty, you may suspect developmental language disorder.

As a diagnostic method, evaluation is recommended when a delay of more than two times compared to the normal onset time is found. The most widely used language development tests are the Preschool Receptive-Expressive Language Scale (PRES) and the Sequenced Language Scale for Infants (SELSI).

Professor Kim Hyun-jung said, “According to general guidelines, if a child has no words to say by the age of 2 or cannot form a sentence using two words until the age of 3, we recommend a language evaluation. “Recently, there are cases where active evaluation is recommended to visit the hospital sooner than this, if word expression does not appear by 18 months or two word connections do not appear by 24 months,” he said.

Speech disorders occur due to defects in the cerebral physiological process of understanding or expressing spoken language. Diseases that accompany language impairment include hearing impairment, intellectual disability, autism spectrum disorder, brain lesions including cerebral palsy, and epilepsy. Genetic diseases such as Down syndrome, Williams syndrome, and fragile Since quantitative growth of the brain and language development occur at the fastest rate in the first few years of life, lack of interaction during infancy and childhood may also be a cause. Professor Kim said, “Treatment is needed during the third period when vocabulary and comprehension skills explode. It is best not to exceed three. He emphasized, “Since early diagnosis and early treatment are the principles, we encourage treatment to be administered immediately upon diagnosis.”

To promote language development, students are encouraged to experience many language patterns intensively in a short period of time. To this end, even if the child expresses himself in incomplete forms, it is a good idea to continuously tell him sentences with complete morphemes and use this as an opportunity to expand his vocabulary or phrases. It is more effective if the content is reprocessed and expressed in various ways.

Even before one’s first birthday, it is important for parents or caregivers to read and respond to their child’s signals and create an appropriate communication environment in their daily life. Social games, responses to children’s utterances, and modeling of communicative behaviors that promote language development are helpful in promoting language development. Also, it is good to allow them to experience a wide range of communication skills and various expressions.

Professor Kim Hyun-jung said, “Some guardians believe that their child will learn to speak naturally without special treatment, but if speech impairment persists, it may lead to a learning disability. Therefore, ongoing language development assessment is necessary to ensure that appropriate measures are taken to ensure that language development progresses normally,” she said. He continued, “With the recent increase in the spread of smart devices, children are often overly exposed to smart devices without parental supervision. “Because direct interaction and communication are important for language development, we must be careful not to expose children to smartphones and videos alone,” he said.

ⓒComprehensive economic information media Edaily – Commercial reproduction and redistribution prohibited

2023-12-24 01:41:03

#children #speak #late #early #treatment #important