Ganglion Impar Block With Botulinum Toxin Type A for Chronic Perineal Pain -A Case Report-
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Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A. (Korean J Pain 2010; 23: 65-69)
Abstract
Chronic perineal pain is an often encountered problem, which produces a great degree of functional impairment and frustration to the patient and a challenge to the treating physician. The reason for this problem is that the region contains diverse anatomic structures with mixed somatic, visceral and autonomic innervations affecting bladder and bowel control and sexual function. A blockade of nociceptive and sympathetic supply to the perineal region, supplied through the ganglion impar has been shown to benefit patients with chronic perineal pain. Several options to this block have been described that chemical neurolysis, radiofrequency ablation etc. Although the analgesic effect of Botulinum toxin type A (BoNT-A) has long been considered secondary to its action for muscle relaxation, BoNT-A also affects the release of the neurotransmitters that are involved in pain perception. We describe a patient who was successfully given ganglion impar block with BoNT-A. (Korean J Pain 2010; 23: 65-69)
참고문헌 (20)
- Toshniwal GR, "Transsacrococcygeal approach to ganglion impar block for management of chronic perineal pain: a prospective observational study", Pain Physician, 10, pp.661~666 (2007)
- Lee HK, "The effect of ganglion impar block for excessive perianal sweating", Korean J Pain, 8, pp.363~366 (1995)
- Kim SK, "Ganglion impar block in the management of rectal tenesmoid pain", Korean J Pain, 9, pp.226~228 (1996)
- Reig E, "Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain", Pain Pract, 5, pp.103~110 (2005)
- Mahant N, "The current use of botulinum toxin", J Clin Neurosci, 7, pp.389~394 (2000)
- Welch MJ, "Sensitivity of embryonic rat dorsal root ganglia neurons to Clostridium botulinum neurotoxins", Toxicon, 38, pp.245~258 (2000)
- Aoki KR, "Evidence for antinociceptive activity of botulinum toxin type A in pain management", Headache, 43(Suppl 1), pp.9~15 (2003)
- Cui M, "Subcutaneous administration of botulinum toxin A reduces formalin-induced pain", Pain, 107, pp.125~133 (2004)
- Tait RC, "The pain disability index: psychometric properties", Pain, 40, pp.171~182 (1990)
- Ailani J, "The role of nerve blocks and botulinum toxin injections in the management of cluster headaches", Curr Pain Headache Rep, 13, pp.164~167 (2009)
- Carroll I, "Sympathetic block with botulinum toxin to treat complex regional pain syndrome", Ann Neurol, 65, pp.348~351 (2009)
- Jin L, "Treatment of phantom limb pain with botulinum toxin type A", Pain Med, 10, pp.300~303 (2009)
- Park HJ, "The effects of botulinum toxin A on mechanical and cold allodynia in a rat model of neuropathic pain", Can J Anaesth, 53, pp.470~477 (2006)
- Ranoux D, "Botulinum toxin type A induces direct analgesic effects in chronic neuropathic pain", Ann Neurol, 64, pp.274~283 (2008)
- Arezzo JC, "Possible mechanisms for the effects of botulinum toxin on pain", Clin J Pain, 18(6 Suppl), pp.125~132 (2002)
- Bach-Rojecky L, "Central origin of the antinociceptive action of botulinum toxin type A", Pharmacol Biochem Behav, 94, pp.234~238 (2009)
- Mailis A, "Sympathectomy for neuropathic pain", Cochrane Database Syst Rev, 2 (2003)
- Kim HJ, "Effects of botulinum toxin type A on the superior cervical ganglia in rabbits", Auton Neurosci, 102, pp.8~12 (2002)
- Swift A, "The current uses of botulinum toxin", Hosp Med, 64, pp.450~451 (2003)
- Radensky PW, "The estimated cost of managing focal spasticity: a physician practice patterns survey", Neurorehabil Neural Repair, 15, pp.570~68 (2001)