• Title/Summary/Keyword: Neuropathic pain scale

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A Case Report of Central Post-stroke Pain Improved by Gami SSanghwa-tang (가미쌍화탕으로 호전된 뇌졸중 후 중추성 통증 환자 치험 1례)

  • Shin, Hee-Yeon;Lee, Sang-Hwa;Lee, Hyoung-Min;Yang, Seung-Bo;Cho, Seung-Yeon;Park, Seong-Uk;Ko, Chang-Nam;Park, Jung-Mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.18 no.1
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    • pp.77-86
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    • 2017
  • ■ Objectives The purpose of this case study is to report the effect of Gami SSanghwa-tang on a patient with central post-stroke pain. ■ Methods The patient was treated with herbal medicine Gami SSanghwa-tang, acupuncture, pharmaco-acupuncture, and moxibustion. The treatment effect was evaluated by Numerical Rating Scale(NRS), Neuropathic Pain Symptom Inventory(NPSI), and 36-item Short-form Health Survey(SF-36). ■ Results After the treatment, the NRS score of pain intensity was reduced from moderate to mild degree. The total NPSI score and subscores also decreased, as the various features of the pain were relieved. The SF-36 score increased, as the patient's quality of life improved. ■ Conclusion This case study suggests that Gami SSanghwa-tang, could be effective in reducing pain and improving quality of life of patients suffering from central post-stroke pain.

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A Case of Idiopathic Peripheral Neuropathy Improved by Combined with Electroacupuncture and Bee Venom Acupuncture (전침 및 봉약침 치료로 호전된 특발성 말초신경병증의 증례보고)

  • An, SunJoo;Choi, Seonghwan;Kang, Shinwoo;Park, Seohyun;Keum, Dongho
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.173-181
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    • 2020
  • The purpose of this study is to report the effects of electroacupuncture and bee venom (BV) acupuncture for a patient suffering with idiopathic peripheral neuropathy. There was a one patient who was diagnosed as idiopathic peroneal neuropathy and tibial neuropathy received electroacupuncture and BV acupuncture at acupoints on peroneal and tibial nerve pathway. The evaluation of clinical outcome was done by range of motion (ROM), manual muscle test (MMT), perimeter of lower leg, neuropathy pain scale (NPS). After treatment, the patient showed improvement in ROM and MMT. The patient's perimeter of lower leg was increased, NPS was decreased. This study suggests that the treatment of acupoints on the damaged nerve pathways could be an effective treatment for peripheral neuropathy, although further studies will be needed.

Miniscalpel Needle Therapy with Integrative Korean Medical Treatment for Carpal Tunnel or Tarsal Tunnel Syndrome: Case Series of Three Patients

  • Kim, Jae Ik;Kim, Hye Su;Park, Gi Nam;Jeon, Ju Hyon;Kim, Jung Ho;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.139-152
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    • 2017
  • Objectives : This study reports the clinical effects of miniscalpel needle therapy in patients with carpal tunnel or tarsal tunnel syndrome. Methods : Three patients with carpal tunnel syndrome (CTS) or tarsal tunnel syndrome (TTS) (first case, patient with CTS and TTS; second case, patient with CTS; and third case, patient with TTS) were treated with miniscalpel needle (MSN) therapy and integrative Korean medical treatment. The Numeric Rating Scale (NRS), Neuropathic Pain Scale (NPS), Boston scale score, and AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score were measured. Results : In general, outcome measures after treatment showed improvement in all cases. In the first case (CTS and TTS), scores on the NRS, NPS, and Boston scale decreased, and AOFAS ankle-hind foot scores increased. In addition, Tinel's sign showed improvement. In the second case (CTS), scores on the NRS, NPS, and Boston scale, and Tinel's sign, were decreased. In the third case (TTS), scores on the NRS and NPS, and Tinel's sign, showed improvement, and AOFAS ankle-hind foot scores were increased. Conclusion : These results suggest that MSN therapy has a meaningful clinical effect in CTS and TTS.

Psychosocial Impact of Chronic Orofacial Pain (만성 구강안면통증의 사회심리적 영향)

  • Yang, Dong-Hyo;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.397-407
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    • 2009
  • The aim of the study was to evaluate psychosocial impact of non-dental chronic orofacial pain (OFP) on daily living using the graded chronic pain (GCP) scale. It is also investigated the clinical profile such as demographics, event related to initiation of OFP and prior treatments for patients. During previous 6 months since September 2008, 572 patients (M:F=1:1.5, mean age=34.7 years) with non-dental OFP attended university-based specialist orofacial pain clinic (Dankook University Dental Hospital, Cheonan) to seek care although 63% of them already experienced related treatment for their OFP problem. They visited the most frequently general dental practitioner and orthopedic doctors due to their pain problem and medication was the most commonly employed modality. Most of the patients (89.2%) had TMD and the most common related event to initiation of their pain was trauma, followed by dental treatment. Almost half of the patients (46%) suffered from chronic pain(${\geq}6\;M$) and 40% of them exhibited relatively high disability due to chronic OFP. GCP pain intensity and disability days were significantly different for age and diagnosis (p<0.05) but not for gender and duration. GCP grades were affected by all the factors including gender, age, pain duration and diagnosis.(p=0.000) Female gender, elders, and long lasting pain were closely related to high disability. The patients with neuropathic Pain and mixed OFP rather than TMD were graded as being highly disabled. Conclusively, a considerable percentage of chronic OFP patients reports high pain-related disability in their daily, social and work activity, which suggest a need for psychosocial support and importance of earlier referral for appropriate diagnosis and tailored management.

A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy

  • Sil, Amrita;Kumar, Hrishikesh;Mondal, Rahul Deb;Anand, Sidharth Sankar;Ghosal, Anirban;Datta, Ashis;Sawant, Sandesh V;Kapatkar, Vaibhavi;Kadhe, Ganesh;Rao, Sameer
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.183-190
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    • 2018
  • Background: Vitamin B12 deficiency has been associated with peripheral neuropathy, loss of sensation in the peripheral nerves, and weakness in the lower extremities. Methylcobalamin is the most effective analogue of vitamin B12 used to treat or prevent the complications associated with vitamin B12 deficiency. The current study aimed to compare the serum cobalamin levels after administration of two different regimes of methylcobalamin in peripheral neuropathy patients. Methods: The present study was a prospective, randomized, comparative study. The study consisted of two parallel groups, group A (methylcobalamin $500{\mu}g$ injection intramuscularly three times a week) and group B (methylcobalamin $1500{\mu}g$ injection intramuscularly once a week). A control group of healthy volunteers was also included. Results: A total of 24 patients (12 in each group) were included in the study. Five healthy volunteers were also included as a control in each group. At the end of treatment, serum cobalamin levels were significantly (P = 0.028) higher in group A ($1892.08{\pm}234.50$) as compared with group B ($1438.5{\pm}460.32$). The serum cobalamin levels in Group A healthy volunteers were also two times higher than that of group B (P = 0.056). Both the LANSS scale and DN4 questionnaire reported similar results at end of treatment. Conclusions: The $500{\mu}g$ methylcobalamin thrice weekly regime is more effective in increasing the serum cobalamin levels as compared to the $1500{\mu}g$ methylcobalamin once weekly regime.

The Effect of Repetitive Magnetic Stimulation in an SCI Rat Model with Stem Cell Transplantation (줄기세포를 이식한 척수손상 흰쥐에서 반복자기자극의 효과)

  • Bae, Young-Kyung;Park, Hea-Woon;Cho, Yun-Woo;Kim, Su-Jeong;Lee, Joon-Ha;Kwon, Jung-Gu;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.22 no.1
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    • pp.67-73
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    • 2010
  • Purpose: We tested whether repetitive transcranial magnetic stimulation (rTMS) improved recovery following spinal cord injury (SCI) in rats with transplantation of adipose tissue-derived stromal cells (ATSCs). Methods: Twenty Sprague-Dawley rats (200-250 g, female) were used. Moderate spinal cord injury was induced at the T9 level by a New York University (NYU) impactor. The rat ATSCs (approximately $5{\times}10^5$ cells) were injected into the perilesional area at 9 days after SCI. Starting four days after transplantation, rTMS (25 Hz, 0.1 Tesla, pulse width=$370{\mu}s$, on/off time=3 sec/3 sec) was applied daily for 7 weeks. Functional recovery was assessed using the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale as well as pain responses for thermal and cold stimuli. Results: Both groups showed similar, gradual improvement of locomotor function. rTMS stimulation decreased thermal and cold hyperalgesia after 7 weeks, but sham stimulation did not. Conclusion: rTMS after transplantation of ATSCs in an SCI model may reduce thermal hyperalgesia and cold allodynia, and may be an adjuvant therapeutic tool for pain control after stem cell therapy in SCI.

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.

Electrophysiological Analysis in Diabetic Patients with Abnormal Sensation and Pain (이상감각과 통증을 호소하는 당뇨병 환자의 전기생리학적 특징 분석)

  • Yang, Jiwon;Lee, Yeong-Bae
    • Science of Emotion and Sensibility
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    • v.19 no.4
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    • pp.111-118
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    • 2016
  • Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

A Study on the Correlation between Pain Intensity and HbA1c for Diabetic Peripheral Neuropathy Patients (당뇨병성 말초신경병증 환자에서 통증 정도와 당화혈색소 간의 상관성 연구)

  • Jung, Se Ho;Sung, Hee Jin;Lim, Su Ji;Lee, Cham Kyul;Jo, Na Young;Roh, Jeong Du;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.17-27
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    • 2015
  • Objectives : The purpose of this study is to evaluate the correlation between HbA1c and pain intensity in diabetic peripheral neuropathy patients, and to compare the difference between two groups divided by the risk of complications. Methods : The participants were 46 men and women suffering from neuropathic pain diagnosed with diabetes mellitus who visited the Hospital of Traditional Korean Medicine, Semyung University from June, 2014 to August, 2015. Age, duration of diabetes mellitus, numeric rating scale(NRS), and Michigan neuropathy screening instrument(MNSI) were used as evaluation tools. Results : 1. In all 46 cases, there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 2. Among 23 cases with a high risk of complications (more than 7.0 % of HbA1c, group A), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 3. Among 23 cases with a low risk of complications(less than 7.0 % of HbA1c, group B), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 4. Means of duration of diabetes mellitus, NRS, MNSIQ, and MNSIE were higher in group A than group B, but there were no significant correlations in statistics. Conclusions : This study could not find statistically significant correlations between pain intensity and HbA1c in diabetic peripheral neuropathy patients, so more studies are required in the future.

Effects of combined acupuncture and gabapentin treatment on chemotherapy-induced peripheral neuropathy: a pilot, randomized, assessor-blinded, controlled trial

  • Hyun Jung Jung;Dae Jun Kim;Joon Seok Byun
    • Journal of Korean Traditional Oncology
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    • v.28 no.1
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    • pp.33-44
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    • 2023
  • 목적: 항암유발말초신경병증은 암 환자가 겪는 흔한 항암 부작용이나 현재까지 효과적으로 알려진 치료법은 없다. 본 연구의 목적은 항암유발말초신경병증에 대한 침 치료와 가바펜틴의 병용 요법의 효과와 안전성을 평가하는 것이다. 방법: 항암유발말초신경병증을 겪고 있는 24명의 암 환자를 침 치료 단독군 (AG, acupuncture group)과 침과 가바펜틴의 병용요법군 (CG, combined acupuncture and gabapentin group)으로 무작위 배정하였다. 두 그룹 모두 침 치료는 주 3회, 4주간 수행하였다. 병용 요법군은 침 치료와 더불어 1일 900mg의 가바펜틴을 복용하도록 하였다. 치료 효과는 Neuropathic Pain Symptom Inventory (NPSI), visual analogue scale (VAS), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 items (EORTC-CIPN20)를 이용하여 측정하였다. 치료로 인한 부작용은 대상자가 방문할 때마다 조사하였다. 결과: 총 23명의 대상자(AG, n=12; CG, n=11)의 평가지표를 분석한 결과, 치료 4 주 후 침 치료 단독군은 NPSI 점수가 44.33±25.04에서 30.58±21.55으로 감소하였고, 병용 요법군은 30.55±25.59에서 18.64±19.42로 감소하였으며, 두 군 모두 통계적으로 유의미하게 감소하였다(p<0.001). VAS점수는 침 치료 단독군에서는 4.79±2.17 에서 3.42±2.49으로 감소하였고, 병용 요법군에서는 3.55±2.07에서 2.73±2.49 로 감소하였다(p<0.05). 치료 효과는 치료 완료 2주후까지 지속되었으며, 두 군간의 유의미한 차이는 없었다. EORTC-CIPN20은 침 치료 단독군은 30.27±18.87에서 20.84±16.35으로 감소하여(p<0.01), 두 군 모두에서 삶의 질이 향상되었다. 결론: 본 연구로 침 치료와 가바펜틴의 병용 요법이 항암유발말초신경병증 환자의 증상 및 삶의 질 개선에 효과적이며 안전한 치료법임을 확인하였다. 그러나 침 치료와 가바펜틴의 시너지 효과에 대해서는 확인 할 수 없었으며, 이를 확인하기 위해 추가적인 연구가 필요할 것으로 사료된다.