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KMID : 0391520060140010146
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Journal of the Korean Child Neurology Society
2006 Volume.14 No. 1 p.146 ~ p.152
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A Case of Thalamic Pain Syndrome after Meningoencephalitis.
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Chi Hye-Mi
Kwahk Jae-Hyok
Lee Cho-Ae
Chae Kyu-Young
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Abstract
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Thalamic pain syndrome is a type of central pain caused by damage to both thalami and produces persistent and intractable pain; extreme burning or aching sensation by light touch, even without external stimuli. In adults, thalamic pain syndrome occurred in vascular diseases such as a stroke, but in children, it was reported that infectious diseases-upper respiratory infection or meningitis-were usually preceded by development of central pain syndrome. This paper reports on a 12 year old boy with meningoencephalitis followed by evolving to thalamic pain syndrome 10 days later, who suffered from hypersensitivity and severe generalized pain on his whole body. On the brain MRI, both medial temporal lobes showed increased signal intensity, worse on the right side. A combination therapy of intravenous ketamine, amitriptyline and gabapentine for intensive pain control markedly reduced the pain and hypersensitivity in about 1 month. On the following brain SPECT, a strong focal perfusion at the right temporo-parietal cortex area was nearly normalized compared to previous one.
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KEYWORD
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Thalamic pain syndrome, Meningoencephalitis
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