• Title/Summary/Keyword: Neuropathic

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Donor-Site Morbidity Analysis of Thenar and Hypothenar Flap

  • Dong Chul Lee;Ho Hyung Lee;Sung Hoon Koh;Jin Soo Kim;Si Young Roh;Kyung Jin Lee
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.94-101
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    • 2024
  • Background For the small glabrous skin defect, Thenar and Hypothenar skin are useful donors and they have been used as a free flap. Because of similar skin characteristics, both flaps have same indications. We will conduct comparative study for the donor morbidity of the Free thenar flap and Hypothenar free flap. Methods From January 2011 to December 2021, demographic data, characteristics of each flap, and complications using retrospective chart review were obtained. Donor outcomes of the patient, who had been followed up for more than 6 months, were measured using photographic analysis and physical examination. General pain was assessed by Numeric Rating Scale (NRS) score, neuropathic pain was assessed by Douleur Neuropathique 4 Questions (DN4) score, scar appearance was assessed by modified Vancouver Scar Scale (mVSS), and patient satisfaction was assessed on a 3-point scale. Statistical analysis was performed on the outcomes. Results Out of the 39 survey respondents, 17 patients received Free thenar flaps, and 22 patients received Hypothenar free flaps. Thenar group had higher NRS, DN4, and mVSS (p < 0.05). The average scores for the Thenar and Hypothenar groups were 1.35 and 0.27 for NRS, 2.41 and 0.55 for DN4, and 3.12 and 1.59 for mVSS, respectively. Despite the Hypothenar group showing greater satisfaction on the 3-point scale (1.82) compared with the Thenar group (1.47), the difference was not significant (p = 0.085). Linear regression analysis indicated that flap width did not have a notable impact on the outcome measures, and multiple linear regression analysis revealed no significant interaction between flap width and each of the outcome measures. Conclusion Despite the limited number of participants, higher donor morbidity in general pain, neuropathic pain, and scar formation was noted in the Thenar free flap compared with the Hypothenar free flap. However, no difference in overall patient satisfaction was found between the two groups.

The Relation of Restless Legs Syndrome with Diseases of Peripheral Nerves (말초신경질환과 하지불안증후군의 연관성에 관하여)

  • Hong, Yoon-Ho
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.101-103
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    • 2008
  • Many neurologists, particularly whose subspecialty is in peripheral neurology, may agree that patients with peripheral neuropathy often complain of the "restless legs" symptoms. These symptoms seem to share the typical features of the so-called "restless legs syndrome (RLS)", i.e., unpleasant sensations in the leg/feet, worsening in the evening or at night, and the partial relief of the positive sensory symptoms by the movements such as walking, shaking or rubbing. In fact, a higher incidence of RLS was reported among the neuropathic patients, and peripheral neuropathy was found to be more prevalent in patients with RLS than in general population. Moreover, RLS share many risk factors with peripheral neuropathy such as diabetes, uremia, amyloidosis and cryoglobulinemia, which suggests that peripheral neuropathy may play a pathophysiologic role in the development of RLS.

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A case report of a Phantom Limb Pain (PLP) patient treated with integrative Korean and Western medicine

  • Lee, Heun Ju;Baek, Ji Young;Ahn, Chang Beohm
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.101-107
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    • 2017
  • Objectives : We report a case of Phantom Limb Pain (PLP) and propose the possibility of integrative Korean and Western medicine in PLP treatment. Methods : For 42 days, a patient who complained of pain and insomnia with PLP (December 20, 2016 to January 20, 2017) received Korean and Western medical treatment. The patient was treated with analgesic injection, a neuropathic pain inhibitor, the combined herbal formula powders Bojungikgitang, and acupuncture. Symptom improvement was assessed using the numerical rating scale (NRS) and continuous sleep time. Results : The patient's NRS scores decreased, and continuous sleep time increased after treatment. The NRS scores decreased from 10 to 0, and the continuous sleep time increased from 2 hours to 7 to 8 hours. Conclusion : According to the results, this report suggests that integrative Korean and Western medicine could be effective in the treatment of PLP patients.

Effect of Placental Extract on Immobilization of Shoulder Joint in a Complex Regional Pain Syndrome Patient (복합국소통증증후군 환자의 견관절 운동제한에 미치는 자하거 가수분해물 약침요법의 효과)

  • Cho, Tae-Hwan;Park, Kyeong-Mee
    • Journal of Acupuncture Research
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    • v.29 no.4
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    • pp.93-97
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    • 2012
  • Complex regional pain syndrome type 1(CRPS 1) is a neuropathic pain disorder that accompanies severe pain and motor deficit as well as changes in the skin in the extremities. The pathophysiology of CRPS 1 is still not exactly elucidated. However, the general consensus of involvement of inflammatory mediators in the development of CRPS 1 is amply made. On the basis that placental extract successfully inhibited the production of inflammatory cytokines and mediators in several experimental models, we have tried a long-term weekly injection of placental extract into acupuncture points to a CRPS 1 patient suffering pain and immobilization of shoulder joint. The results say that placental extract effectively resolved pain, restored skin color and improved immobilization of shoulder joint in the CRPS 1 patient.

Two Stage Procedure with a Temporary Antibiotic-impregnated Cement Spacer of Infected Hallux Interphalangeal Joint (A Case Report) (항생제 혼합 시멘트 충전물을 이용한 감염된 족무지 지관절의 2단계 치료(1예 보고))

  • Chae, Soo-Uk;Kim, Yeung-Jin;Song, Ha-Heon;Kim, Jong-Yun
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.135-139
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    • 2012
  • The interphalangeal joint (IPJ) of the hallux has received little attention compared with the first metatarsophalangeal joint. But, the hallucal IPJ has several disorders such intra-articular fractures, dorsal dislocation, alignment disorder, and inflammatory or degenerative arthritis. Among these disorders septic arthritis of the IPJ of the hallux is rare. We report a case of sepsis of the hallucal IPJ and adjacent underlying osteomyelitis without neuropathic problem and was performed through infected soft tissue and osseous debridement, temporary antibiotic-impregnated cement spacer, and delayed intercalary allogenic fibular bone graft with K-wire fixation.

Temporary Facial Nerve Paralysis after Post-op Edema -A Case Report - (일시적 안면신경마비 -증례보고-)

  • Lim, Byung-Sup;Hwang, Kyung-Gyun;Shim, Kwang-Sup
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.5 no.2 s.9
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    • pp.112-116
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    • 2005
  • Facial nerve paralysis following delayed complication after trauma was rare and hard to find reason After symptom of facial nerve paralysis was found, careful clinical and neuropathic investigation needed through electromyography and nerve conduction velocity. It is necessery to Hewing that functional degenaration of nerve conduction was irresible or not. It is important to determine if palsy is already present alter trauma or some later time because origin of viral infection or temperature change may possible.

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The Effect of Epidural Ketamine in Complex Regional Pain Syndrome Occuring after Lumbar Epidural Block -A case report- (요부경막외차단술 후 발생한 복합부위 통증증후군에서의 경막외 Ketamine의 효과 -증례 보고-)

  • Ock, Kyung-Jong;Han, Kyung-Rim;Kim, Jin-Soo;Kim, Chan;Kim, Eun-Young
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.251-254
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    • 2000
  • A 20-year-old male patient developed severe right leg pain, hyperesthesia and allodynia after multiple lumbar epidural blocks. His pain was neuropathic pain (complex regional pain syndrome type I). The patient was treated with repeated administration of epidural ketamine at the rate of 0.2~0.7 mg/kg on multiple occasions. Complete relief of pain was achieved.

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Congenital Insensitivity to Pain and Anhidrosis Masquerading as a Chronic Osteomyelitis of the Talus (A Case Report) (족관절부의 만성 골수염으로 오인된 유전성 감각 및 자율신경병증 제 4형 환아(1예 보고))

  • Shin, Yong-Woon;Chung, Hyung-Jin;Oh, Jong-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.203-206
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    • 2009
  • We experienced a case of congenital insensitivity to pain with anhidrosis mimicking a chronic osteomyelitis of the talus, with recurrent ankle swelling and intermittent fever. He was misdiagnosed as low virulence osteomyelitis at other hospital in annual recurrence for 3 years. A Charcot joint in children is a very rare condition and diagnosis should be made in a careful approach.

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Ilioinguinal and Iliohypogastric Nerve Block for Neuropathic Pain Following the Laparoscopic Surgery -A case report- (복강경 수술후 발생한 신경병증성 통증 치료를 위한 장골서혜신경 및 장골하복신경 차단 -증례 보고-)

  • Choy, Yoon-Keun;Kim, Myoung-Hee;Jo, Dae-Hyun;Kim, In-Hyun
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.124-126
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    • 1998
  • As laparoscopic surgery becomes more popular, various complications following the laparoscope are also increasing. Nerve injury following the laparoscope is an infrequent but serious complication for both the doctor and patient. A 30-year old female patient suffered severe burning pain of the left buttock, inguinal area, external genitalia and inner side of vagina following laparoscopic surgery for ovarian mass. We successfully treated this patient with ilioinguinal, iliohypogastric nerve block in combination with epidural blocks.

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Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases

  • Ghai, Babita;Dhiman, Deepanshu;Loganathan, Sekar
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.215-220
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    • 2018
  • Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1-2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.