Clinical Study on the Case of Patient with Iatrogenic Brachial Plexus Injury after Cervical Lymph Node Biopsy: A Case Report

Article information

J Korean Acupunct Moxib Soc. 2013;30(5):219-226
Publication date (electronic) : 2013 December 20
doi : https://doi.org/10.13045/acupunct.2013061
1Department of Acupuncture & Moxibustion Medicine, Pusan National University Korean Medicine Hospital
2Division of Clinical Medicine, School of Korean Medicine, Pusan National University

This study was supported by the clinical research grant from Pusan National University Hospital in 2013

*Corresponding author : Division of Clinical Medicine, School of Korean Medicine, Pusan National University, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, Republic of Korea Tel : 055-360-5943 Email : kjk@pnu.kr
Received 2013 October 28; Revised 2013 November 22; Accepted 2013 November 27.

Abstract

Objectives:

The purpose of this study is to report the effect of Korean medicine treatment on a patient with brachial plexus injury.

Methods:

The patient with symptoms of pain and dysesthesia on right forearm and hand was treated with acupuncture treatment, herbal medicine, moxibustion and physical treatment. Improvement of the patient`s symptoms was evaluated by Hepatic dullness sound, NRS, VAS, SF-36 bodily pain, grip strength.

Results:

After 42 days of treatment, NRS score significantly decreased. VAS score, SF-36 bodily pain and grip strength showed moderate improvement.

Conclusions:

This results suggest that Korean medicine treatment may be effective in reducing the symptoms of brachial plexus injury.

Fig. 1.

Changes of SF-36 bodily pain

Fig. 2.

Changes of VAS

Fig. 3.

Changes of NRS

Comparison of CMAPs

Comparison of SNAPs

Revised STandards for Reporting Intervention in Clinical Trials of Acupuncture(STRICTA)

Changes of Grip Strength

References

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Article information Continued

Fig. 1.

Changes of SF-36 bodily pain

Fig. 2.

Changes of VAS

Fig. 3.

Changes of NRS

Table 1.

Comparison of CMAPs

Nerve and site Lt Rt
Latency(ms) Amplitude(mV) Latency(ms) Amplitude(mV)
Median Wrist 2.4 12.3 2.3 5.6
Elbow 5.9 12.3 5.9 5.3
Ulnar Wrist 2.4 10.0 2.2 7.8
Below elbow 5.5 7.6 5.3 7.5
Radial Forearm 1.4 4.4 1.4 4.2
Lateral brachium 3.4 3.5 3.2 3.8
Spiral groove 4.5 3.5 4.3 3.8
Musculocutaneous 3.9 5.4 4.3 0.9
Axillary Supraclavicular fossa 2.8 7.2 3.5 3.3

Table 2.

Comparison of SNAPs

Nerve and site Lt Rt
Latency(ms) Amplitude(mV) Latency(ms) Amplitude(mV)
Median Wrist 2.8 34 2.8 26
Ulnar Wrist 3.1 31 2.8 33
Radial Forearm 2.5 28 2.3 28
Lateral cutaneous Elbow 2.3 27 2.9 6

Table 3.

Revised STandards for Reporting Intervention in Clinical Trials of Acupuncture(STRICTA)

1. Acupuncture rationale
1a) Style of acupuncture Soyangin Taegeuk acupuncture (Korean)
1b) Reasoning for treatment provided Based on historical context and literature sources
1c) Extent to which treatment was varied Fixed formula
2. Details of needling
2a) Number of needle insertions per subject per session 6 / 14
2b-1) Names of points used HT3, SP9, KI3, LI4, LI11, ST36 / + LI11, LI10, LI4, TE5, Ex-UE9(Palsa)
2b-2) Uni/bilateral Unilateral
2c) Depth of insertion About 1.5 cm
2d) Response sought De-qi sensation
2e) Needle stimulation Manual stimulation ; rotation with deep breathing / +EA
2f) Needle retention time 20 minutes
2g) Needle type 0.25×40 mm, Dong-bang stainless steel disposable acupuncture needle
3. Treatment regimen
3a) Number of treatment sessions 50
3b) Frequency and duration of treatment sessions Twice daily for 25 days
4. Other components of treatment
4a) Details of other interventions administered to the acupuncture group Dry-cupping, ICT, indirect moxibustion, herbal decoction in accordance with the patient's condition
4b) Setting and context of treatment, including instructions to practitioners, and information and explanations to patients No specific setting or context
5. Practitioner background
5) Description of participating acupuncturists Specialist of acupuncture and moxibustion medicine with more than 30 years of experience
6. Control or comparator interventions No control intervention

Table 4.

Changes of Grip Strength

Grip strength (lbs) 1st Adm 2nd Adm
Admission Discharge Admission Discharge
Rt 8 11 14 16
Lt 31 35 34 30
Deficit Rt −74 % Rt −71 % Rt −58 % Rt −44 %