Korean Medicine Treatment with Scalp Acupuncture for Diplopia and Lateropulsion in a Patient with Lateral Medullary Infarction: A Case Report

Yeong-Sang Kim; Hyeonjun Woo; Jin-Ah Oh; Su-Hyeon Jeong; Kim, Yeong-Sang; Woo, Hyeonjun; Oh, Jin-Ah; Jeong, Su-Hyeon

doi:10.13048/jkm.24050

JKM > Volume 45(3); 2024 > Article

Kim, Woo, Oh, and Jeong: Korean Medicine Treatment with Scalp Acupuncture for Diplopia and Lateropulsion in a Patient with Lateral Medullary Infarction: A Case Report

Case Report

The Journal of Korean Medicine 2024; 45(3): 211-223.

Published online: September 1, 2024

DOI: https://doi.org/10.13048/jkm.24050

Korean Medicine Treatment with Scalp Acupuncture for Diplopia and Lateropulsion in a Patient with Lateral Medullary Infarction: A Case Report

Yeong-Sang Kim¹

, Hyeonjun Woo¹

, Jin-Ah Oh²

, Su-Hyeon Jeong¹^{, *}

¹Department of Rehabilitation Medicine of Korean Medicine, Se-Myung University Chungju Korean Medicine Hospital

²Department of Sasang Constitutional Medicine, Se-Myung University Chungju Korean Medicine Hospital

Correspondence to: Su-Hyeon Jeong, Department of Rehabilitation Medicine of Korean Medicine, Se-Myung University Chungju Korean Medicine Hospital, 63 Sangbang 4-gil, Chungju-si, Chungcheongbuk-do 27429, Republic of Korea, Tel: +82-43-841-1737, E-mail: js365a@hanmail.net

Received July 15, 2024 Revised August 20, 2024 Accepted August 23, 2024

Abstract

Background

This case study aimed to report the efficacy of scalp acupuncture in a patient with diplopia or lateropulsion and lateral medullary infarction.

Case report

A 41-year-old woman with lateral medullary infarctions presented with symptoms of left-sided diplopia, left lateropulsion, headache, dizziness, and right-sided dysesthesia for 8 months. She received daily Korean medicine treatments, including scalp acupuncture. During the treatment period, various assessments were conducted, including the symptom score, visual analog scale (VAS), diplopia questionnaire (DQ), eyeball movement, dizziness handicap inventory (DHI), Korean version of the berg balance scale (K-BBS), activities-specific balance confidence scale (ABC), vestibular disorders activities of daily living scale (VADL), and the EuroQol five-dimension index (EQ-5D index). The patient’s symptom score, VAS, DQ, DHI, and VADL scores decreased, while K-BBS, ABC, and EQ-5D scores increased. Additionally, eyeball movements improved after Korean medicine treatment including scalp acupuncture.

Conclusions

The observed improvements suggest that Korean medicine treatment including scalp acupuncture can effectively alleviate diplopia and lateropulsion in patients with lateral medullary infarction.

Keywords: lateral medullary infarction, scalp acupuncture, diplopia, lateropulsion, Korean traditional medicine

Fig. 1

The patient’s brain magnetic resonance imaging apparent diffusion co-efficient (left) and diffusion weighted image (right).

Fig. 2

Picture of the patient who treated with scalp acupuncture. balance area, vision area (left), vertigo and hearing area (right).

Fig. 3

The change of diplopia questionnaire.

Fig. 4

Eyeball movement of patient on day of admission (October 4, 2023). (A) At rest. (B) The eyes open widely. (C) Frontal gaze. (D) Upward gaze. (E) Downward gaze. (F) Left lateral gaze. (G) Right lateral gaze.

Fig. 5

Eyeball movement of patient on day of two days before the discharge (December 6, 2023). (A) At rest. (B) The eyes open widely. (C) Frontal gaze. (D) Upward gaze. (E) Downward gaze. (F) Left lateral gaze. (G) Right lateral gaze.

Fig. 6

The change of eye movement ranges (At rest, The eyes open widely, Frontal gaze, Upward gaze, Downward gaze, Left lateral gaze, Right lateral gaze).

Fig. 7

The diplopia symptom score change before and after scalp acupuncture.

Fig. 8

The lateropulsion symptom score change before and after scalp acupuncture.

Table 1

The Composition of Herbal medicine

Name	Botanic name	Amount(g)	Name	Botanic name	Amount(g)
Cheonghunhwadam-tang
生薑	Zingiber officinale Roscoe	6	半夏	Pinellia ternata (Thunb.) Breitenbach	4
陳皮	Citrus unshiu Markovich	4	白茯苓	Poria cocos Wolf	4
枳實	Poncirus trifoliata Rafin.	2.8	白朮	Atractylodes japonica Koidz.	2.8
白芷	Angelica dahurica Bentham et Hooker	2	黃芩	Scutellaria baicalensis Georgi	2
羌活	Ostericum koreanum Maximowicz	2	川芎	Cnidium officinale Makino	2
人蔘	Panax ginseng C.A Mey	2	南星	Arisaema amurense Maximowicz	2
防風	Saposhnikovia divaricata Schischkin	2	細辛	Asarum sieboldi Miq.	1.2
黃連	C. chinensis Franch	1.2	甘草	Glycyrrhiza uralensis Fisch.	1.2

Table 2

The Changes of Evaluation method.

Day	10.04	10.11	10.18	10.26	11.02	11.09	11.15	11.23	11.30	12.07
Dizziness symptom score	7	3	0	0	0	0	0	2	0	0
Headache VAS	7	5.5	0	0	0	0	2	0	0	0
Dysaesthesia symptom score	7	6.5	5	3.5	3	3	5.5	2	1.5	1.5
DHI	21	16	12	2	4	0
K-BBS	43	53	53	54	55	56
VADL	51	43	37	31	32	32	31	32	31	31
ABC	1320	1440	1500	1500	1550	1550	1540	1530	1530	1530
EQ-5D index	0.738		0.805		0.871		0.862		0.871

VAS: visual analog scale, DHI: Dizziness Handicap Inventory, K-BBS: Korean version of Berg Balance Scale, VADL: Vestibular Disorders Activities of Daily Living Scale, ABC: Activities-specific Balance Confidence Scale, EQ-5D index: EuroQol five dimension index.

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