• Title/Summary/Keyword: 신경병증

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Treatment of Diabetic Charcot Arthropathy (당뇨병성 샤콧 관절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.243-250
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    • 2013
  • Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

Peripheral Neuropathy in a Patient with Churg-Strauss Syndrome - A case report - (Churg-Strauss 증후군에 의한 말초신경병증의 치료경험 - 증례보고 -)

  • Lee, Jun Hwa;Lee, Jeong Hyun;Go, Young Kwon;Lee, Won Hyung
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.208-212
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    • 2007
  • Although Churg-Strauss syndrome (CSS) is a rare disease that is generally associated with vasculitis, nerve involvement is also common in cases of CSS. A 48-year old man was diagnosed with a herniated disc at L4-5 and an annular tear at L5-S1 after complaining of pain and numbness in the left lower leg. Peripheral edema was observed during physical examination and the patient was diagnosed with CSS after a biopsy was conducted. In addition, electromyography and nerve conduction velocity revealed the presence of multiplex mononeuropathy, which indicated the pain and numbness was due to peripheral neuropathy caused by CSS. The symptoms were relieved after oral administration of prednisolone. This case indicates that when symptoms of peripheral neuropathy do not match the radiographic evidence other causes, such as CSS, must be considered.

Review of Experimental Researches on Bee Venom Pharmacopuncture Therapy for Chemotherapy-induced Peripheral Neuropathy (항암화학요법 유발 말초신경병증에 대한 봉독 약침 요법의 효과 및 기전에 대한 실험연구 고찰)

  • Kwon, Bo In;Woo, Yeonju;Kim, Joo-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.1
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    • pp.1-7
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    • 2021
  • Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common dose-limiting side effects of neurotoxic chemotherapeutic agents that lead to decreased quality of life and dose reduction, delay or even cessation of treatment. The purpose of this systematic review is to evaluate the effect and the underlying mechanisms of bee venom (BV) pharmacopuncture therapy for CIPN in animal models. We searched for the available experimental literature using BV for CIPN through the Pubmed databases. Ten experimental studies were finally included in this review. In the oxaliplatin or paclitaxel-induced CIPN animal model, BV significantly relieved pain caused both mechanical and cold stimulation. It was suggested that the effect of BV is mediated by the stimulation effect of spinal α1- and α2-adrenergic receptors as a potential mechanism. In the future, more experimental studies are needed.

Effects of Cervical traction and Muscle Energy Technique on Pain, Neck Disability Index, Function, Range of Motion in Patients with Cervical Radiculopathy (목 견인과 근 에너지 기법이 목 신경뿌리병증 환자의 통증, 목 기능장애지수, 관절가동범위에 미치는 영향)

  • Hong, Jin-gi;Kim, Young-min
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.3
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    • pp.57-67
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    • 2021
  • Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy in patients with cervical radiculopathy. Methods: Patients were randomly divided into two groups muscle energy technique (8 subjects) and cervical traction (8 subjects). Each group performed their exercise 70 minutes per day, three times week for four weeks. Pain intensity was measured with a visual analogue scale (VAS). Function was measured with the neck disability index (NDI). Cervical range of motion (ROM) was measured with a cervical range of motion (CROM) goniometer. Results: After four weeks of therapy, VAS (p<.05) and NDI (p<.05) significantly decreased, and ROM significantly increased in both groups (p<.05). There were also significant differences between the two groups for these three measures (p<.05). Conclusion: The muscle energy technique and cervical traction are more effective than cervical traction alone in reducing VAS and NDI and increasing ROM in patients with cervical radiculopathy.

Korean Medicine Treatments with Joripewon-tang for Chemotherapy-Induced Peripheral Neuropathy of Ovarian Cancer : Case Report (난소암의 항암화학요법 유발 만성 말초신경병증의 조리폐원탕 및 복합한의치료 치험 1례)

  • Ji-yoon, Yeum;Su-hyun, Kim;Seung-yun, Oh;Soo-jung, Park
    • Journal of Korean Traditional Oncology
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    • v.27 no.1
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    • pp.49-56
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    • 2022
  • Objective: This case report represented that Korean traditional medicine therapies can make effective results for chemotherapy-induced peripheral neuropathy(CIPN) patients. Methods: A 63-year-old female patient has been diagnosed with ovarian cancer(Sertoli-Leydig cell tumor). Total excision of uterus and appendages was operated, and Bleomycin, etoposide and cisplatin combination therapy was applied. After three cycles of chemotherapy, the severe side effects of neutropenia and CIPN occurred. Chemotherapy was terminated, but numbness and tingling pains in the limbs persisted for several months. We provided Korean medicine treatments including herbal medicine, pharmacopuncture, acupuncture, moxibustion and physiotherapies. Results: After treatments, the numbness and pain were reduced from 10 to 1 in hand and 6 to 0 on the numeric rating scale(NRS). Functional assessment of cancer therapy/Gynecologic oncology group neurotoxicity (FACT/GOG-NTX) score was improved from 58 to 97. Conclusion: According to these results, Korean medicine treatments could be considered effective for CIPN. Prospective studies are needed to confirm and expand these findings.

A Case Report of Chemotherapy-Induced Peripheral Neuropathy Treated with Modified Guibi-tang (귀비탕가미방으로 호전된 항암화학요법 유발 말초신경병증 치험 1례)

  • Park, Su Bin;Yoon, Jee-Hyun;Kim, Eun Hye;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.451-459
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    • 2022
  • Objective: The purpose of this study was to report the effectiveness of modified Guibi-tang in a patient suffering from chemotherapy-induced peripheral neuropathy (CIPN). Methods: A 54-year-old Korean female patient diagnosed with recurrent ovarian cancer had CIPN with other symptoms, such as anorexia, dyspepsia, insomnia, etc. She was diagnosed with Simbiyangheo and hence treated with a modified Guibi-tang. Neuropathic symptoms were assessed using a numerical rating scale (NRS) and a sensory score. Quality of life was assessed using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group Neurotoxicity (FACT/GOG-Ntx). Results: After 14 days of treatment, the patients showed a decrease in NRS for bilateral limb pain and improvement in other symptoms, such as general weakness, insomnia, dizziness, and headache. Quality of life also increased. Conclusion: Modified Guibi-tang may be considered an optional treatment for CIPN if the patient is diagnosed with Simbiyangheo. Further studies are needed to confirm this finding.

Sciatic Neuropathy after Intramuscular Injection at a Site Remote from the Nerve (신경과 먼 부위 근육 내 주사 후 발생한 좌골신경병증)

  • Yun, Soo In;Park, Jisoo;Ko, Yun Dam;Song, Dae-Heon;Park, Jihye
    • Clinical Pain
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    • v.20 no.1
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    • pp.43-48
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    • 2021
  • Sciatic nerve can be injured by various mechanism such as compression, traction during surgery, and direct trauma. This case reports a sciatic neuropathy caused by compression due to hematoma occurring after intramuscular injection in the gluteus medius muscle far from the nerve. In order to avoid occurrence of sciatic neuropathy after buttock injection, the injection was made in the upper outer quadrant of the buttock, but sciatic neuropathy occurred. Sciatic neuropathy can be confused with lumbar radiculopathy, so differential diagnosis is important.

A Case Report of Korean Medicine Treatment Focused on Acupotomy Therapy for Acute Cervical Radiculopathy Presenting with Shoulder Pain (어깨 통증 양상으로 나타난 급성 경추부 신경뿌리병증 환자의 침도치료를 중심으로 한 한의치료 1례)

  • Taehyeong, Kim;Dasol Park;Jungtae Leem;Gawon Choe
    • Korean Journal of Acupuncture
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    • v.41 no.2
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    • pp.51-57
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    • 2024
  • This case report aims to illustrate the diagnostic challenge and effective management of acute cervical radiculopathy presenting as shoulder pain, differentially diagnosed through physical examinations, and subsequently treated with acupotomy. A male patient in his late 20s with no significant medical history or comorbidities reported acute left shoulder pain upon awakening, rated at a severity of 7 on the numeric rating scale (NRS). Initial physical evaluations of the shoulder assembly revealed no abnormalities, but a positive Spurling test, relief with cervical distraction, and diminished sensation across the left C5~C8 dermatomes pointed towards a cervical spine origin. Immediate acupotomy at identified tender points significantly reduced pain, with additional therapies enhancing recovery. Pain was eliminated after the second treatment, and this resolution was sustained at the 4-week follow-up, confirming the treatment's effectiveness and verifying the absence of adverse effects. This case presents the critical need for precise diagnosis in cases of neck and shoulder pain. Additionally, the employment of acupotomy provided a swift and effective resolution of symptoms in acute cervical radiculopathy, showing its value in clinical practice.

The Effects of Muscle Energy Techniques Applied to Upper trapezius on Pain, Range of Motion and Muscle Performance in Patients with Cervical Radiculopathy (위 등세모근에 적용한 근육 에너지 기법이 목 신경뿌리병증 환자의 통증, 관절가동범위 및 근수행력에 미치는 영향)

  • Jin-gi Hong;Young-min Kim
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.30 no.1
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    • pp.15-27
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    • 2024
  • Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy to patients with cervical radiculopathy. Methods: Twenty-six patients with cervical radiculopathy were randomized into two groups: the experimental group (n=13) and the control group (n=13). The two groups performed the muscle energy technique and for 4 weeks, 3 times a week, in 70-minute sessions. Pain, range of motion, function, and muscle performance were assessed using the visual analogue scale (VAS), cervical range of motion (CROM) goniometer, neck disability index (NDI), and stabilizer pressure biofeedback, before and after training. Results: After four weeks of therapy, the VAS (p<.001), NDI (p<.01), and the maximum strength of the deep neck flexion muscles significantly decreased (p<.01) and CROM significantly increased in both groups (p<.05). Conclusion: The muscle energy technique and therapeutic modalities such as cervical traction are effective in reducing VAS and NDI and increasing CROM and muscle performance in patients with cervical radiculopathy.

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Surgical Management of Neuropathic Arthropathy due to Rheumatoid Arthritis: A Case Report (류마티스 관절염 환자에서 발생한 신경병성 관절병증의 수술적 접근: 증례 보고)

  • Hyunkyu Yu;Jaewon Kim;Sunghyun Lee
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.3
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    • pp.107-110
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    • 2024
  • Neuropathic arthropathy (Charcot arthropathy) is a progressive joint disease often associated with conditions such as diabetes, leading to severe joint deformity and pain. However, its occurrence in patients with rheumatoid arthritis (RA) is rare and not well documented. This case report describes a 48-year-old woman with a long history of RA who developed a severe deformity of her right ankle, identified as neuropathic arthropathy extending to the subtalar joint (Brodsky classification type 3A). After excluding other potential causes, the condition was determined to be secondary to RA-associated peripheral neuropathy. Surgery, including allograft and autograft fixation, was performed to correct the deformity. Post-operative complications, such as wound infection, were treated with negative pressure wound therapy and skin grafting. At the 18-month follow-up, the patient was able to walk without pain, demonstrating successful joint fusion.