• 대한한방내과학회지
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• 제44권6호
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• pp.1327-1336
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• 2023

This case report presents the effectiveness of Korean medicine in the treatment of occipital neuralgia. The patient with occipital neuralgia was treated with acupuncture. Acupuncture treatment was administered to the occipital nerve area, which is commonly used in occipital nerve blocks by western medicine doctors. The severity of the symptoms was assessed daily using the Numerical Rating Scale (NRS) score of pain. The patient received outpatient treatment a total of 7 times, and only received acupuncture treatment each time. According to the patient, his symptoms decreased by about 90% two days after acupuncture treatment, and the frequency and duration of the symptoms also decreased. Seven days after all acupuncture treatments, the severity of pain was reduced from NRS 6 to NRS 0. The findings of this case report suggest that treatment with Korean medicine can be an effective option for treating occipital neuralgia. Acupuncture can be a good treatment method for occipital neuralgia, along with western drug treatment and occipital nerve block.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• 대한두경부종양학회지
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• 제37권2호
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• pp.77-80
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• 2021

Plexiform neurofibromas (PNFs) represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1), in which neurofibromas arise from multiple nerves as bulging and deforming masses involving connective tissue and skin folds. We report the case of a 17-year-old man with known NF-1 presenting with bilateral occipital neuralgia that began in his late adolescence. His chief complaint was radiating pain in the occiput induced by protective helmet wear when riding alpine skiing. Craniofacial magnetic resonance imaging (MRI) confirmed the presence of fusiform masses arising from the bilateral greater occipital nerves. Histopathological examination of the biopsy samples showed PNFs. After surgical treatment, the patient's symptoms completely improved. Unlike cutaneous neurofibromas, PNFs have different clinical characteristics and have the risk of malignant mutations. Correct diagnosis and adequate surgical treatment are necessary for PNFs.

• The Korean Journal of Pain
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• 제18권1호
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• pp.48-51
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• 2005

Although the atlantoaxial joint is the most common site of rheumatoid arthritis, our patient had no symptoms or signs suggestive of rheumatoid arthritis. The atlantoaxial joint is frequently involved in degenerative osteoarthritis, especially in elderly patients. An 81-year old man presented with severe intermittent electric shock like, lancinating pain from the occipital to the temporal and parietofrontal areas. He also had neck pain and a limited range of motion. After many examinations and laboratory tests, at the department of neurology and neurosurgery, he was diagnosed with idiopathic neuralgia. The diagnosis of atlantoaxial joint syndrome was confirmed, and treated successfully with atlantoaxial joint block.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.238-244
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• 2023

Background: Occipital neuralgia (ON) is an established risk factor for headaches in the posterior cervical region. Several conservative treatments by nerve decompression and pain relief are available for ON, but these treatments have limitations. Acupuncture treatment, which is known to demonstrate analgesic effects, involves various stimulation methods, and several studies have reported their clinical benefit. No recent systematic review (SR) has compared each acupuncture type for ON treatment. Thus, this SR aims to investigate the clinical effectiveness of each acupuncture type for treating ON. Methods: We will identify relevant studies using electronic databases, including EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Korean Studies Information Service System (KISS), Korean Medical Database, KoreaMed, and National Digital Science Library (NDSL) from the inception until August 2023. The primary outcome will include the numerical change of pain symptoms (visual analog scale and numerical rating scale) and effective rate. Safety and secondary outcomes will include adverse events and quality of life. We will compare the conservative treatment with the acupuncture treatment using network meta-analysis. The Cochrane Collaboration "risk of bias" tools will be used to assess the quality of included trials. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to examine the evidence level. Conclusion: This study will provide clinical evidence of several acupuncture types for ON and help clinicians decide on the best.

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.200-204
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• 2014

Objective : To evaluate the incidence of postsurgical sensory complications in patients with scalp masses and classify the locations of them from a surgical standpoint according to anatomical considerations. Methods : A total of 121 patients who underwent surgery for scalp mass were included in this study. The authors reviewed medical records and preoperative radiologic images. We investigated the complications related to sensory changes after procedure. Enrolled patients have been divided into three groups. Group A included patients with tumors above the superior nuchal line (SNL), Group B with tumors within the trapezius muscle area and patients who had tumors on the lateral trapezius muscle area were assigned to Group C. We compared the incidence related to postoperative sensory complications and summarized their additional treatments for these with clinical outcome. Results : There were 12 patients (10%) with sensory complications related on the mass excision site (Group A : 1 patient, Group B : 2 patients, Group C : 9 patients). Six patients were affected with lesser occipital nerve (LON), 2 patients on greater occipital nerve (GON) and 4 patients on GON and LON. Over 6 months after surgery, two of the twelve patients with sensory complications did not have complete recovered pain in spite of proper medications and local chemical neurolysis with 1.0% lidocaine and dexamethasone. Conclusion : Occipital neuropathy should be considered as a complication related excision of scalp mass. The sensory complications are more frequent in Group C because of the anatomical characteristics of the occipital nerves and there were no statistical difference for other variables.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.264-266
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• 2007

Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.