• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1058-1069
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• 2018

Neuropathic cancer pain (NCP) is caused by nerve damage attributable to the cancer per se, and/or treatments including chemotherapy, radiotherapy, and surgery; the prevalence is reported to be as high as 40%. The etiologies of NCP include direct nerve invasion or nerve compression by the cancer, neural toxicity, chemotherapy, and radiotherapy. NCP is subdivided into plexopathy, radiculopathy, and peripheral neuropathies, among several other categories. The clinical characteristics of NCP differ from those of nociceptive pain in terms of both the hypersensitivity symptoms (burning, tingling, and an electrical sensation) and the hyposensitivity symptoms (numbness and muscle weakness). Recovery requires several months to years, even after recovery from injury. Management is complex; NCP does not usually respond to opioids, although treatments may feature both opioids and adjuvant drugs including antidepressants, anticonvulsants, and anti-arrhythmic agents, all of which improve the quality-of-life. This review addresses the pathophysiology, clinical characteristics and management of NCP, and factors rendering pain control difficult.

• Journal of Oral Medicine and Pain
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• v.47 no.3
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• pp.152-155
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• 2022

Lingual dystonia is an uncommon focal type of oromandibular dystonia that only affects the tongue. Although the use of several treatment modalities has been attempted to reduce involuntary tongue movements, such as anticonvulsants and anticholinergics, the results do not seem promising, and the efficacy of such treatments is unpredictable among patients. This case report describes botulinum toxin injection for a patient with lingual dystonia with favorable clinical results. Botulinum toxin injection to the muscles of the tongue could be an alternative treatment option for lingual dystonia.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.54-58
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• 2022

Superficial peroneal nerve (SPN) injuries happen occasionally during surgical treatment of fibular fracture, lateral ankle ligament repair, etc. These injuries are caused because of the variable location of the SPN. It is the injuries are usually treated by steroid injections or anticonvulsants. However, neural symptoms may not respond to treatment and may persist and progress to a painful neuroma. Intractable pain may need surgical treatment. We examined two cases of iatrogenic postoperative SPN injury, and we treated them with transection of the SPN and the intraosseous transposition of the proximal nerve stump using the thrombin-fibrinogen complex with satisfactory outcomes. We report these two cases with a review of the relevant literature.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.210-216
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• 2021

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

• The Journal of Internal Korean Medicine
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• v.23 no.2
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• pp.268-273
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• 2002

Anticonvulsant hypersensitivity syndrome includes fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis, but its mechanism remains unknown. Anticonvulsants including phenytoin, carbamazepine can cause hypersensitivity reaction. We treated a patient who had severe itching sensation and insomnia: he had undergone an operation for cerebral hemorrhage and was administered anti-convulsant agents to prevent convulsions. We administered the anti-convulsant, Dangkwieumja(Dangguiyinzi). After the treatment, clinical symptoms caused by hypersensitivity were improved.

• The Journal of the Korean dental association
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• v.48 no.9
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• pp.688-695
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• 2010

Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

• Journal of Pharmaceutical Investigation
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• v.29 no.1
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• pp.47-53
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• 1999

Gastrodia elata (GE) is an oriental medicinal herb which has been used traditionally for the treatment of various brain diseases including convulsion and epilepsy. The purpose of this study was to determine pharmacokinetic parameters of 4-hydroxy-3-methoxybenzaldehyde (HMBA) and p-hydroxybenzaldehyde (PHBA), constituents of GE, in rats. Male rats were cannulated in the femoral vein, femoral artery, bile duct and ureter. They received a single i.v. bolus dose of either HMBA or PHBA through the femoral vein. The concentration of HMBA or PHBA in plasma, bile and urine samples were analyzed by reversed-phase HPLC. HMBA and PHBA have very short half-lives, i.e. 4.03 and 2.26 minutes respectively. Most of HMBA and PHBA were thought to be eliminated through metabolism as the metabolized fraction approaches unity. Derivatives of HMBA or PHBA with longer biological half-lives should be designed to develop better anticonvulsants and more complete qualitative and quantitative understanding of the overall pharmacokinetic fate of these compounds awaits further investigation.

• CELLMED
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• v.3 no.4
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• pp.29.1-29.11
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• 2013

Certain dietary contents, biological supplements might influence the occurrence or treatment of epilepsy. Some studies have found that the supplementation with individual nutrients reduced seizure frequency or improved other aspects of health in patients with epilepsy. Potentially beneficial dietary interventions include treating blood glucose dysregulations. Identifying and avoiding allergenic foods, and avoiding suspected triggering agents such as alcohol, aspartame, and monosodium glutamate. The Atkins diet (very low in carbohydrates) is a less restrictive type diet that may be effective in some cases. Nutrients that may reduce seizure frequency include vitamin B6, magnesium, vitamin E, manganese, taurine, dimethylglycine, and omega-3 fatty acids. Administration of thiamine may improve cognitive function in patients with epilepsy. Supplementation with folic acid, vitamin B6, biotin, vitamin D, and L-carnitine may be needed to prevent or treat deficiencies resulting from the use of anticonvulsant drugs. Vitamin K1 has been recommended near the end of pregnancy for women taking anticonvulsants. Melatonin may reduce seizure frequency in some cases, and progesterone may be useful for women with cyclic exacerbations of seizures. In most cases, nutritional therapy is not a substitute for anticonvulsant medications. However, in selected cases, depending on the effectiveness of the interventions, dosage reductions or discontinuation of medications may be possible. However, nutrient supplementation may be necessary to prevent or reverse the effects of certain deficiencies that frequently result from the use of antiepileptic drugs.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.286-289
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• 2010

A 55-year old woman with advanced stage non-small cell lung cancer was admitted to hospital for the management of severe chest pain, which measured 7 out of 10 on a numerical rating scale (NRS). Despite palliative radiation and the application of multiple epidural blocks, she continued to experience severe cancer pain. We gradually increased the dose of transdermal fentanyl patches from $500{\mu}g/hr$ to $3,650{\mu}g/hr$, for 3 months without any significant side effects. Concomitantly, adjuvant therapy with antidepressants and anticonvulsants were added, decreasing the patient's pain to NRS 3~4 down from 7. After being transferred to a hospice clinic, her chest pain was well-controlled below NRS 4 by means of strong opioid medications, including the highest dose of transdermal fentanyl $4,050{\mu}g/hr$ for more than 16 months.

• Bulletin of the Korean Chemical Society
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• v.32 no.2
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• pp.576-582
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• 2011

Various 2-amino-6-[3-(substituted phenyl)-5-phenyl-4,5-dihydropyrazol-1-yl]-4-(substituted phenyl)nicotinonitriles (3a-t) were designed and synthesized by clubbing two active anticonvulsant pharmacophores pyrazole and pyridine. All the synthesized compounds possessed the pharmacophoric elements essential for good anticonvulsant activity. The anticonvulsant screening was performed by maximal electroshock seizure (MES) and subcutaneous pentylenetetrazole (scPTZ) tests. Two compounds 3i and 3s showed significant anticonvulsant activity in both the screens with $ED_{50}$ values 17.5 mg/kg and 22.6 mg/kg respectively in MES screen and 154.1 mg/kg and 242.6 mg/kg respectively in scPTZ screen. They were also found to have no acute toxic effects in mice when tested at elevated doses.