An Insomniac Patient Case with Myasthenia Gravis under Treatment with Prednisolone Successfully Treated with Saikokaryukotsuboreito
10.3937/kampomed.63.251
- VernacularTitle:プレドニゾロン加療中の重症筋無力症患者の不眠症に対して柴胡加竜骨牡蠣湯が奏効した1例
- Author:
Yoshiharu NAKAE
;
Yukie KUMAGAI
;
Takaaki KOSUGE
- Publication Type:Journal Article
- Keywords:
myasthenia gravis;
insomnia;
corticosteroid;
saikokaryukotsuboreito
- From:Kampo Medicine
2012;63(4):251-254
- CountryJapan
- Language:Japanese
-
Abstract:
Benzodiazepines are frequently used for the treatment of insomnia, although these drugs cause dose-related centrally mediated respiratory depression. Moreover, benzodiazepines are contraindicated in patients with my asthenia gravis, so treating myasthenia gravis patients with insomnia is difficult.
A 67-year-old woman developed myasthenia gravis on December 20XX. Her myasthenia gravis went into remission with oral high-dose prednisolone medication and plasma exchange, after which her oral predniso lone medication was continued. On January 20XX+2, she suffered from insomnia. She had poor sleep quality, nocturnal awakenings and middle-of-the-night insomnia. She had high abdominal resistance and fullness, ten derness, and discomfort of the hypochondrium. She was treated with saikokaryukotsuboreito and could then sleep comfortably soon afterwards.
According to the Shang Han Lun, saikokaryukotsuboreito is effective for susceptibility to fright and deliri ous speech. Although our patient had no psychological symptoms such as these, an abdominal palpation examination led to diagnosis of a Sho (indication) for saikokaryukotsuboreito. So we started therapy with saikokaryukotsuboreito and her insomnia began improving immediately. To our knowledge, this is the first report of an insomnia patient with myasthenia gravis successfully treated with saikokaryukotsuboreito. Saiko karyukotsuboreito is not contraindicated in patients with myasthenia gravis. Thus we conclude that saikoka ryukotsuboreito is effective and safe for insomnia patients with myasthenia gravis.
