• The Journal of the Korean dental association
• /
• v.54 no.11
• /
• pp.874-879
• /
• 2016

Damage to the inferior alveolar nerve(IAN) is a relatively infrequent complication in endodontic treatment. However, endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve resulting in sensory disturbances such as pain, dysesthesia, paresthesia or anesthesia. Two mechanism(chemical neurotoxicity and mechanical compression) are responsible for the IAN injury. When absorbent materials overfilled, it can be treated as a non-surgical procedure. But early surgical intervention required when mechanical, chemical nerve damage expected. We report surgical removal of overfilled gutta-percha and IAN decompression through sagittal split osteotomy in case of dysesthesia after overfilling of endodontic material into the mandibular canal. Dysesthesia recovered 3 months after surgical treatment.

• Journal of Oral Medicine and Pain
• /
• v.32 no.3
• /
• pp.263-272
• /
• 2007

The purpose of this study was to analyze the nerve damage after tooth extraction and implant surgery, and to establish a predictive model for assessment and management of dysesthesia. In this questionnaire study, the subjects chosen for this study were 276 dentists who answered the questionnaire about dysesthesia after tooth extraction and implant surgery. The analysis of the results consist of the sex and age distribution, affected site, associated symptoms, rate and duration of the recovery. The results are summarized as follows. : 1. There were no significant difference between the sex and the dysesthesia. 2. The most common affected site was the mandibular region. In the group of the implant surgery, 100% affected the mandibular site. The tooth extraction group was 93.2% affected. 3. Pain was one of the most associated symptom with dysesthesia-46.5% of the tooth extraction and 44.8% of the implant surgery. 4. The recovery ratio was 72.3% in the tooth extraction, 71.8% in the implant surgery. Most of them, they recovered in $1{\sim}6$ months. In conclusion, most of dysesthesia may be recovered within 1 year. However, the possibility of persistent dysesthesia should not be neglected. Therefore, practitioners must discuss the possibility of nerve injury with their patients, and include this possibility in the consent forms. Various methods of monitoring recovery of sensation should be considered for objective assessment of prognosis. In addition, immediate referral to orofacial pain specialists can offer the patients an opportunity for more effective and noninvasive treatments.

• Journal of Acupuncture Research
• /
• v.31 no.3
• /
• pp.91-102
• /
• 2014

Objectives : This study was done to determine the effect of Korean medical treatment to patient diagnosed as cauda equina syndrome(CES) suffering from both lower limb dysesthesia, saddle dysesthesia, buttock dysesthesia, dysuria, dyschezia and gait disturbance. Methods : A patient with CES was treated with acupuncture, sweet bee venom pharmacopuncture, herbal medicine from February 2 to April 9 at Department of Acupuncture & Moxibustion, Daejeon Korean Hospital of Daejeon University. Patient received acupuncture treatment($CV_1$, $CV_3$, $CV_4$, $CV_6$, $ST_{36}$, $BL_{31}$, $BL_{32}$, $BL_{33}$, $BL_{34}$) 12 times a week, bee-venom pharmacopuncture($BL_{23}$, $BL_{28}$) was conducted twice a week, herbal medicine(Samilsingihwan decoction) was applied to patient thrice a day for nine weeks. The following symptoms were observed saddle, and lower limb dysesthesia, dysuria, dyschezia and gait disturbance. Results : After treatment, dysesthesia, dysuria, dyschezia and gaiting developed good outcome. But anal reflex remained still. Conclusions : Acupuncture, bee-venom pharmacopuncture, herbal medicine combined treatment might be effective to patients with CES.

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

• The Korean Journal of Pain
• /
• v.29 no.1
• /
• pp.40-47
• /
• 2016

Background: Neuropathic pain, including paresthesia/dysesthesia in the lower extremities, always develops and remains for at least one month, to variable degrees, after percutaneous endoscopic lumbar discectomy (PELD). The recently discovered dual analgesic mechanisms of action, similar to those of antidepressants and anticonvulsants, enable nefopam (NFP) to treat neuropathic pain. This study was performed to determine whether NFP might reduce the neuropathic pain component of postoperative pain. Methods: Eighty patients, who underwent PELD due to herniated nucleus pulposus (HNP) at L4-L5, were randomly divided into two equal groups, one receiving NFP (with a mixture of morphine and ketorolac) and the other normal saline (NS) with the same mixture. The number of bolus infusions and the infused volume for 3 days were compared in both groups. The adverse reactions (ADRs) in both groups were recorded and compared. The neuropathic pain symptom inventory (NPSI) score was compared in both groups on postoperative days 1, 3, 7, 30, 60, and 90. Results: The mean attempted number of bolus infusions, and effective infused bolus volume for 3 days was lower in the NFP group for 3 days. The most commonly reported ADRs were nausea, dizziness, and somnolence, in order of frequency in the NFP group. The median NPSI score, and all 5 median sub-scores in the NFP group, were significantly lower than that of the NS group until postoperative day 30. Conclusions: NFP significantly reduced the neuropathic pain component, including paresthesia/dysesthesia until 1 month after PELD. The common ADRs were nausea, dizziness, somnolence, and ataxia.

• Journal of Korean Neurosurgical Society
• /
• v.44 no.1
• /
• pp.19-25
• /
• 2008

Objective : To analyze the relationship of concomitant foraminallumbar disc herniation (FLDH) with postoperative leg pain after microdecompression for extraforaminallumbar disc herniation (EFLDH) at the L5-S1 level. Methods : Sixty-five patients who underwent microdecompression for symptomatic EFLDH at the L5-S1 level were enrolled, According to the severity of accompanying FLDH, EFLDH was classified into four categories (Class I : no FLDH; Class II : mild to moderate FLDH confined within a lateral foraminal zone; Class III : severe FLDH extending to a medial foraminal zone; Class IV : Class III with intracanalicular disc herniation). The incidence of postoperative leg pain, dysesthesia, analgesic medication, epidural block, and requirement for revision surgery due to leg pain were evaluated and compared at three months after initial surgery. Results : The incidences of postoperative leg pain and dysesthesia were 36.9% and 26.1%, respectively. Pain medication and epidural block was performed on 40% and 41.5%, respectively, Revision surgery was recommended in six patients (9.2%) due to persistent leg pain, The incidences of leg pain, dysesthesia, and requirement for epidural block were higher in Class III/IV, compared with Class I/II. The incidence of requirement for analgesic medication was significantly higher in Class III/IV, compared with Class I/II (p=0,02, odds ratio=9,82). All patients who required revision surgery due to persistent leg pain were included in Class III/IV. Conclusion : Concomitant FLDH seems related to postoperative residual leg pain after microdecompression for EFLDH at the L5-S1 level.

• 대한치주과학회:학술대회논문집
• /
• 2006.11a
• /
• pp.41-42
• /
• 2006

• Proceedings of the KACD Conference
• /
• 2006.05a
• /
• pp.235-235
• /
• 2006

• Journal of Oriental Neuropsychiatry
• /
• v.20 no.4
• /
• pp.185-196
• /
• 2009

Objectives : This case report presents a 7-year-old female patient diagnosed with conversion disorder improved by application of oriental medical psychotherapy, the Giungoroen. Her chief complaint was dysesthesia of anal. Methods : Through interview and several psychological testing such as HTP test, DAF test, JTCI 7-11, we assessed her psychological state and seek for the psychological reason induced her physical symptom, dysesthesia of anal. After assessment we concluded her main psychological problem was loss of love relationship with her parents. So we decided to use supportive psychological therapy and behavioral therapy-like changing upbringing attitudes of her parents, for example- with Herbal medicine treatment. Results : After 2-month of therapeutic period, chief physical symptom of patient-dysesthesia of anal-was reduced to 20% compared with first visit day. Conclusions : The Giungoroen corresponds to supportive psychotherapy and behavioral therapy. And this oriental medical psychotherapy is fairly effective on the treatment of conversion disorder in childhood.

• Journal of Oriental Neuropsychiatry
• /
• v.29 no.3
• /
• pp.197-206
• /
• 2018

Objectives: Conversion disorder is combination of clinical symptoms and can be promoted until diagnosis is confirmed. In this case, we used Korean medical psychotherapy, M&L therapy, and Korean traditional medicine for treating a conversion disorder patient. Methods: The patient was diagnosed with conversion disorder, and main complaints were lower limb dysesthesia, and anxiety. We used BAI, BDI, HRV, CSEI-S, MMPI, Drawing room of mind for assessment. We treated the patient with Korean medical psychotherapy with M&L therapy, and Korean traditional medicine including acupuncture, moxa and herbal medicine. Results: After treatment, clinical symptoms improved to 40% compared with first visit and the BAI, BDI, HRV, CSEI-S scores decreased, especially scores for anxiety and depression. Conclusions: Korean medical psychotherapy and M&L psychotherapy can be effective for treating conversion disorder.