Rinsho Shinkeigaku
Online ISSN : 1882-0654
Print ISSN : 0009-918X
ISSN-L : 0009-918X
Volume 64, Issue 12
Displaying 1-12 of 12 articles from this issue
Committee Report
  • Yoko Mochizuki, Katsuhisa Ogata, Satoko Kumada, Tomihiro Imai, Chikako ...
    2024 Volume 64 Issue 12 Pages 861-865
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 16, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML

    The Japanese Society of Neurology’s Special Committee on Measures for Transition from Pediatric to Adult Health Care held a workshop to discuss the activities of the transitional care support centers (TCSCs). The following points were addressed: (1) from Kanagawa Prefecture, the activities of the TCSC, which is set up alongside the Intractable Disease Consultation Support Center and the Intractable Disease Information Coordination Center, separated from medical institutions, and the efforts addressing cases of difficult transitions and consultations where patients cannot transition from specific pediatric chronic diseases to designated intractable diseases; (2) from Nagano Prefecture, the supporting the health care transition undertaken by the neurologist as intractable disease medical coordinator, and (3) the efforts of the transitional health care support coordinator at the TCSC established at the university hospital in collaboration with the Nagano Children’s Hospital and the government. For the creation of a seamless support system, we hope that the pioneering activities reported at this time will spread nationwide.

Original Articles
  • Yoshinori Sunaga, Tatsuro Sakashita, Tadashi Koga, Takayuki Sawada, Sh ...
    2024 Volume 64 Issue 12 Pages 866-877
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 21, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML
    Supplementary material

    We conducted an additional analysis using the data from the post-marketing surveillance of Alglucosidase alfa for Pompe disease. We aimed to investigate the changes in the percentage of predicted forced vital capacity (%FVC) and the changes in the distance of the 6-min walk test (6MWT) by overall improvement and to investigate the %FVC change by the duration from symptom onset to survey registration (shorter/longer groups) using a linear mixed model. Thirty-seven and eighteen survey participants had %FVC and 6MWT data available, respectively; of the patients whose overall improvement was rated as “relatively improved,” %FVC and 6MWT worsened in 71.4% and 66.7%, respectively. The %FVC at the survey registration estimated using a linear mixed model was significantly higher in the shorter group than in the longer group (P = 0.0413). The estimated slope of %FVC was significantly lower in the shorter group than in the longer group (P = 0.0051). These results suggest the importance of early treatment initiation and quantitative evaluation of each symptom.

Case Reports
  • Yukito Ueda, Ko Matsuo, Kana Matsuda, Ryo Momosaki, Akihiro Shindo, Hi ...
    2024 Volume 64 Issue 12 Pages 878-883
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 16, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML

    A patient with behavioral variant frontotemporal dementia presented with stereotypic speech. The 85-year-old right-handed man had progressive language disorder over 2 years, with changes in eating behavior. His verbal output consisted mainly of the stereotypic speech; his articulation was mildly distorted, but his speech was intelligible. Spontaneous speech was rare, but there was no evidence of difficulty in initiating speech or effort. MRI of the head showed atrophy of the left frontal lobe, mainly in the superior, middle, and inferior frontal gyrus. Cerebral blood flow SPECT showed decreased cerebral blood flow in the same areas and in the left basal ganglia. We diagnosed behavioral variant frontotemporal dementia based on the symptoms, progression, and lesions. The stereotypic speech was judged to be non-meaningful recurrent utterance.

  • Junichi Uemura, Saki Miyazato, Shinji Yamashita, Yoshiki Yagita, Takes ...
    2024 Volume 64 Issue 12 Pages 884-889
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 16, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML

    Posterior spinal artery (PSA) infarctions are rare and challenging to diagnose in the acute phase. Herein, we report two cases of PSA infarctions diagnosed using spinal diffusion-weighted imaging-MRI (DWI-MRI). Case 1 involved a 74-year-old male patient presenting to our hospital with right leg numbness and unsteadiness while walking. Neurological examination revealed muscle weakness in the right lower limb and decreased vibration sensation in the dermadrome below the right Th8 level. Spinal DWI-MRI showed a high-intensity signal in the posterior right Th8, leading to the diagnosis of thoracic spinal cord infarction in the PSA region. In Case 2, a 70-year-old woman visited our hospital complaining of numbness of the left hand. Neurological examination revealed left-sided paresthesia exhibiting a positive Romberg’s sign. Spinal DWI-MRI showed a high-intensity signal in the right C2 level posterior region, confirming the diagnosis of cervical spinal cord infarction in the PSA region. A neurological examination for PSA infarction and highlights the usefulness of a spinal cord DWI for auxiliary diagnosis.

  • Takuma Kato, Keisuke Imai, Takehiro Yamada, Masanori Cho, Toshi Sai, T ...
    2024 Volume 64 Issue 12 Pages 890-897
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 21, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML

    We present a case of a 53-year-old man who was admitted with lower back pain and bilateral lower limb weakness. Neurologically, he exhibited paralysis of both lower limbs, complete sensory loss below the 10th thoracic spinal level, and bladder and rectal dysfunction. Spinal MRI revealed intramedullary high-signal lesions extending from the 10th vertebral level to the conus medullaris on diffusion-weighted and T2-weighted images. By the 10th day, the extensive intramedullary lesion had progressed to the 2nd vertebral level. Although aortic angiography on the 3rd day showed no vascular abnormalities, concurrent infarction of the paraspinal muscles at the 2nd lumbar vertebral level was confirmed. Based on the spinal vascular anatomy, it was deduced that both the spinal cord and the paraspinal muscle lesions had the same vascular etiology. Therefore, the spinal cord lesion was diagnosed early as spinal cord infarction. In cases of acute spinal symptoms, the coexistence of paraspinal muscle infarction observed on contrast-enhanced CT can assist in diagnosing spinal cord infarction.

Brief Clinical Notes
  • Yuki Nakamura, Rintaro Yokoyama, Seiichiro Imataka, Takehiro Saga, Koi ...
    2024 Volume 64 Issue 12 Pages 898-900
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 16, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML
    Supplementary material

    We retrospectively investigated mechanical thrombectomy (MT) in nonagenarians and older with cerebral infarction. Analysis of 21 consecutive patients showed favorable outcomes (improved modified Rankin scale [mRS] 0–2 or returned prestroke mRS) in 33.3% and poor outcome (mRS 5 or 6) in 52.4%. Factors related to favorable outcomes remain unknown, but the overall results of MT were good. MT is effective for the treatment of very elderly patients and further research is required to predict prognosis.

  • Ichiro Naoi, Hiroshi Aino
    2024 Volume 64 Issue 12 Pages 901-903
    Published: 2024
    Released on J-STAGE: December 21, 2024
    Advance online publication: November 21, 2024
    JOURNAL OPEN ACCESS FULL-TEXT HTML
    Supplementary material

    This study aims to quantify the economic burden of Parkinson’s disease (PD) in Japan. We conducted a targeted literature review and extracted data on the direct medical costs and long-term care costs of PD patients based on their severity, as categorized by the Hoehn and Yahr (HY) disease severity scale. These costs were estimated using information from literature sources and governmental statistics. The mean annual long-term care costs for HY1 to 5 were estimated: JPY 333 433, 527 194, 982 578, 2 023 735, and 3 080 743, respectively. These estimates were based on a cross table of HY severity and designated grade of long-term care, which was extracted from a survey of PD patients in Tokyo conducted in 2017 and national statistics on long-term care expenditure per person in June 2023. Assuming that the number of PD patients in Japan is 200,000, the annual costs for direct medical, long-term care, and the total are estimated approximately JPY 380, 270, and 650 billion, respectively. These results suggest that PD requires a significant amount of long-term care resources.

Letters to the Editor
Reply from the Author
Proceedings of the Regional Meeting
Notice
Editor’s Note
feedback
Top