• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.121-124
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• 2010

In athletes, repetitive low-energy impacts in plantar lesion lead often to tendinitis, stress fracture, or overuse syndrome. The major cause of heel pain in athletes is plantar fasciitis. And it is most often attributable to repetitive low energy impact, but the vast majority patients with heel pain achieve symptomatic relief with conservative treatment and return to full activities. Not commonly, Nerve entrapment may be occurred from repetitive low energy trauma in athletes, and is not as easily diagnosed. The authors observed a basketball player who complained of chronic heel pain that do not respond to conservative treatment, he had the lesions both plantar fasciitis and lateral plantar nerve entrapment. The authors described an unusual mechanism of entrapment of the lateral plantar nerve combined with a chronic plantar fasciitis in a basketball player and reported with review of literature.

• Clinical Pain
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• v.19 no.2
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• pp.97-100
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• 2020

An intraneural ganglion in the peripheral nerve and the resulting ulnar neuropathy at the elbow are uncommon and may show various symptoms ranging from local pain to motor and sensory impairment. We report a case of a 76-year-old man who was diagnosed with ulnar neuropathy caused by an intraneural ganglion derived from the elbow. We also discuss the pathophysiology, treatment, prognosis, and diagnostic value of ultrasonography in neuropathy caused by a ganglion.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.199-205
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• 2011

During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

• Clinical Pain
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• v.20 no.1
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• pp.20-24
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• 2021

In this case report, we present a rare case of lipoma of the tendon sheath localized to the wrist which caused median entrapment neuropathy and was successfully treated with surgical excision. Dynamic examination using ultrasonography revealed the exact location of the lipoma. Electrodiagnostic study (EDX) was done before surgery to elucidate combined neuropathy, and surgery for ulnar neuropathy around elbow was also performed simultaneously. Diagnostic ultrasound can be used for dynamic examinations with real-time visualization.

• Journal of Life Science
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• v.27 no.5
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• pp.600-610
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• 2017

It was common that the classification of itching was classified into four categories according to the neurophysiological mechanisms of pruritoceptive itching, neuropathic itching, neurogenic itching and psychogenic itching. Recently it was classified by clinical criteria. The neurotransmission pathway of itch is divided into histamine-dependent pathway and histamine-independent pathway. Different receptors and neuropeptides act on each itch mediator. Itch mediators such as histamine, BAM8-22, and chloroquine are transmitted through the histamine-dependent pathway. Cowhage spicule, protease, and TSLP (Thymic stromal lymphopoietin) have been reported to be related to the histamine-independent pathway. These itch mediators, receptors, and neuropeptides are the targets of treatment for itching. Although itching and pain are typical noxious stimuli, and in the past, it was argued that two senses were transmitted through one noxious stimulus receptor. It has recently been shown that itching and pain have an independent neurotransmitter system and both neuronal systems inhibit each other. In addition, the mutual antagonism between itching and pain is explained by various mechanisms. Recently, many new mediators and receptors are being studied. The studies on histamine 4 receptor (H4 receptor) have been actively conducted. And the H4 receptors are expressed in immune cells such as T cells. The therapeutic agent for blocking the H4 receptor can inhibit the inflammatory reaction itself, which is important for the itching and chronicization. Understanding the underlying mechanisms of itching and studying new itch mediators will lead to the development of effective therapies, and this is what I think the itching study will go on.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.379-385
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• 2009

The purpose of this study was to present basic data that is needed in comprehension of dysesthesia after mandibular nerve injury and grasp meaning. We analyzed medical records of 59 patients who were diagnosed as dysesthesia after mandibular nerve injury from January 2007 to July 2009. The results are summarized as follows. 1. The most frequent cause was implant surgery (59%) and the most frequent injured branch of mandibular nerve was inferior alveolar nerve(81%). 2. The period passed after nerve injury showed significant interrelationship with level of pain. Visual Analogue Scale(VAS) increased from 4.82 to 6.91 after 6 month. 3. The period passed after nerve injury did not show significant interrelationship with recovery of dysesthesia. But, when conservative treatment was offered at earlier stage, ratio of patients who showed recovery of symptom tended to increase. 4. In computed tomography, level of invasion into inferior alveolar nerve canal did not show significant interrelationship with level of pain and recovery of dysesthesia. Conclusively, in the patients with dysesthesia of mandibular nerve, inferior alveolar nerve injury by dental implant surgery dominated most significant problem. Although level of invasion into inferior alveolar nerve is the most important factor to initiation of dysesthesia, there are other various factors exert more influence on the level of pain or recovery of dysesthesia. Therefore, begining conservative therapy at earlier stage is encouraged. Also, because nerve injuries can occur without direct invasion into nerve canal, so leaving enough safe space from nerve canal is needed for prevention of indirect nerve injury.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.301-305
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• 2018

Hemangiomas are benign neoplasms of endothelial cells origin, rarely found in hand region. Authors report a 62-year-old female with capillary hemangioma of right index finger causing a neuropathic symptom via nerve compression. A space-occupying vascular lesion surrounding the radial digital nerve was revealed in magnetic resonance imaging (MRI), which was removed under microscopic assist. The digital nerve was decompressed consequently. The mass was firmly attached to both the digital nerve and digital artery, requiring a meticulous microscopic dissection to preserve the nerve and artery. Compression neuropathy caused by space-occupying lesions is rare and its diagnosis is often difficult. A microscopic surgical approach can be used to successfully relieve neuropathic pain after proper diagnosis established by diagnostic tools such as MRI as in this case.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.15-24
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• 2017

Purpose: The aim of this study was to determine the effectiveness of arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy. Materials and Methods: Between May of 2006 and July of 2014, a total of 43 patients who had undergone surgery for primary osteoarthritis of the elbow with ulnar neuropathy were included in this study. We divided the subjects into two groups according to the method of surgery: group 1 (n=18) received mini-open ulnar nerve decompression only, and group 2 (n=25) received arthroscopic debridement with mini-open ulnar nerve decompression. Patients were assessed for the following clinical outcomes: visual analogue scales (VAS) score, range of motion of the elbow joint, Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder and hand (DASH) at the time before surgery and 6 months after surgery. We analyzed the recovery of the ulnar nerve by the McGowan grade and Bishop rating score preoperatively and at 6 months after the surgery. Results: The VAS score, range of motion of the elbow joint, MEPS, and DASH showed significant statistical difference after the surgery (p<0.05). However, between the 2 groups, there was no significant difference. For the McGowan grade, all cases of both groups-except one case each group-showed at least one grade improvement. Moreover, group 2 showed a greater significant difference than group 1 (p=0.001). At the final follow-up, according to the Bishop rating score, group 2 had a greater significant difference than group 1 (p=0.036). Conclusion: Arthroscopic debridement with mini-open ulnar nerve decompression in primary osteoarthritis of the elbow with ulnar neuropathy is a useful technique, which has several advantages, including the benefits associated with a minimally invasive surgery and also the improvement of elbow joint function and excellent recovery of the ulnar nerve.

• The Journal of Dong Guk Oriental Medicine
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• v.8 no.2
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• pp.47-67
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• 2000

The purpose of this study is to assess the usefulness of thermography in patients with musculoskeletal disease. Thermography is noninvasive, easy to reading, objective and physiologic instrument by measuring and imaging infrared energy emitted from skin surface. Thermography can show the skin temperature changes in various conditions of the body with musculoskeletal disease. This literature review was done for the usefulness of thermography in diagnosing musculoskeletal disease. In conclusion, thermography was adapted in radiculopathy, MPS, peripheral neuropathy, RSD, Raynaud's phenomen, TMJ dysfunction, etc. It was useful as a secondary diagnostic method in those diseases, also possible as a primary diagnostic method in RSD, Raynaud's phenomen. And, it might be reliable tool for estimating disease procedure and consequence after treatment. But, the objectivity of the reading and the development of the operating method are required for further adaptation in musculoskeletal disease.