OBJECTIVETo compare therapeutic effects of catgut implantation at acupoint plus small dose of Paroxetine Hydrochloride and simple Paroxetine Hydrochloride.

METHODSEighty-eight cases of such disease were divided into 2 groups, a treatment group (n=54) and a control group (n=34). The treatment group were treated with catgut implantation at main points Dazhui (GV 14), Zhongwan (CV 12), Tianshu (ST 25), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), etc., plus oral administration of small dose of Paroxetine Hydrochloride; and the control group were treated with simple Paroxetine Hydrochloride. They were treated for 6 weeks. Hamilton Depression Rating Scale (HAMD) was used for assessment of the therapeutic effect.

RESULTSThe effective rate was 92.6% in the treatment group and 85.3% in the control group with a significant difference between the two groups (P < 0.05); at the end of the first week and the second week of treatment, the score for HAMD in the treatment group significantly decreased as compared with that in the control group (P < 0.01).

CONCLUSIONCatgut implantation at acupoint plus small dose of Paroxetine Hydrochloride has a better therapeutic effect on somatic form disorders.

Acupuncture Points ; Adult ; Catgut ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Somatosensory Disorders ; therapy

BACKGROUND: Herpetic disorders cause pain and skin lesion. So, asymmetric temperature of both sides of the involving dermatome has been reported in thermogram. This study examined the usefulness of infrared thermography for a predictor of post-herpetic neuralgia (PHN). METHODS: Patients with acute herpes zoster who underwent nerve block were randomly selected. Biographic data, including age, gender and times of onset of the skin lesions, development of PHN, combined diseases were recorded. Infrared thermography was performed and subjective pain severity, dysesthesia and allodynia, skin lesion size were assessed. RESULTS: The temperature differences between the lesion site and the contralateral site at lateral and posterior were significantly correlated with lesion size (P < 0.01) and the temperature differences at anterior and lateral site were correlated with duration of disease (ant: P < 0.01, lat: P < 0.05). The temperature differences were not correlated with the pain severity, dysesthesia and allodynia (P > 0.05). PHN was correlated with skin lesion size and infrared thermal imaging (P < 0.01). CONCLUSIONS: Infrared thermal imaging cannot demonstrate subjective pain objectively in herpes zoster. Short duration showed high temperature on the lesion sites compared to the contralateral sites. The patients with big skin lesions developed PHN more. The PHN can be predicted by the infrared thermal imaging as low temperature on the lesion site compared to the contralateral site.
Herpes Zoster* ; Humans ; Hyperalgesia ; Nerve Block ; Neuralgia ; Paresthesia ; Skin ; Thermography

BACKGROUND AND PURPOSE: Whether or not migraine can cause cumulative brain alterations due to frequent migraine-related nociceptive input in patients is largely unclear. The aim of this study was to characterize longitudinal changes in brain activity between repeated observations within a short time interval in a group of female migraine patients, using resting-state functional magnetic resonance imaging. METHODS: Nineteen patients and 20 healthy controls (HC) participated in the study. Regional homogeneity (ReHo) and functional interregional connectivity were assessed to determine the focal and global features of brain dysfunction in migraine. The relationship between changes in headache parameters and longitudinal brain alterations were also investigated. RESULTS: All patients reported that their headache activity increased over time. Abnormal ReHo changes in the patient group relative to the HC were found in the putamen, orbitofrontal cortex, secondary somatosensory cortex, brainstem, and thalamus. Moreover, these brain regions exhibited longitudinal ReHo changes at the 6-week follow-up examination. These headache activity changes were accompanied by disproportionately dysfunctional connectivity in the putamen in the migraine patients, as revealed by functional connectivity analysis, suggesting that the putamen plays an important role in integrating diverse information among other migraine-related brain regions. CONCLUSIONS: The results obtained in this study suggest that progressive brain aberrations in migraine progress as a result of increased headache attacks.
Brain Stem ; Brain* ; Female ; Follow-Up Studies ; Headache ; Humans ; Longitudinal Studies* ; Magnetic Resonance Imaging ; Migraine Disorders* ; Putamen ; Somatosensory Cortex ; Thalamus

The pain associated with acute herpes zoster is neuropathic. In this case report, we describe acute herpes zoster patients with severe pain, allodynia, and hyperesthesia over the T1 to T8 dermatomes. Patients received continuous epidural administration of ketamine at a dose of 20 mg with 0.125% bupivacaine at a dose of 110 ml for 2 days. Their acute herpes zoster pain was controlled without any sign of side effects. This case report, epidural blocks with ketamine, an antagonist of the N-methyl-D-aspartic acid receptor and bupivacaine effectively in treated acute herpes zoster pain, when applied soon after the onset of the acute phase of the disease.
Anesthetics, Local* ; Bupivacaine ; Herpes Zoster* ; Humans ; Hyperalgesia ; Hyperesthesia ; Ketamine* ; N-Methylaspartate

No abstract available.
Hyperalgesia

Guillain-Barre syndrome (GBS) and syringomyelia are diseases of different entities. GBS is an acute post-infectious autoimmune disease which is mediated by autoantibodies against the myelin of peripheral nerves. Syringomyelia is a chronic disease characterized by a cavity extending longitudinally inside the spinal cord. A 67-year-old man is being hospitalized due to severe numbness and ascending weakness in all limbs. On neurological examination, the motor power of all limbs are decreased and show absence of deep tendon reflexes (DTRs). The patient is being diagnosed with GBS on the basis of the acute clinical course, nerve conduction studies of segmental demyelinating polyneuropathy, and a finding of albuminocytologic dissociation in the cerebrospinal fluid. The patient is presented with a new set of symptoms thereafter, which composes of sensory changes in the upper extremities, the urinary dysfunction including frequency and residual urine, spastic bilateral lower extremities, and increased reflexes of the knee and the biceps at follow-up examinations. The spinal magnetic resonance imaging in the sagittal section revealed a syrinx cavity between the fifth cervical and the first thoracic vertebral segment in the cord. The somatosensory evoked potential show sensory pathway defects between both the brachial plexus and the brain stem. Thus, this patient is being diagnosed with both GBS and syringomyelia. We report a case of symptomatic syringomyelia coexisting with GBS. Since the GBS is presented with a progressive muscle weakness and reduced DTRs, the muscle weakness and stiffness in the extremities suggests a concurrent syringomyelia might be easily overlooked.
Aged ; Autoantibodies ; Autoimmune Diseases ; Brachial Plexus ; Brain Stem ; Chronic Disease ; Dissociative Disorders ; Evoked Potentials, Somatosensory ; Extremities ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Hypesthesia ; Knee ; Lower Extremity ; Magnetic Resonance Imaging ; Muscle Spasticity ; Muscle Weakness ; Myelin Sheath ; Neural Conduction ; Neurologic Examination ; Peripheral Nerves ; Polyneuropathies ; Reflex ; Reflex, Stretch ; Spinal Cord ; Syringomyelia* ; Upper Extremity

OBJECTIVE: The purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal cord stimulation (SCS) trial. METHODS: A retrospective review of the failed trials (44 patients, 36.1%) among the patients (n=122) who underwent SCS trial between January 1990 and December 1998 was conducted. We reviewed the causes of failed trial stimulation, age, sex, etiology of pain, type of electrode, and third party support. RESULTS: Of the 44 patients, 65.9% showed unacceptable pain relief in spite of sufficient paresthesia on the pain area with trial stimulation. Four of six patients felt insufficient paresthesia with stimulation had the lesions of the spinal cord. Seventy five percent of the patients experienced unpleasant or painful sensation during stimulation had allodynia dominant pain. Third-party involvement, sex, age and electrode type had no influence on the outcome. CONCLUSION: We conclude that SCS trial is less effective for patients with neuropathic pain of cord lesions, postherpetic neuropathy or post-amputation state. Further, patients with allodynia dominant pain can feel unpleasant or painful during trial stimulation.
Chronic Pain ; Electrodes ; Humans ; Hyperalgesia ; Neuralgia ; Paresthesia ; Retrospective Studies ; Sensation ; Spinal Cord ; Spinal Cord Stimulation

Adrenomyeloneuropathy (AMN), one of the variants of X-linked adrenoleukodystrophy (ALD), is inherited peroxisomal disorder associated with the accumulation of very long chain fatty acids (VLCFA). AMN is characterized primarily by involvements of long ascending and descending tracts of the spinal cord and peripheral neuropathy, which leads to spastic paraparesis and urinary and erectile dysfunction. We experienced the AMN case of a 33-year-old man presenting bilateral progressive spastic paraparesis, impotence and urge incontinence with primary adrenal failures, as confirmed by increased serum of VLCFA concentrations. Considering that somatosensory evoked potentials in posterior tibial nerve was the only abnormal finding in electrophysiologic findings when compared with the severe spastic gait pattern shown, it is necessary to follow up with electrophysiologic studies.
Adrenal Insufficiency ; Adrenoleukodystrophy ; Erectile Dysfunction ; Evoked Potentials, Somatosensory ; Fatty Acids ; Gait Disorders, Neurologic ; Male ; Paraparesis, Spastic ; Peripheral Nervous System Diseases ; Peroxisomal Disorders ; Spinal Cord ; Tibial Nerve ; Urinary Incontinence, Urge

BACKGROUND AND PURPOSE: Nicergoline is an ergoline derivative that is used to treat cognitive deficits in cerebrovascular disease and various forms of dementia. Although therapeutic effects of nicergoline have been established, little is known about its effects on cerebral perfusion in Alzheimer's disease (AD). The aim of this study was to examine the role of nicergoline in regional cerebral blood flow (rCBF) of AD patients using technetium-99m hexa-methyl-propylene-amine-oxime single photon emission computed tomography (SPECT). METHODS: Sixteen patients with early AD underwent a comprehensive clinical assessment including cognitive testing and SPECT scans before and after nicergoline treatment. Nicergoline (30 mg twice daily) was administered for an average duration of 1.5 years. Clinical and cognitive functioning was assessed using the Mini-Mental State Examination, Clinical Dementia Rating (CDR), CDR-Sum of Boxes, Global Deterioration Scale, Barthel Activities of Daily Living Index, Instrumental Activities of Daily Living, and Geriatric Depression Scale. RESULTS: Nicergoline treatment induced changes in the severity of dementia, cognitive function, activities of daily living, and depressive symptoms, which were not statistically significant. During the follow-up, the patients showed significant increases in their relative rCBF in the superior frontal gyrus, precentral gyrus, and postcentral gyrus. CONCLUSIONS: Nicergoline treatment improves perfusion of the frontal and parietal regions in early AD patients. It is possible that the increased perfusion in the superior frontal gyrus may be related to the mechanisms that delay or prevent progressive deterioration of cognitive functions in AD.
Activities of Daily Living ; Alzheimer Disease* ; Cerebrovascular Circulation ; Cerebrovascular Disorders ; Cognition ; Cognition Disorders ; Dementia ; Depression ; Ergolines ; Follow-Up Studies ; Frontal Lobe ; Humans ; Nicergoline* ; Parietal Lobe ; Perfusion* ; Pilot Projects* ; Prefrontal Cortex ; Somatosensory Cortex ; Therapeutic Uses ; Tomography, Emission-Computed, Single-Photon

A pure extradural spinal arteriovenous malformation, in the absence of a vertebral body hemangioma, is extremely rare. 33-year-old male presented with spinal extradural arteriovenous malformation(AVM) that caused compressive radiculo- pathy of the L4 nerve root in the left side. The initial symptoms were presented to pain in the left leg and low back pain. Neurological examination showed paresthesia and hyperalgesia in the anterolateral aspect of the left thigh and in the medial to lateral aspect of the left lower leg as like a case of L4 root compression of suspiciously acute disc herniation. MRI showed a mass like a central protruding disc at L3-4 combined with a cystic mass with no specific findings in the vertebral body, and no evidence of vascular abnormality. The spinal extradural AVM was excised with laminectomy. The patient recovered completely from the initial signs and symptoms.
Arteriovenous Malformations ; Hemangioma ; Humans ; Hyperalgesia ; Intervertebral Disc ; Laminectomy ; Leg ; Low Back Pain ; Male ; Neurologic Examination ; Paresthesia ; Radiculopathy ; Thigh