Longitudinal follow-up of symptom severity of a patient with continuous neuropathic pain assessed by actual drug consumption record

Chiyomi Nagamatsu, Kumiko Nawachi, Atsushi Mine, Kenji Maekawa, Takuo Kuboki

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Abstract

PATIENT: The patient was a 56-year-old female, suffering from severe burning pain in the left maxillary alveolar area. The pain was initiated by periodontal curettage under no local anesthesia. No abnormal local findings in dental X-ray images and no abnormal central nervous system findings in brain magnetic resonance images were observed. Extraction of the tooth temporarily abated her pain, however the pain recurred gradually. Since the observed signs and symptoms of the patient agreed well with the diagnostic standard for continuous neuropathic pain (atypical alveolar pain) of Graff-Radford & Solberg (1992), medications (tricyclic antidepressant, non-steroidal anti-inflammatory drug (NSAID), anxiolytics, topical application of capsacin cream) and supportive psychological therapy have been administered continuously. To measure symptom severity over a long term, daily amounts of taken NSAID and anxiolytics were recorded continuously by the patient in a simple table diary for 7 years. As a result, the total amount of the drugs per month gradually decreased with the passage of time. DISCUSSION AND CONCLUSIONS: Clinical evidence regarding the prognosis of continuous neuropathic pain in the orofacial region is obviously insufficient, making it difficult to inform such patients of their prognosis of the disorder on the basis of clinical evidence. In this report, we have plotted the total amount of drugs taken per month by the patient as a good reference for the pain severity and the results clearly suggest that pain severity decreased with time. This kind of information may help both clinicians and patients for case-based explanation of the disorder.

Original languageEnglish
Pages (from-to)691-696
Number of pages6
JournalNihon Hotetsu Shika Gakkai zasshi
Volume49
Issue number5
Publication statusPublished - 2005

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Neuralgia
Pain
Pharmaceutical Preparations
Anti-Anxiety Agents
Anti-Inflammatory Agents
Tooth Extraction
Curettage
Tricyclic Antidepressive Agents
Local Anesthesia
Signs and Symptoms
Tooth
Magnetic Resonance Spectroscopy
Central Nervous System
X-Rays
Psychology
Brain

Cite this

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title = "Longitudinal follow-up of symptom severity of a patient with continuous neuropathic pain assessed by actual drug consumption record",
abstract = "PATIENT: The patient was a 56-year-old female, suffering from severe burning pain in the left maxillary alveolar area. The pain was initiated by periodontal curettage under no local anesthesia. No abnormal local findings in dental X-ray images and no abnormal central nervous system findings in brain magnetic resonance images were observed. Extraction of the tooth temporarily abated her pain, however the pain recurred gradually. Since the observed signs and symptoms of the patient agreed well with the diagnostic standard for continuous neuropathic pain (atypical alveolar pain) of Graff-Radford & Solberg (1992), medications (tricyclic antidepressant, non-steroidal anti-inflammatory drug (NSAID), anxiolytics, topical application of capsacin cream) and supportive psychological therapy have been administered continuously. To measure symptom severity over a long term, daily amounts of taken NSAID and anxiolytics were recorded continuously by the patient in a simple table diary for 7 years. As a result, the total amount of the drugs per month gradually decreased with the passage of time. DISCUSSION AND CONCLUSIONS: Clinical evidence regarding the prognosis of continuous neuropathic pain in the orofacial region is obviously insufficient, making it difficult to inform such patients of their prognosis of the disorder on the basis of clinical evidence. In this report, we have plotted the total amount of drugs taken per month by the patient as a good reference for the pain severity and the results clearly suggest that pain severity decreased with time. This kind of information may help both clinicians and patients for case-based explanation of the disorder.",
author = "Chiyomi Nagamatsu and Kumiko Nawachi and Atsushi Mine and Kenji Maekawa and Takuo Kuboki",
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T1 - Longitudinal follow-up of symptom severity of a patient with continuous neuropathic pain assessed by actual drug consumption record

AU - Nagamatsu, Chiyomi

AU - Nawachi, Kumiko

AU - Mine, Atsushi

AU - Maekawa, Kenji

AU - Kuboki, Takuo

PY - 2005

Y1 - 2005

N2 - PATIENT: The patient was a 56-year-old female, suffering from severe burning pain in the left maxillary alveolar area. The pain was initiated by periodontal curettage under no local anesthesia. No abnormal local findings in dental X-ray images and no abnormal central nervous system findings in brain magnetic resonance images were observed. Extraction of the tooth temporarily abated her pain, however the pain recurred gradually. Since the observed signs and symptoms of the patient agreed well with the diagnostic standard for continuous neuropathic pain (atypical alveolar pain) of Graff-Radford & Solberg (1992), medications (tricyclic antidepressant, non-steroidal anti-inflammatory drug (NSAID), anxiolytics, topical application of capsacin cream) and supportive psychological therapy have been administered continuously. To measure symptom severity over a long term, daily amounts of taken NSAID and anxiolytics were recorded continuously by the patient in a simple table diary for 7 years. As a result, the total amount of the drugs per month gradually decreased with the passage of time. DISCUSSION AND CONCLUSIONS: Clinical evidence regarding the prognosis of continuous neuropathic pain in the orofacial region is obviously insufficient, making it difficult to inform such patients of their prognosis of the disorder on the basis of clinical evidence. In this report, we have plotted the total amount of drugs taken per month by the patient as a good reference for the pain severity and the results clearly suggest that pain severity decreased with time. This kind of information may help both clinicians and patients for case-based explanation of the disorder.

AB - PATIENT: The patient was a 56-year-old female, suffering from severe burning pain in the left maxillary alveolar area. The pain was initiated by periodontal curettage under no local anesthesia. No abnormal local findings in dental X-ray images and no abnormal central nervous system findings in brain magnetic resonance images were observed. Extraction of the tooth temporarily abated her pain, however the pain recurred gradually. Since the observed signs and symptoms of the patient agreed well with the diagnostic standard for continuous neuropathic pain (atypical alveolar pain) of Graff-Radford & Solberg (1992), medications (tricyclic antidepressant, non-steroidal anti-inflammatory drug (NSAID), anxiolytics, topical application of capsacin cream) and supportive psychological therapy have been administered continuously. To measure symptom severity over a long term, daily amounts of taken NSAID and anxiolytics were recorded continuously by the patient in a simple table diary for 7 years. As a result, the total amount of the drugs per month gradually decreased with the passage of time. DISCUSSION AND CONCLUSIONS: Clinical evidence regarding the prognosis of continuous neuropathic pain in the orofacial region is obviously insufficient, making it difficult to inform such patients of their prognosis of the disorder on the basis of clinical evidence. In this report, we have plotted the total amount of drugs taken per month by the patient as a good reference for the pain severity and the results clearly suggest that pain severity decreased with time. This kind of information may help both clinicians and patients for case-based explanation of the disorder.

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