Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9691-9698
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9691
Traditional Chinese medicine for gait disturbance in adrenoleukodystrophy: A case report and review of literature
Hyungsuk Kim, Taeoh Kim, Whisung Cho, Hokyung Chang, Won-Seok Chung
Hyungsuk Kim, Taeoh Kim, Whisung Cho, Hokyung Chang, Won-Seok Chung, Department of Korean Medicine Rehabilitation, Kyung Hee University, Seoul 02447, South Korea
Author contributions: Kim H, and Kim T contributed equally to this study; Kim H was responsible for the conceptualization, formal analysis, methodology, project management, supervision, verification, visualization, and review and editing of the manuscript; Kim T was responsible for the conceptualization, data management, formal analysis, investigation, verification and writing of the manuscript; Cho W is responsible for data management, investigation, project management, and visualization; Chang H is responsible for data management, resources, and software; Chung WS was responsible for the conceptualization, formal analysis, fund acquisition, methodology, project management, software, supervision, and review and editing of the manuscript.
Supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) (funded by the Ministry of Health & Welfare of the Republic of Korea), No. HI20C1405.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors of this work have nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Won-Seok Chung, PhD, Professor, Department of Korean Medicine Rehabilitation, Kyung Hee University, Kyungheedae-ro 23, Dongdaemun-gu, Seoul 02447, South Korea. omdluke@naver.com
Received: July 6, 2021
Peer-review started: July 6, 2021
First decision: July 26, 2021
Revised: August 2, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: November 6, 2021
Processing time: 115 Days and 5.5 Hours
Abstract
BACKGROUND

Adrenoleukodystrophy (ALD) is caused by a deficit in the ABCD1 gene, which leads to demyelination of neurons and dysfunction of the adrenal cortices and testicles. Of the three known phenotypes, 30%-50% of male ALD patients present with the adrenomyeloneuropathy phenotype, characterized by gait disturbance as the initial symptom.

CASE SUMMARY

A 46-year-old man with a prior diagnosis of ALD was admitted to a Korean medicine hospital for the treatment of gait disturbance. His ability to walk was severely impaired at admission, significantly affecting the patient’s quality of life. He was treated with acupuncture, pharmacopuncture, electroacupuncture, and herbal medicine for 23 d. The 25-Foot Walk test (25FW), timed up and go (TUG), comfortable gait speed (CGS), numeric rating scale (NRS), Berg Balance Scale (BBS), Tinetti test, manual muscle test (MMT), and 3-level version of EuroQol-5 dimension (EQ-5D-3L) were used to evaluate the patient. The outcomes of the 25FW, TUG, and CGS improved during hospitalization. From the time of admission to discharge we observed: A decrease in NRS scores in the lower extremities and the lower back; an increase of 3 points in the BBS; a 1-point increase in the balancing part of the Tinetti Test; MMT and EQ-5D-3L performances remained unchanged.

CONCLUSION

Traditional Chinese medicine treatments could be a therapeutic option to alleviate issues related to gait disturbance in ALD.

Keywords: Traditional Chinese medicine; Herbal medicine; Gait disturbance; Adrenoleukodystrophy; Adenosine triphosphate; Case report

Core Tip: A 46-year-old male patient with adrenoleukodystrophy (ALD) associated with gait disturbance was treated with acupuncture, pharmacoacupuncture, electroacupuncture, and herbal medicine with conventional medicine. Interventions improved gait speed, balance, and pain. Traditional Chinese medicine is a promising form of treatment for gait disturbance in ALD.