鍼治療が有効であった舌咽神経痛症例

Effect of Electroacupuncture on Glossopharyngelagia

　はじめに

　舌咽神経痛は1910年Weisenburg^1）によって初めて症例報告がなされた。この症例は後に死後剖検により小脳橋角腫瘍による刺激症状として生じた症候性舌咽神経痛と診断された。原因のはっきりしない，いわゆる特発性舌咽神経痛については1920年Sicardら^2）により報告されたのが最初である。

　この神経痛の特徴は咽頭部，口蓋弓，扁桃部，舌根部，耳深部などの舌咽神経支配領域に誘発点を持つ，限局した反復性の激痛発作を主症状とすることにある。嚥下，会話，くしゃみ，咳，笑い，うがい，痰の喀出，歯を磨くことなどによって誘発される。

A 74-year-old male developed glossopharyngeal pain in the right side in 1985. He had been treated by glossopharyngeal nerve and satellite ganglion blocks with recurrence. Acupuncture was performed at acupoints (LI-4/LI-11, ST-36/GB-38 of both sides and TH-17 of right side) and a pain-point with No.20 needles.

Recutangular electric current was put between paired points at frequency of 2 Hz for 30min. This treatment was performed approximately every 4 days for the first 3 months and every 1-2 weeks for next 2 months and whenever the patient felt pain thereafter. The pain decreased to the level of 10 %, of the original strength and has been suffici-ently controlled until now.

Another case of glossopharyngeal neuralgia due to the elongated styloid process was treated in thesame way without sufficient control of the pain.

The indication and mechanism of elcctroacu-puncture were briefly discussed.