• Journal of Oral Medicine and Pain
• /
• 제48권1호
• /
• pp.25-30
• /
• 2023

We present the case of a 60-year-old male with post-macrotrauma disc displacement and retrodiscitis, in which temporomandibular joint (TMJ) injection and manual therapy were used to alleviate his symptoms. He visited our clinic with complaints of pain and swelling in his right facial area and malocclusion of his right side teeth after being hit on the right side of his face five days earlier. During clinical and radiological examinations, the inflammatory state of the joint and disc displacement on the right side, which led to malocclusion, were noted. At the initial visit, we performed TMJ intracapsular injection and prescribed medications to control pain and inflammation. Simultaneously, manual manipulation was performed to relocate the disc. The same treatments were employed two days later. However, 10 days after the first visit, his symptoms did not mitigate substantially. We also performed magnetic resonance imaging (MRI), prescribed nortriptyline, and created a stabilization splint. MRI images depicted inflammatory disc displacement and joint effusion in the right TMJ. Based on the accurate diagnosis, we kept administering a stabilization splint, intra-articular injection, and medication. His signs and symptoms were alleviated 20 days after the initial visit and did not reoccur for the next 40 days.

• The Korean Journal of Pain
• /
• 제14권2호
• /
• pp.266-270
• /
• 2001

An 85-year old female patient visited our pain clinic because of pin pricking pain and allodynia on the left forehead area for 2 days. Vesicular eruptions were seen along the left supraorbital nerve distribution. She experienced similar pain and eruptions on the contralateral forehead, the supraorbital counter area, 8 years previous. She had been taking antihypertensive medications for 15 years. She also had suffered from diabetes mellitus. She received a total hysterectomy and anterior posterior colporrhapy due to procidentia uteri and severe cystocele and rectocele. She had been treated intermittently for back pain due to advanced osteoarthritis and spondylosis. She was treated with famciclovir and triamcinolone acetonide with daily stellate ganglion block and supraorbital nerve block. Nortriptyline (a tricyclic antidepressant) and midazolam was prescribed to relieve pain and difficulty in sleeping. After 3 days, all treatment was ended because it was impossible to assess the severity of pain due to the senile psychosis of the patient. She eventually expired after 2 months. We report this case because it is rare for herpes zoster to recur, and particularly on the contralateral counter area.

• The Korean Journal of Physiology and Pharmacology
• /
• 제2권3호
• /
• pp.307-312
• /
• 1998

This study was performed to investigate the mechanism of central analgesic effects of antidepressants. Thirty four male rats were anesthetized with pentobarbital sodium (40 mg/kg, ip). A stainless steel guide cannula and a PE tube (PE10) were implanted into the lateral ventricle and cisterna magna area. Stimulating and recording electrodes were implanted into the incisor pulp and anterior digastric muscle. Electrodes were led subcutaneously to the miniature cranial connector sealed on the top of the skull with acrylic resin. The jaw opening reflex was used in freely moving rats, and antidepressants were administered intracisternally in order to eliminate the effects of anesthetic agents on the pain assessment and evaluate the importance of the central action site of antidepressants. After 48 hours of recovery from surgery, digastric electromyogram (dEMG) of freely moving rats was recorded. Electrical shocks (200 ${\mu}sec$ duration, 0.5-2 mA intensity) were delivered at 0.5 Hz to the dental pulp every 2 minute. Intracisternal administration of $15\;{\mu}g$ imipramine suppressed dEMG elicited by noxious electrical stimulation in the tooth pulp to $76{\pm}6%$ control. Intracisternal administration of $30\;{\mu}g$ desipramine, nortriptyline, or imipramine suppressed dEMG remarkably to $48{\pm}2,\;27{\pm}8,\;or\;25{\pm}5%$ of the control, respectively. Naloxone, methysergide, and phentolamine blocked the suppression of dEMG produced by intracisternal antidepressants from $23{\pm}2\;to\;69{\pm}4%,\;from\;32{\pm}5\;to\;80{\pm}9%,\;and\;from\;24{\pm}6\;to\;77{\pm}5%$ of the control, respectively. These results indicate that antidepressants produce antinociception through central mechanisms in the orofacial area. Antinociception of intracisternal antidepressants seems to be mediated by an augmentation of descending pain inhibitory influences on nociceptive pathways.