Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Epidemiology Study of Patients with Neuropathic Pain in Korea

한국의 신경병성 동통 환자에 대한 역학조사

  • Won, Jung-Yeon (Department of Oral Medicine, College of Dentistry and Medical Laser Research Center, Dankook University) ;
  • Kim, Ki-Suk (Department of Oral Medicine, College of Dentistry and Medical Laser Research Center, Dankook University)
  • 원정연 (단국대학교 치과대학 구강내과학 교실) ;
  • 김기석 (단국대학교 치과대학 구강내과학 교실)
  • Published : 2008.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

비록 신경병성 동통이 환자에게 주는 심리적 부담에 대하여 잘 알고 있지만 동통의 역학조사에 대해서는 아직 잘 알려져 있지 않다. 신경병성 동통의 정확한 발병률도 잘 알려져 있지 않은 데, 이는 여러가지 새로운 의료기기가 개발되었지만 정확한 진단을 하지 못하고 있으며, 적절한 치료를 제대로 하지 못하기 때문이다. 본 연구의 목적은 한국내 모든 종류의 병원에서 치료한 몇 가지 특정 신경병성 동통에 대하여 역학조사를 시행하는 것이다. 2003년 1월부터 2005년 12월까지 건강보험심사평가원(심평원)의 전산에 입력된 환자들을 대상으로 조사한 신경병성 동통 환자와 치료 받은 과 및 치료기간 등에 대하여 조사하였다. 신경병성 동통 환자의 수와 유병률을 살펴보면 삼차신경통 77,053명(27.6%), 비정형적 안면통 12,382명(4.4%), 설인후 신경통 1,319명(0.5%), 포진후 신경통 84,598명(30.3명), 당뇨병성 신경통 85,989명(30.8%), 비정형적 치통 16,001명(5.7%), 설통 2,133명(0.8%) 이며, 시간이 경과함에 따라 포진후 신경통과 당뇨병성 신경통은 증가하는 경향을 보이나, 그 외 신경통은 대부분 증가가 둔화되는 양상을 보였다. 대부분의 환자들은 57.6-72.8% 에 이르도록 1차 의료기관인 개인의원에서 치료받았으나 비정형적 치통의 경우에만 10.3% 정도로 1차 의료기관에서 진료받는 비율이 낮았다. 치과의원에 내원하는 환자의 비율은 삼차신경통 3.2%, 비정형적 치통 35.4%, 설통 15.4%이며 그 외 나머지 신경병성 동통은 대부분 의원에서 치료받았다.

Keywords

References

  1. Dworkin RH. An overview of neuropathic pain: syndromes, symptoms, signs, and several mechanisms. Clinical Journal of Pain 2002;18:343-349 https://doi.org/10.1097/00002508-200211000-00001
  2. Benett M(eds). Neuropathic pain. Oxford, 2006, Oxford University Press
  3. Burger A, Dukes EM, Oster G. Clinical characteristics and economic costs of patients with painful neuropathic disorders. Journal of Pain 2004;5:143-149 https://doi.org/10.1016/j.jpain.2003.12.004
  4. Torrance N, Smith BH, Bennett M, Lee AJ. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population study. Journal of Pain 2006;7:281-289 https://doi.org/10.1016/j.jpain.2005.11.008
  5. Hall GC, Carroll D, Parry D, McQuay HJ. Epidemiology and treatment of neuropathic pain: The UK primary care perspective. Pain 2006;122:156-162 https://doi.org/10.1016/j.pain.2006.01.030
  6. 한국 표준질병-사인분류(제3권 색인). 1판, 2003, 통계청: 대한 의무기록협회
  7. Backonja M, Beydoun A, Edwards K et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus. JAMA 1998;280:1831-1836 https://doi.org/10.1001/jama.280.21.1831
  8. Rosenstock J, Touchman M, LaMoreaux L, Sharma U. Pregabalin for the treatment of painful diabetic peripheral neuropathy: a double-blind, placebocontrolled trial. Pain 2004;110(3):628-638 https://doi.org/10.1016/j.pain.2004.05.001
  9. Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998;280:1837-1842 https://doi.org/10.1001/jama.280.21.1837
  10. Sabatowski R, Galvez R, Cherry DA et al. 1008-045 Study group. Pregabalin reduces pain and improves sleep and mood in patients with postherpetic neuralgia: results of a randomized, placebo-controlled clinical trial. Pain 2004;109(1-2):26-35 https://doi.org/10.1016/j.pain.2004.01.001
  11. Kitt C, Gruber K, Davis M, Woolf C, Levine J. Trigeminal neuralgia: opportunities for research and treatment. Pain 2000;231:343-351
  12. Numikko T, Eldridge P. Trigeminal neuralgia: pathophysiology, diagnosis and current treatment. Br J Anaesth 2001;87:117-132
  13. Katusic S, Williams D, Beard C, Bergstralh E, Kurland LT. Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984. Neuroepidemiology 1991;10:276-281 https://doi.org/10.1159/000110284
  14. Brown GR. Herpes zoster: correlation of age, sex, distribution, neuralgia, and associated disorder. South Med J 1976;69:576-578 https://doi.org/10.1097/00007611-197605000-00028
  15. Jensen TS, Krebs B, Nielsen J, Rasmussen P. Non-painful phantom limb phenomena in amputees: incidence, clinical characteristics and temporal course. Acta Neurol Scand 1984;70:407-414 https://doi.org/10.1111/j.1600-0447.1984.tb01228.x
  16. Boulton AJ, Knight G, Drury J, Ward JD. The prevalence of symptomatic, diabetic neuropathy in an insulin-treated population. Diabetes Care 1985;8:125-128 https://doi.org/10.2337/diacare.8.2.125
  17. Buchanan D, Mandel A. The prevalence of phantom limb experience in amputees. Rehabil Psychol 1986;31:183-188
  18. Chan A, MacFarlane IA, Bowsher D, Wells JC, Bessex C, Griffiths K. Chronic pain in patients with diabetes mellitus: comparison with a non-diabetic population. Pain Clinic 1990;3:147-159
  19. Naborro JD. Diabetes in the United Kingdom: a personal series. Diabet Med 1991;8:59-68 https://doi.org/10.1111/j.1464-5491.1991.tb01517.x
  20. O'Hare JA, Abuaisha F, Geoghegan M. Prevalence and forms of neuropathic morbidity in 800 diabetics. Ir J Med Sci 1994;163:132-135 https://doi.org/10.1007/BF02965972
  21. Kooijman CM, Dijkstra PU, Geertzen JH, Elzinga A, van der Schans CP. Phantom pain and phantom sensation in upper limb amputees: an epidemiological study. Pain 2000;87:33-41 https://doi.org/10.1016/S0304-3959(00)00264-5
  22. Cockerell OC, Goodridge DM, Brodie D, Sander JW, Shorvon SD. Neurological disease in a defined population: the results of a pilot study in two general practices. Neuroepidemiology 1996;15:73-82 https://doi.org/10.1159/000109892
  23. Hope-Simpson RE. Postherpetic neuralgia. J R Coll Gen Pract 1975;25:571-575
  24. MacDonald BK, Cockerell OC, Sander JW, Shorvon SD. The incidence and lifetime prevalence of neurological disorders in a prospective communitybased study in the UK. Brain 2000;123(Pt. 4):665-676 https://doi.org/10.1093/brain/123.4.665
  25. Brewis M, Poskanzer DC, Rolland C, Miller H. Neurological disease in an English city. Acta Neurol Scand 1966;42(Suppl.24):1-89
  26. Katusic S, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol 1990;27:89-95 https://doi.org/10.1002/ana.410270114
  27. Young MJ, Boulton AJ, MacLeod AF, Williams DR, Sonksen PH. A multicentre study of the prevalence of diabetes peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993;36:150-154 https://doi.org/10.1007/BF00400697