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Treatment of Traumatic Brachial Plexus Injury with Traditional Korean Medicine Focusing on Warm Needling and Bee Venom Injection: A Case Report

Article information

Acupunct. 2015;32(2):229-240
Dae Hyun Jo, Min Soo Kwon, Jung Hwan Kim, Ji Eun Choi, Ji Sun Han, Dong Woo Nam, Do Young Choi, Jae Dong Lee
Department of Acupuncture & Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital
*Corresponding author: Department of Acupuncture & Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, Republic of Korea, Tel: +82-2-958-9202, E-mail: ljdacu@khmc.or.kr
Received 2015 May 15; Revised 2015 May 26; Accepted 2015 May 29.

Abstract

Objectives:

The purpose of this report is to show the effect of complex traditional Korean medical care focused on warm needling(WN) and bee venom(BV) injection for a patient suffering from traumatic brachial plexus injury(BPI).

Methods:

A 51-year-old female patient with BPI was suffering from paresis and hypoesthesia with upper-extremity impairment. The patient had been treated once a day from 4 Feb to 11 Apr of 2015 mainly with WN and BV injection on the acupoints near the distribution of the brachial plexus. Improvement of the symptoms was measured by range of motion(ROM), manual muscle test(MMT) grip strength, and with the numeric rating scale(NRS) of tactile and pain sensitivity.

Results:

After 67 days of treatment, all obtained results showed remarkable improvement. The patient’s satisfaction declaration was recorded through an interview at the end of the treatment.

Conclusions:

The results suggest that anatomically concerned WN and BV treatment can be a valuable option in reducing or normalizing pains from traumatic BPI.

Keywords: BPI; Warm needling; Bee venom; ROM; MMT; NRS
Fig. 1.

MRI images of brachial plexus

With the evidence of preserved neural continuity and mildly stretched nerve roots in this image, patient can be diagnosed as subacute stage of traumatic brachial plexopathy, left

Fig. 2.

Changes in range of motion of shoulder and elbow joints

Bar-graph indicates the counted numbers of the patient’s flexing and extending her own elbow, which was first executed on February 23th.

The ranges of movement of shoulder medial rotation, lateral rotation, elbow extension, wrist extension, wrist flexion were full almost from the start, Feb 7th, thus those results were emitted from this graph.

Fig. 3.

Changes in grasping strength of patient

Proportions of the power between intact right hand and impaired left hand was measured. The fact that the one’s strengths are fluctuating everyday makes these measurements reflect patient’s condition better

Fig. 4.

Changes in numeric rating scale score of tactile sensation

Fig. 5.

Changes in numeric rating scale score of pain sensitivity

Manual Muscle Test

Records of Muscle Manual Test before and During Treatment Period

Appendices

Appendix 1.

Time-table of Present History

Appendix 2.

Record of the Interview

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Article information Continued

Copyright © 2015 KAMMS. Korean Acupuncture & Moxibustion Medicine Society. All rights reserved.

Time-table of Present History

Record of the Interview

Fig. 1.

Fig. 1.

MRI images of brachial plexus

With the evidence of preserved neural continuity and mildly stretched nerve roots in this image, patient can be diagnosed as subacute stage of traumatic brachial plexopathy, left

Fig. 2.

Fig. 2.

Changes in range of motion of shoulder and elbow joints

Bar-graph indicates the counted numbers of the patient’s flexing and extending her own elbow, which was first executed on February 23th.

The ranges of movement of shoulder medial rotation, lateral rotation, elbow extension, wrist extension, wrist flexion were full almost from the start, Feb 7th, thus those results were emitted from this graph.

Fig. 3.

Fig. 3.

Changes in grasping strength of patient

Proportions of the power between intact right hand and impaired left hand was measured. The fact that the one’s strengths are fluctuating everyday makes these measurements reflect patient’s condition better

Fig. 4.

Fig. 4.

Changes in numeric rating scale score of tactile sensation

Fig. 5.

Fig. 5.

Changes in numeric rating scale score of pain sensitivity

Table 1.

Manual Muscle Test

Gr Definition
5 Normal strength
4 Muscle holds the joint against a combination of gravity and moderate resistance
3 Muscle can‘t hold the joint against resistance, but moves the joint fully against gravity
2 Muscle moves the joint when gravity is eliminated
1 A flicker of movements is seen or felt in the muscle
0 No movement

Table 2.

Records of Muscle Manual Test before and During Treatment Period

Motion Date * 1. 16 * 1. 26 2. 4 2. 10 2. 17 2. 23 3. 2 3. 8 4. 10
Shoulder Flexion n.r 1 2 3 3 3+ 3+ 3+ 3
Extension n.r 1 2 2 3 3+ 3+ 3+ 3+
Medial Rotation n.r n.r 2 3 3 3+ 4 4 4
Lateral Rotation n.r n.r 2 3 3 3+ 5 5 5
Abduction 1 1 2 2 2 2 3 3 3
Elbow Flexion 1 2 2 2 3 3 3+ 4 4+
Extension 1 2 1 4 4 4 4+ 4+ 4+
Wrist Flexion 3 3 4 3 4 5 5 5 5
Extension 3 3+ 4 4 4 5 5 5 5
*

tests in these days are executed and recorded in another place, Asan Medical Center in Seoul. n.r: not recorded.