Nam Kyung Eun, Kim Joon Sung, Hong Bo Young, Sul Bomi, Choi Hyehoon, Jun So Yeon, Lim Seong Hoon
Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Ann Rehabil Med. 2017 Dec;41(6):1088-1092. doi: 10.5535/arm.2017.41.6.1088. Epub 2017 Dec 28.
Neuropathic pain is usually managed pharmacologically, rather than with botulinum toxin type A (BTX-A). However, medications commonly fail to relieve pain effectively or have intolerable side effects. We present the case of a 62-year-old man diagnosed with an intracranial chondrosarcoma, which was removed surgically and treated with radiation therapy. He suffered from neuropathic pain despite combined pharmacological therapy with gabapentin, amitriptyline, tramadol, diazepam, and duloxetine because of adverse effects. BTX-A (100 units) was injected subcutaneously in the most painful area in the posterior left thigh. Immediately after the injection, his pain decreased significantly from 6/10 to 2/10 on a visual analogue scale. Pain relief lasted for 12 weeks. This case report describes intractable neuropathic pain caused by a brain tumor that was treated with subcutaneous BTX-A, which is a useful addition for the management of neuropathic pain related to a brain tumor.
神经性疼痛通常采用药物治疗,而非A型肉毒毒素(BTX-A)治疗。然而,药物治疗通常无法有效缓解疼痛,或会产生难以忍受的副作用。我们报告一例62岁男性患者,诊断为颅内软骨肉瘤,接受了手术切除及放射治疗。尽管联合使用加巴喷丁、阿米替林、曲马多、地西泮和度洛西汀进行药物治疗,但由于不良反应,他仍遭受神经性疼痛。在左大腿后部最疼痛的区域皮下注射了100单位的BTX-A。注射后,他的疼痛在视觉模拟量表上立即从6/10显著降至2/10。疼痛缓解持续了12周。本病例报告描述了由脑肿瘤引起的顽固性神经性疼痛,通过皮下注射BTX-A进行治疗,这为与脑肿瘤相关的神经性疼痛管理提供了一种有用的补充方法。