• 제목/요약/키워드: 신경병증성 통증

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CRPS Type-I Patient Treated with Acupuncture and Bee-venom Acupuncture: A Case Report (침과 봉독약침으로 치료한 CRPS 제1형 환자 1례)

  • Ko, Jeong-Min;Kim, Jong-In;Lee, Jae-Dong;Nam, Sang-Su;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.165-170
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    • 2009
  • 목적 : 복합부위 통증증후군은 사고나 외상 이후 한 쪽 사지에서 시작되는 신경병증성 통증이다. 그 기전은 명확히 밝혀지지 않아 추천되는 치료도 아직 없는 실정이다. 이에 한의학적인 치료 방법을 적용하여 그 효과를 보고자 하였다. 방법 : 전통 한의학에서 이 환자의 상태는 통비로 볼 수 있다. 양쪽 무릎과 왼쪽 발의 통증을 호소하는 26세 남자 환자가 3년 전 복합부위 통증증후군 제1형으로 진단 받은 후 봉독약침, 침, 뜸으로 4주 동안 주 2회씩 치료를 받았다. 치료 효과는 DITI, VAS를 통해 평가하였다. 결과 : DITI, VAS를 통하여 환자의 통증에 호전이 있었다. 결론 : 침, 봉독, 뜸을 이용하여 복합부위 통증증후군 환자 1명을 치료한 결과 효과가 있는 것으로 나타났다.

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Effects of Exercise on Affected and Unaffected Hindlimb Muscles in Rats with Neuropathic Pain Induced by Unilateral Peripheral Nerve Injury (운동이 일측성 말초신경 손상에 의해 유발된 신경병증성 통증 쥐의 환측과 정상측 뒷다리근에 미치는 영향)

  • Choe, Myoung-Ae;An, Gyeong-Ju
    • Journal of Korean Academy of Nursing
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    • v.40 no.5
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    • pp.611-619
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    • 2010
  • The purpose of this study was to examine the effects of exercise on muscle weight and Type I and II fiber cross-sectional area of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The Pain+Exercise (PE) group (n=21) and the Sham+Exercise (SE) group (n=20). All rats had 28 sessions of treadmill exercise at grade 10 for 30 minutes, twice/day at 10 m/min for 14 days. Body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected. Muscle weight and Type I, II fiber cross-sectional area of the dissected muscles were measured. Results: The PE group showed significant increases (p<.05), as compared to the SE group for body weight and total diet intake, muscle weight of the unaffected soleus and plantaris, and in Type I and II fiber cross-sectional area of unaffected three muscles and affected plantaris. Conclusion: Exercise for 14 days attenuates unaffected soleus, plantaris and gastrocnemius muscle atrophy in neuropathic pain model.

Experience with Gabapentin for Neuropathic Pain -Case report- (신경병증성 통증 환자에서 Gabapentin 사용의 임상경험 -증례 보고-)

  • Lim, Kyung-Joon;Chung, Yong-Hun;Cho, Nam-Su
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.242-245
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    • 1999
  • Gabapentin is an oral antiepileptic agent with an unknown mechanism of action. There have been many proposed uses for gabapentin, including neuropathic pain, reflex sympathetic dystrophy, postherpetic neuralgia, midscapular pain secondary to radiation myelopathy and migraine prophylaxis. This report presents patients who were treated with gabapentin when other pharmacologic interventions failed to relieve neuropathic pain 3 patients with neuropathic pain were included among these cases. All patients were started on 200 mg gabapentin. The maximum dose required for pain relief was between 800 mg and 2400 mg. Gabapentin may be a useful adjunct for treating neuropathic pain with minimum of side effects.

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Efficacy of Gabapentin Monotherapy on the Neuropathic Pain -Case report- (신경병증성 통증환자에서 Gabapentin 단일 요법의 효과 -증례 보고-)

  • Kim, Woo-Sun;Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.101-104
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    • 2000
  • Since conventional analgesics have showed limited therapertic value in the treatment of painful neuropathy, the new anticonvulsant gabapentin, has been tried and turned out to be effective and safe in the treatment for various forms of neuropathic pain. The basic pathophysiology of neuropathic pains is abnormal neuronal hyperactivity similar to epileptic seizures. Therefore, we could expect that neuropathic pain would be suppressed by anticonvulsants which inhibit abnormal excessive neuronal output and nerve conduction. This report include effective pain relief in four cases of neuropathic pain with gabapentin without any significant complications.

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Neuropathic Pain Management with NMDA Receptor Antagonist (Ketamine) in Pain Clinic -A case report- (NMDA 수용체의 길항제인 Ketamine를 이용한 신경병증성 통증 치료)

  • Ahn, Mi-Jung;Kim, Hae-Ja;Lee, Won-Hyung;Shin, Yong-Sup;Lee, Jung-Un
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.294-298
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    • 1998
  • The feature of neuropathic pain may occur in the absence of any apparent stimulus and be exaggerated in either amplitude or duration. Peripheral nerve injury may produce neuropathic pain and opioids have been shown to be relatively unsatisfactory for the treatment of most cases of neuropathic pain. The NMDA receptor system is involved in transmission and modulation of nociceptive information. We treated patients with severe pain, hyperaesthesia and allodynia with epidural injection of NMDA receptor antagonist, ketamine (10 mg) and morphine (0.5 mg) or other opioid. The combinations provided effective pain management in 23 patients with neuropathic pain.

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Experience with Spinal Cord Stimulation for Treating Intractable Penile Pain after Partial Neurectomy of the Dorsal Penile Nerve (음부배부신경절제술 후 발생한 만성 음경부 신경병증성 통증 환자에서의 척수신경자극술의 치료 효과 경험)

  • Kim, Na Hyun;Han, Kyung Ream;Park, Kyung Eun;Kim, Nan Seol;Kim, Chan;Kim, Sae Young
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.107-111
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    • 2009
  • Neuroablation should be performed cautiously because neuropathic pain can occur following denervation of a somatic nerve. A 34-year-old man presented with severe penile pain and allodynia following a selective neurectomy of the sensory nerve that innervated the glans penis for treatment of his premature ejaculation. He was treated with various nerve blocks, including continuous epidural infusion, lumbar sympathetic block and sacral selective transforaminal epidural blocks, as well as intravenous ketamine therapy. However, all of the treatments had little effect on the relief of his pain. We performed spinal cord stimulation as the next therapy. After this therapy, the patient has currently been satisfied for 3 months.

Effects of Nitric Oxide Synthase Inhibitor on Hindlimb Muscles in Rats with Neuropathic Pain Induced by Unilateral Peripheral Nerve Injury (산화질소 합성효소 억제제가 일측성 말초신경 손상에 의해 유발된 신경병증성 통증 쥐의 뒷다리근에 미치는 영향)

  • Choe, Myoung-Ae;An, Gyeong-Ju
    • Journal of Korean Academy of Nursing
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    • v.41 no.4
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    • pp.520-527
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    • 2011
  • Purpose: The purpose of this study was to examine effects of nitric oxide synthase (NOS) inhibitor on muscle weight and myofibrillar protein content of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The NOSI group (n=19) had NOS inhibitor (L-NAME) injections daily for 14 days, and the Vehicle group (n=20) had vehicle injections daily for 14 days. Withdrawal threshold, body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected from hindlimbs. Muscle weight and myofibrillar protein content of the dissected muscles were determined. Results: The NOSI group showed significant increases as compared to the Vehicle group for body weight at 15 days, muscle weight and myofibrillar protein content of the unaffected soleus and gastrocnemius. The NOSI group demonstrated a higher pain threshold than the vehicle group. Conclusion: NOSI for 14 days attenuates unaffected soleus and gastrocnemius muscle atrophy in neuropathic pain model.

Nonodontogenic Toothache : Case Reports (비치성 치통의 치험 증례)

  • Yoon, Seung-Hyun;Choi, Jong-Hoon;Kim, Seong-Taek;Ahn, Hyung-Joon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.401-407
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    • 2008
  • The most common type of orofacial pain is toothache. However, many other types of pain which derived from nonodontogenic problems can mimic toothache. Nonodontogenic toothache is heterotopic pain that the site of pain is not in the same location of the source of pain. This differs from primary pain, in which the site of pain is the actual site which the pain originates. Heterotopic pain can be alleviated by direct treatment toward the source of pain. The common sources of nonodontogenic toothache include neuropathic pain, sinus pain, Myofascial pain, neurovascular pain and even cardiac pain and psychogenic pain. Thus, clinicians should have a thorough knowledge about causes of nonodontogenic toothache, and through pain history and examination of dental and nondental structures are needed. This case report is about some cases of nonodontogenic toothache, and it also emphasizes essential considerations for proper differential diagnosis and appropriate treatment.

Curcumin Attenuates Chronic Constriction Nerve Injury-Induced Neuropathic Pain in Rats (Curcumin의 신경병증성 통증 억제효과)

  • Kim, Chae-Eun;Park, Eun-Sung;Jeon, Young-Hoon
    • Korean Journal of Medicinal Crop Science
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    • v.16 no.3
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    • pp.183-187
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    • 2008
  • Nerve injury can lead to neuropathic pain, which is often resistant to current analgesics and interventional therapeutic methods. Extracellular signal-regulated kinase (ERK) plays important role in the induction of neuropathic pain. We explored the antinociceptive effect of curcumin and its effect on ERK in the spinal cord in the neuropathic pain model of rats induced by chronic constriction injury (CCI) of the sciatic nerve. In injured rats, mechanical allodynia, which is one of characteristics of neuropathic pain developed and the activation of ERK in spinal cord significantly increased compared with control group. However, administration of curcumin (50 mg/kg/day p.o) for 7 days started from one day before the injury prevented the development of mechanical allodynia and increase of ERK phosphorylation. These results indicate that curcumin can be a new therapeutic agent in the treatment of neuropathic pain.

The Combined Antiallodynic Effect of Gabapentin and Milnacipran in a Rat Neuropathic Pain Model (흰 쥐의 신경병증성 통증 모델에서 Gabapentin과 Milnacipran의 병용 효과)

  • Lee, Hyeon Jeong;Shin, Sang-Wook;Jang, Hee Jeong
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.8-14
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    • 2007
  • Background: Anticonvulsants and antidepressants are adjuvant analgesic drugs that are used widely for treating chronic neuropathic pain syndromes. The combined analgesic effect of gabapentin and milnacipran was investigated with a rat neuropathic pain model. Methods: The rat neuropathic pain model was made by ligating the spinal nerves (L5 and L6). An intrathecal catheter was inserted into the subarachnoid space. Tactile allodynia was tested with the up-down method using von Frey hair. We determined the antiallodynic effect of intraperitoneal (I.P.) and intrathecal (I.T.) gabapentin. The combined effect of I.P. gabapentin (50 mg/kg) and milnacipran (0, 10 and 30 mg/kg) was investigated. Results: Intraperitoneal and intrathecal administration of gabapentin increased the threshold for tactile allodynia (the ED50 was 60.6 mg/kg and $45.5{\mu}g$, respectively). Co-administration of I.P. milnacipran increased the antiallodynic effect of I.P. gabapentin in a dose-dependent fashion. Conclusion: The combined administration of milnacipran and gabapentin may increase the total analgesic effect during treatment of neuropathic pain.