• Title/Summary/Keyword: persistent pain

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Trigeminal Neuralgia Caused by Persistent Primitive Trigeminal Artery

  • Park, Chang Kyu;Choi, Hyuk Jai;Lee, Sung Ho;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.278-280
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    • 2014
  • A 66-year-old man presented with typical trigeminal neuralgia (TN). Magnetic resonance angiography (MRA) revealed a primitive trigeminal artery (PTA) that came into contact with the trigeminal nerve. Based on MRA, we performed microvascular decompression (MVD). In the operational field, we confirmed the PTA location and performed MVD successfully. Postoperatively, the patient's pain subsided without any complications.

Anaplastic Large Cell Lymphoma of the Duodenum in a Teenage Girl: Misdiagnosed as an Intramural Duodenal Hematoma

  • Sriphongphankul, Hansa;Tanpowpong, Pornthep;Ruangwattanapaisarn, Nichanan;Thirapattaraphan, Chollasak;Treepongkaruna, Suporn
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.571-575
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    • 2019
  • We report a case of a 13-year-old girl who presented with a 2-month history of intermittent abdominal pain. Laboratory examination showed hepatitis and pancreatitis. Because of persistent vomiting, computed tomography (CT) was performed, which revealed a circumferential soft tissue density in the duodenal wall, causing partial obstruction. Supportive therapy failed. Repeat CT showed no significant change from the initial study. The patient underwent upper endoscopy, which revealed a mass in the second portion of the duodenum, which occluded most parts of the lumen. The histopathological finding was consistent with an anaplastic large cell lymphoma, a rare form of small bowel neoplasm. After the third course of chemotherapy, complete resolution of the mass was noted, and her symptoms were relieved.

Is Subtalar Joint Instability an Important Consideration When Treating Ankle Joint Instability? (거골하관절 불안정성이 족관절 불안정성을 치료하는 데 중요한 요소로 작용할까?)

  • Lee, Hyobeom;Kim, Gab-Lae;Kim, Donghyeon
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.38-45
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    • 2021
  • Subtalar joint instability (STI) is one of the causes of persistent hindfoot pain even after treatment for ankle instability. Diagnosis of STI is often neglected because it is a poorly understood concept. However, understanding of the anatomy and injury mechanism of the subtalar joint is a prerequisite of appropriate treatment. Patients with STI usually complain of several symptoms, such as recurrent sprains or a giving way sensation and rolling over. Recently, various diagnostic tools and treatment methods have been investigated. This study was undertaken with the aim of helping clinicians by providing a comprehensive understanding of STI.

Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink

  • Leung, Yiu Yan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.5
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    • pp.233-240
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    • 2019
  • Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.

An unusual complication during arthrocentesis: N. facialis paralysis, with N. lingualis and N. alveolaris inferior anesthesia

  • Aliyev, Toghrul;Berdeli, Eynar;Sahin, Onur
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.2
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    • pp.115-118
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    • 2019
  • This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

Treatment Outcome and Prognosis of the Outpatients with Orofacial Pain (구강안면통증 환자의 치료결과와 예후에 관한 연구)

  • Choi, Sea-Hun;Kim, Ki-Suk;Kim, Mee-Eun;Lee, Dong-Ju;Jin, Sang-Bae
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.155-165
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    • 2006
  • The purpose of this study was to evaluate treatment outcome and prognosis of the patients with orofacial pain disorders who visited for treatment in the Department of Oral Medicine, Dankook University Dental Hospital from January 2002 to December 2004. Orofacial pain disorders were categorized into TMD(myogenous, arthrogenous and muscle-joint combined TMDs), neuropathic pain disorder, oral soft tissue disease and complex condition simultaneously having more and two aforementioned categories and treatment period, method and treatment outcome were evaluated. The results of this study were as follows; 1. Average longevity of treatment period was the longest in the neuropathic pain, followed by soft tissue disease, complex conditions, arthrogenous TMD, muscle-joint combined TMD and myogenous TMD in order. 2. When treatment methods were largely categorized into pharmacologic, physical and oral appliance therapy, pharmacologic therapy was used the most frequently for the patients with neuropathic pain or oral soft tissue diseases, oral appliance therapy for those with arthrogenous TMD and physical therapy for those with myogenous TMD. 3. Of physical therapeutic methods used in our clinic, EAST and microwave was employed the most frequently in the patients with myogenous TMD, ultrasound for those with arthogenous TMD and LLLT for those with neuropathic pain or oral soft tissue disease. 4. In comparison with change of pain after treatment, there existed a tendency that pain from neuropathic pain disorders persisted while pain from TMD was getting better or totally disappeared. 5. Concerning the change of mouth opening range in the TMD subgroups, there was no significant difference among the subgroups but significant difference existed among opening ranges, indicating comfortable maximum mouth opening increased the most following treatment. Improvement of active range of mouth opening was the most considerable in those with disc displacement without reduction. It can be said on the basis of the findings from this study that various treatments currently used for the orofacial pain showed good results with TMD in regards with pain control and improvement of function, suggestive of favorable prognosis, while neuropathic pain or soft tissue disease was the clinical conditions difficult to resolve, requiring a long and persistent treatment.

Effects of Red or Black Ginseng Extract in a Rat Model of Inflammatory Temporomandibular Joint Pain (흰 쥐의 턱관절 염증성 통증모델에서 홍삼 및 흑삼추출물의 효과)

  • Lee, Hyeon-Jeong;Kim, Yun-Kyung;Choi, Ja-Hyeong;Lee, Jung-Hwa;Kim, Hye-Jin;Seong, Mi-Gyung;Lee, Min-Kyung
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.65-72
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    • 2017
  • Temporomandibular joint (TMJ) pain is characterized by persistent jaw pain associated with dysfunction and tenderness of the temporomandibular muscles and joints. The aim of this study was to investigate whether treatment with red or black ginseng extract helps in the modulation of inflammatory TMJ pain. Male Sprague-Dawley rats weighing 220~260 g were used. The experimental group was subdivided into 4 groups based on the treatment method (n=6, each group): formalin (5%, $30{\mu}l$), formalin after distilled water (vehicle), formalin after red or black ginseng extract (per oral, single or repeated, respectively). To induce TMJ pain, $30{\mu}l$ of formalin was injected into the articular cavity under ether inhalation anesthesia. The number of noxious behavioral responses of scratching the facial region proximal to the injection site was recorded for 9 successive 5-min intervals following formalin injection. Repeated treatment with red or black ginseng extract reduced the nociceptive responses in the second phase (11~45 min). Nuclear factor erythroid 2-related factor 2 (Nrf2) is an oxidative stress-mediated transcription factor. Both ginsengs significantly down-regulated the increased Nrf2 level compared to the vehicle group. In the test for liver and kidney functions, repeated treatment with red or black ginseng was not different compared to the vehicle group. These results indicate that red and black ginseng extract might be promising analgesic agents in the treatment of inflammatory TMJ pain.

Botulinum Toxin type A injection Versus Lidocaine Injection for Myofascial Pain Involving upper Trapezius (승모근 근막동통에 대한 보툴리눔 독소와 리도카인 주사의 치료효과 비교)

  • Ahn, Sung-Woo;Park, Eun-Hee;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.345-351
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    • 2005
  • The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.

The Report on Relaxation Therapy Application for Chronic Neck Pain with Tension Myositis Syndrome Trend (긴장성 근육통 증후군으로 인한 만성 경항통 환자에 대한 이완 요법 적용 1례(例))

  • Kim, Gyu-Tae;Kwon, Seung-Ro;Song, Joo-Hyun;Kim, Su-Yong;Lee, Je-Kyun
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.277-285
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    • 2005
  • Tension Myositis Syndrome is defined as the muscle syndromes affected by brain signal as a result of stress. Furthermore, painful muscles cause tensional emotions in body system. Pain is the result of mutual co-operations between the brain and muscles. Unpleasant feelings increase the pain intensity. In addition, painful muscles were seen to have influences on the brain neurological system. Therefore, in spite of physical treatments, chronic pain has a tendency to be persistent and incurable. For psychological cures, We applied deep breathing, muscle relaxation therapy for anxious, sensitive chronic neck pain patient, then we evaluated her Visual Analogue Scale in reference to subjective feelings of pains every other day at 9 PM. In conclusion, We found that deep breathing and muscle relaxations helped reduce the feeling of pains for those who suffered from anxiety, tensional pains. Therefore, relaxation therapies are necessary methods for pain controls as well as physical treatments.

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