• The Korean Journal of Pain
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• v.20 no.2
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• pp.174-180
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• 2007

Background: The diagnosis of trigeminal neuralgia (TN) is based on only clinical criteria. The purpose of this study was to estimate the clinical manifestations of TN patients treated at our pain clinic. Methods: A total of 341 patients with TN from Jan. 2004 to Dec. 2006 was evaluated the intensity, site, and onset of pain, facial sensation, duration of pain attack, pain free interval, triggering factors, and effects of the previous treatments with TN specific questionnaire and interview at the first visit of our pain clinic. Results: About 80% of the patients were over 50 years of age and 256 (75%) patients were women. Average durations from first attack of their pain and from current pain attack were 7 years and 16 weeks, respectively. The two most frequently involved trigeminal nerve branches were maxillary (40%) and mandibular (39%) branches. Three quarters of the total patients experienced only paroxysmal pain that lasted less than one minute. About 90% of patients had pain free period at least one time. Most common triggering factors were chewing (88%), brushing teeth (82%), washing face (79%), and talking (70%). Only 16 patients (5%) had no previous treatment and the others had more than one treatment, such as medication (68%) and interventional procedures (35%). The most common reasons for early discontinuation of carbamazepine were dizziness, ataxia, and vomiting. Conclusions: TN has specific clinical features of pain, which should be considered at diagnosis.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.177-195
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• 2009

Objectives : This study is performed to investigate the acupuncture on Sciatica through the literature of oriental medicine. Methods : We collected the oriental medical literature from ancient to modern times, and extracted the causes, symptoms, treatments and acupoints of sciatica. Results : The findings of this study are as follows: 1. The etiology of Sciatica is differentiated into the exogenous pathogenic factors(wind, cold, dampness, trauma, bad posture) and the internal pathogenic factors(deficiency of the kidney energy, congenital debility). 2. The symptoms of Sciatica are pain, weakness and dysesthesia in the low back, hip and lower limb. 3. In the treatment of Sciatica, The Leg Greater Yang Bladder (BL) Meridian and The Leg Lesser Yang Gall Bladder (GB) Meridian out of 12 meridians were mainly used and the acupoint GB30(Hwando) was most frequently used in the acupuncture literature. 4. The number of acupoints used for sciatica was 95, and those acupoints in the order of frequency were GB30(Hwando), GB34(Yangnungch'on), BL40(Wijung), BL60(Kollyun), GB31(P'ungshi), GB39(Hyonjong), BL57(Sungsan), ST36(Chok-samni). Conclusion : The most frequently used acupoints for the treatment of sciatica are as follows; GB30(Hwando), GB34(Yangnungch'on), GB31(P'ungshi), GB39(Hyonjong) of The Leg Lesser Yang Gall Bladder Meridian, BL40(Wijung), BL60(Kollyun), BL57(Sungsan) of The Leg Greater Yang Bladder Meridian.

• Journal of Korean Neurosurgical Society
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• v.37 no.5
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• pp.357-363
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• 2005

Objective: The microvascular decompression(MVD) for trigeminal neuralgia(TN) is known as an effective surgical technique. But the failed MVD cases have been reported in long term follow-up studies. This study is to evaluate the efficacy of MVD through our operative techniques, offending vessels in operative field, failed cases with the review of the literatures. Methods: We analyzed total 63 cases of TN which underwent MVD from 1955 to 2003 according to characters of pain, operative findings, operative results related to causative vessel compression and operative method, progonotic factor. Statistical analysis was performed using paired t-test with SPSS Ver 11.0. Results: In TN, the most common offending vessel was superior cerebellar artery(45.0%). In compression group of nerve root by offending vessel, the cure rate was 91.7%. However, the cure rate of the contact group was 64.7% and the cure rate of the negative group was 37.5%. There was no statistical significance between the degree of compression by vessel and the operative result(p=0.076). In 51 cases with MVD only, the cure rate was 84.3% and in 3 cases with PSR only, 42.8% and in 2 cases with PSR(partial sensory rhizotomy) with MVD, 50.0%. TN recurred in 7 cases within the follow-up period and reoperations(PSR) were added in 2 cases of them. Conclusion: This study shows that MVD provided a high rate of success with a minor risk of complications, which has been regarded as the most safe and effective procedure for trigeminal neuralgia. Additional MVD in recurred TN by severe adhesion of teflon showed poor outcome. But, revisional operation(PSR) in recurred TN showed relatively good outcome. PSR should be considered for treatment of recurrent TN after MVD.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.235-240
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• 2000

This study was carried out among 34 patients who visited Yonsei Dental Hospital from 1996. 1. to 1999. 5 for trigeminal neuralgia. By studying the patient's treatment prior to visiting our hospital, features of trigeminal neuralgia, treatment process of trigeminal neuralgia, prognosis of treatment, consultation with other professions and involvement of surgery, etc., the results are as follows: 1. 67.7% of onset age range from 40s to 60s, and average age is 50.2. 2. Ratio of right to left involvement is 1:2.1, male to female ratio is 1:1.9. 3. Occurrence rate of each branch is V3(44.1%), V2(11.8%), V1+V2+V3(11.8), V1+V2(8.8%). 4. Treatments prior to admission to our hospital are extraction(5.9%), endodontic treatment(5.9%), medication(11.8%), Oriental Medicine treatment(5.9%). 5. Routes of admittance to our hospital are by their preference(55.9%), local clinic referral(32.4%), E.N.T referral(5.9%), Neurology referral(5.9%). 6. 70.6% of patients treated at our hospital who were relieved of symptoms, were referred to Neurology(66.7%) and Pain Clinic(33.3%) for the reason of relapse, side effects of the drug itself, incomplete relief of pain. 7. 2 patients who were referred to medical part showed brain vessels contacting trigeminal nerve root on Brain MRangiography. But pain is being controlled by medication and no specific surgical procedure was carried out. The results show that 17.7% of patients admitted received inappropriate early treatment. In order to relieve tooth loss and patient's psychologic stress due to inappropriate treatment, precise differential diagnosis must be made among local teeth disease and idiopathic facial pain. Medication may show side effects of the drug itself, incomplete relief of pain or relapse of symptoms. Therefore, to treat trigeminal neuralgia appropriately by drug injection, surgery or radiation therapy, consultations among dentists, neurologists and anesthesiologists are required.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.760-767
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• 2019

Objective: This study reports the efficacy of using integrative Korean medicine treatments for a patient with facial paralysis and accompanying trigeminal neuralgia. Methods: A 45-year-old male patient with left side facial palsy and facial pain due to Bell's palsy with trigeminal neuralgia was treated with herbal medicine, acupuncture, pharmacopuncture, and cupping for 18 days. The treatment effect was evaluated by measuring the scores for the numerical rating scale (NRS) of facial pain, the House-Brackmann scale, and the Yanagihara scale. Results: After the hospital treatment, the patient's facial pain NRS score was decreased, and the House-Brackmann scale and Yanagihara scale scores improved after the administration of the Korean medicine treatments. Conclusions: The integrative Korean medicine treatments appeared to be effective in treating facial nerve palsy and associated trigeminal neuralgia.

• Journal of Radiation Industry
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• v.12 no.4
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• pp.337-341
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• 2018

Sector block is not used for Gamma Knife surgery in patients with generalized trigeminal neuralgia but sector block is used to reduce the dose reaching the brain stem when the trigeminal ganglgia and the 'Brain stem', radiation sensitive tissue, are adjacent. In the Gamma Knife surgical plan of this study, a surgical plan was established using a Leksell Gamma Plan 11. 1.0 (Elekta Instrument AB, Sweden) with one patient (Block unused, Brain stem dose No volume over 12 Gy, Case 1) who did not need a sector block and four patients (Block unused, Brain stem dose 12 Gy or more, Case 2~5) with a sector block. Magnetic resonance images were obtained by MPRAGE T1 and CISS Respectively. When the trigeminal ganglion is in close proximity to the brain stem, the brain stem volume is decreased when the sector block is used, while the treatment time was increased. In conclusion, This Study evaluates the usefulness of the Sector block in brain stem through Gamma Knife surgery in trigeminal neuralgia, which is considered to be the most important factor for the Gamma Knife surgery.

• Journal of Physiology & Pathology in Korean Medicine
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• v.34 no.6
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• pp.299-308
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• 2020

This study aimed to evaluate the effects of Chuna therapy for Sciatica. We searched the following 16 online databases without a language restriction (Pubmed, Cochrane, Embase, CINAHL, Ovid, Kmbase, RISS, NDSL, OASIS, KISS, KNAL, KTKP, DBpia, CNKI, Wangfang, J-stage) to find randomized controlled clinical trials that used Chuna therapy for Sciatica. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane risk of bias tool and meta-analysis were performed. Among 496 articles that were searched, 15 RCTs were finally selected for systematic review. 14 studies showed that Chuna therapy has positive effect on sciatica. Two studies noted that there were side effects, and the difference between the intervention group and the control group was statistically insignificant. One study noted no side effects and the rest of the study, there was no mention of side effects. Meta-analysis showed positive results for Chuna single therapy in terms of efficiency rate compared to painkiller, herb medicine excepting acupuncture. When comparing Chuna therapy plus acupuncture and acupuncture, Chuna therapy plus acupuncture had a more positive result than acupuncture in terms of efficiency rate. Cochrane Risk of Bias (RoB)evaluation method, most of the studies's selection, performance, detection and reporting bias were unclear. The studies showed that Chuna therapy can significantly effective on sciatica. However, most of the studies's Risk of Bias included in the analysis were not low enough. In the future, to prove the level of evidence of Chuna therapy, more high-quality studies will be needed.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.2
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• pp.105-121
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• 2022

Objectives This study was conducted to evaluate the effect of electro-acupuncture for sciatica. Methods We searched 13 online databases (Kmbase, Research Information Sharing Service [RISS], National Digital Science Library [NDSL], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies, Koreantk, DBpia, PubMed, Cochrane, EMBASE, Medline, China National Knowledge Infrastructure [CNKI], J-stage) to find randomized-controlled clinical trials (RCTs) that used electro-acupuncture for sciatica. Efficacy rate and visual analogue scale (VAS) were mainly analyzed as a main evaluation criteria. Results Among 583 articles that were searched, 24 RCTs were finally selected and 18 RCTs were statistically analyzed. Electro-acupuncture was more effective than acupuncture in terms of efficacy rate (p<0.00001) and VAS (p<0.00001). Also, Electro-acupuncture was more effective than western medication in terms of efficacy rate (p=0.0005). However, the effectiveness of electro-acupuncture was not identified compared to physical therapy (p=0.42). Electro-acupuncture significantly improved efficacy rate when combined with physical therapy than physical therapy alone (p<0.0001). In addition, electro-acupuncture plus Chuna manual therapy compared to Chuna manual therapy alone showed positive results for efficacy rate (p=0.05) and VAS (p<0.0001). Conclusions Based on results, the effectiveness of electro-acupuncture for sciatica was identified. However, this study has limitations because the RCTs included in this study were small in number and published in a particular region. Although this study could be a groundwork for well designed research for sciatica.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.980-988
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• 2022

The most common definition of postherpetic neuralgia is the presence of pain more than a month after the onset of the eruption of zoster. This case report suggests the effect of Korean medicine on postherpetic neuralgia. An 85-year-old male patient with postherpetic neuralgia was treated with a combination of Korean medical remedies. Kyung Hee Gongjin-dan and Hyangbujapalmul-tang-gagam were applied for 23 days. The Numerical Rating Scale was used to measure pain intensity. The Barthel Index and Beck Depression Inventory were used for the functional assessment and depression evaluation, respectively. After treatment, the patient's pain intensity decreased. Additionally, the patient's independence increased during activity, and the severity of their depression decreased. Thus, this case suggests that a combination of Korean medicine treatments might be effective for postherpetic neuralgia. In particular, it shows that Kyung Hee Gongjin-dan and Hyangbujapalmul-tang-gagam can be therapeutic options in the treatment of postherpetic neuralgia.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1273-1285
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• 2022

Purpose MR neurography (MRN) is an imaging technique optimized to visualize the peripheral nerves. This review aimed to discover an optimized protocol for MRN of the lumbosacral plexus (LSP) and identify evidence for the clinical benefit of lumbosacral plexopathies. Materials and Methods We performed a systematic search of the two medical databases until September 2021. 'Magnetic resonance imaging', 'lumbosacral plexus', 'neurologic disease', or equivalent terms were used to search the literature. We extracted information on indications, MRN protocols for LSP, and clinical efficacy from 55 studies among those searched. Results MRN of the LSP is useful for displaying the distribution of peripheral nerve disease, guiding perineural injections, and assessing extraspinal causes of sciatica. Three-dimensional short-tau inversion recovery turbo spin-echo combined with vascular suppression is the mainstay of MRN. Conclusion Future work on the MRN of LSP should be directed to technical maturation and clinical validation of efficacy.