The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
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A Case Report of Occipital Neuralgia Treated with Acupuncture in the Occipital Nerve Area

후두신경 영역 침치료로 호전된 후두신경통 증례 1례

  • Min-hwa Kim (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • I-rang Nam (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Mariah Kim (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Ki-beom Ku (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Se-yeon Lee (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Jung-nam Kwon (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • In Lee (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Jun-yong Choi (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Young-ju Yun (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • So-yeon Kim (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Chang-woo Han (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • So-jung Park (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University) ;
  • Jin-woo Hong (Dept. of Internal Medicine, Korean Medicine Hospital, Pusan National University)
  • 김민화 (부산대학교 한방병원 한방내과) ;
  • 남이랑 (부산대학교 한방병원 한방내과) ;
  • 김마리아 (부산대학교 한방병원 한방내과) ;
  • 구기범 (부산대학교 한방병원 한방내과) ;
  • 이세연 (부산대학교 한방병원 한방내과) ;
  • 권정남 (부산대학교 한방병원 한방내과) ;
  • 이인 (부산대학교 한방병원 한방내과) ;
  • 최준용 (부산대학교 한방병원 한방내과) ;
  • 윤영주 (부산대학교 한방병원 한방내과) ;
  • 김소연 (부산대학교 한방병원 한방내과) ;
  • 한창우 (부산대학교 한방병원 한방내과) ;
  • 박소정 (부산대학교 한방병원 한방내과) ;
  • 홍진우 (부산대학교 한방병원 한방내과)
  • Received : 2023.11.07
  • Accepted : 2023.12.22
  • Published : 2023.12.30
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Abstract

This case report presents the effectiveness of Korean medicine in the treatment of occipital neuralgia. The patient with occipital neuralgia was treated with acupuncture. Acupuncture treatment was administered to the occipital nerve area, which is commonly used in occipital nerve blocks by western medicine doctors. The severity of the symptoms was assessed daily using the Numerical Rating Scale (NRS) score of pain. The patient received outpatient treatment a total of 7 times, and only received acupuncture treatment each time. According to the patient, his symptoms decreased by about 90% two days after acupuncture treatment, and the frequency and duration of the symptoms also decreased. Seven days after all acupuncture treatments, the severity of pain was reduced from NRS 6 to NRS 0. The findings of this case report suggest that treatment with Korean medicine can be an effective option for treating occipital neuralgia. Acupuncture can be a good treatment method for occipital neuralgia, along with western drug treatment and occipital nerve block.

Keywords

Acknowledgement

본 연구는 2022년도 부산대학교병원 임상연구비 지원으로 이루어졌음.

References

  1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1-211.  https://doi.org/10.1177/0333102417738202
  2. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache classification committee of the international headache society. Cephalalgia 1988;8 Suppl 7:1-96.  https://doi.org/10.1046/j.1468-2982.1988.0801001.x
  3. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;24 Suppl 1:9-160.  https://doi.org/10.1111/j.1468-2982.2003.00824.x
  4. Derek M, Kevin B. Occipital Neuralgia. Treasure Island: Statpearls; 2020. 
  5. Gazelka HM, Knievel S, Mauck WD, Moeschler SM, Pingree MJ, Rho RH, et al. Incidence of neuropathic pain after radiofrequency denervation of the third occipital nerve. Journal of Pain Research 2014;7:195-8.  https://doi.org/10.2147/JPR.S60925
  6. Son BC. Diagnosis and treatment of occipital neuralgia: focus on greater occipital nerve entrapment syndrome. J Korean Med Assoc 2023;66(1):31-40.  https://doi.org/10.5124/jkma.2023.66.1.31
  7. Pan W, Peng J, Elmofty D. Occipital Neuralgia. Curr Pain Headache Rep 2021;25(9):61. 
  8. Urits I, Schwartz RH, Patel P, Zeien J, Connor D, Hasoon J, et al. A review of the recent findings in minimally invasive treatment options for the management of occipital neuralgia. Neurol Ther 2020;9(2):229-41.  https://doi.org/10.1007/s40120-020-00197-1
  9. Juskys R, Sustickas G. Effectiveness of treatment of occipital neuralgia using the nerve block technique: a prospective analysis of 44 patients. Acta Med Litu 2018;25(2):53-60.  https://doi.org/10.6001/actamedica.v25i2.3757
  10. Natsis K, Baraliakos X, Appell HJ, et al. The course of the greater occipital nerve in the suboccipital region: a proposal for setting landmarks for local anesthesia in patients with occipital neuralgia. Clin Anat 2006;19(4):332-6.  https://doi.org/10.1002/ca.20190
  11. Tubbs RS, Salter EG, Wellons JC, Blount JP, Oakes WJ. Landmarks for the identification of the cutaneous nerves of the occiput and nuchal regions. Clin Anat 2007;20(3):235-8.  https://doi.org/10.1002/ca.20297
  12. Baron EM. Spinal cord and spinal nerves: gross anatomy. Elsevier 2016;462-773. 
  13. Cesmebasi A, Muhleman MA, Hulsberg P, Gielecki J, Matusz P, Tubbs RS, et al. Occipital neuralgia: anatomic considerations. Clin Anat 2015;28(1):101-8.  https://doi.org/10.1002/ca.22468
  14. Wetzel B, Pavlovic D, Kuse R, Gibb A. The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: a randomized controlled trial. Clin J pain 2011;27(3):262-7.  https://doi.org/10.1097/AJP.0b013e3181fd516c
  15. Dimond E. acupuncture anesthesia. JAMA 1971;218(10):1558-63.  https://doi.org/10.1001/jama.218.10.1558
  16. Ntritsou V, Mavrommatis C, Kostoglou C, Dimitriadis G, Tziris N, Zagka P, et al. Effect of Perioperative Electroacupuncture as An Adjunctive Therapy on Postoperative Analgesia with Tramadol and Ketamine in Prostatectomy: A Randomised Sham-Controlled Single-Blind Trial. Acupunct Med 2014;32(3):215-22.  https://doi.org/10.1136/acupmed-2013-010498
  17. Grube T, Uhlemann C, Weiss T, Meissner W, Influence of acupuncture on postoperative pain, nausea and vomiting after visceral surgery. Schmerz 2009;23(4):370-6.  https://doi.org/10.1007/s00482-009-0798-1
  18. Lee SH, Lee SO, Kwon GO, Kim IB, Kim DH, Cho SW, et al. studies on electroacupunture anesthesia of experimental animal. Korean J Vet Clin Med 1999;16(2):417-21. 
  19. World Health Organization Western Pacific Regional Office. WHO standard acupuncture point locations in the Western Pacific Region. Geneva: World Health Organization. 2008. 
  20. Cheng RS, Pomeranz BH. Electroacupuncture analgesia is mediated by stereospecific opiate receptors and is reversed by antagonists of type I receptors. Life Sci 1980;26(8):631-8.  https://doi.org/10.1016/0024-3205(80)90239-8
  21. Wang JL, Xie WX, Zhang Q. Effects of combined transdermal acupoint electric stimulation and isoflurane anesthesia on isoflurane-induced hypotension and tissue oxygen metabolism in patients undergoing craniotomy. Zhongguo Zhong Xi Yi Jie He Za Zhi 2001;21(3):180-2. 
  22. Han JS. Acupuncture and endorphins. Neurosci Lett 2004;361(1-3):258-61.  https://doi.org/10.1016/j.neulet.2003.12.019
  23. Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci 2003;26(1):17-22.  https://doi.org/10.1016/S0166-2236(02)00006-1
  24. Zhang R, Lao L, Ren K, Berman BM. Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology 2014;120(2):482-503.  https://doi.org/10.1097/ALN.0000000000000101
  25. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;85(4):355-75.  https://doi.org/10.1016/j.pneurobio.2008.05.004
  26. Zhang LX, Li XL, Wang L, Han JS. Rats with decreased brain cholecystokinin levels show increased responsiveness to peripheral electrical stimulation-induced analgesia. Brain Res 1997;745(1-2):158-64.  https://doi.org/10.1016/S0006-8993(96)01095-5
  27. Lee SY, Ryu YH, Lee IS, Chae YB. Understanding the Meaning and Features of Ashi Points. Korean Journal of Acupuncture 2022;39(3):84-90.  https://doi.org/10.14406/acu.2022.014
  28. Asmussen S, Maybauer DM, Chen JD, Fraser JF, Toon MH, Przkora R, et al. Effects of Acupuncture in Anesthesia for Craniotomy: A Meta-Analysis. Journal of Neurosurgical Anesthesiology 2017;29(3):219-27.  https://doi.org/10.1097/ANA.0000000000000290
  29. Zhou J, Chi H, Cheng T, Chen T, Wu Y, Zhou W, et al. Acupuncture anesthesia for open heart surgery in contemporary China. International Journal of Cardiology 2011;150(1):12-6.  https://doi.org/10.1016/j.ijcard.2011.04.002
  30. Taguchi R. Acupuncture anesthesia and analgesia for clinical acute pain in Japan. Evidence-Based Complementary and Alternative 2008;5(2):153-8.  https://doi.org/10.1093/ecam/nem056
  31. Lambru G, Lagrata S, Matharu MS. Cutaneous atrophy and alopecia after greater occipital nerve injection using triamcinolone. Headache 2012;52(10):1596-9.  https://doi.org/10.1111/j.1526-4610.2012.02270.x
  32. Beardwell A. Subcutaneous atrophy after local corticosteroid injection. Br Med J 1967;3:600. 
  33. Jacobs MB. Local subcutaneous atrophy after corticosteroid injection. Postgrad Med 1986;80(4):159-60.  https://doi.org/10.1080/00325481.1986.11699543
  34. Choi YJ, Yoo DS, Park MH, Lee SH, Park JG. Alopecia After Occipital Nerve Blockade. J Korean Neurol Assoc 2013;31(3):186-8.