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

Article information

J Korean Med. 2024;45(3):211-223

Publication date (electronic) : 2024 September 1

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

Yeong-Sang Kim ¹

, Hyeonjun Woo ¹

, Jin-Ah Oh ²

, Su-Hyeon Jeong ¹^,

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 2024 July 15; Revised 2024 August 20; Accepted 2024 August 23.

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

Table 2

The Changes of Evaluation method.

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