Dextrose Injection in Treatment of a Patient Who Was Diagnosed with Notalgia Paresthetica: a Case Report
SN Comprehensive Clinical Medicine, cilt.5, sa.1, 2023 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 5 Sayı: 1
- Basım Tarihi: 2023
- Doi Numarası: 10.1007/s42399-023-01565-2
- Dergi Adı: SN Comprehensive Clinical Medicine
- Derginin Tarandığı İndeksler: Scopus
- Anahtar Kelimeler: Dextrose, Neuropathic pain, Notalgia paresthetica, Prolotherapy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Notalgia paresthetica (NP) is a chronic sensory neuropathy of the upper back. It is characterized with hyperpigmented macular lesions and localized pruritus at the medial border of the inferior scapulae. Neuropathic pain occurs mostly between the T2-6 thoracic dermatomal area and the medial scapulae, due to impingement of the posterior branches of the spinal nerves. The etiology of NP is exactly unknown, but degenerative osteophytes at the spine may contribute impingement or chronic irritation to the dorsal branches of the spinal nerves. The treatment of NP is multidisciplinary; various local and systemic drugs can be used but treatment remains disappointing. We presented a 66-year-old male patient with NP successfully treated with dextrose injection in this report. He had a cardiac pacemaker, so we did not use the local anesthetics or antiepileptic drugs for treatment of NP. We administered a total of 10 cc 5% dextrose solution around and inside the hyperpigmented skin lesion on the affected scapulae, subcutaneously and intradermally for treatment of neuropathic back pain. Back pain severity was evaluated with a visual analog scale (VAS). At 1 and 3-week follow-ups, VAS score decreased from 9 to 4 and 2, respectively. Five percent dextrose injection was repeated by the same technique and dosage when the patient came to the controls. At six months’ control, the patient was symptom-free and VAS score was 0. Dextrose injection may be a promising novel treatment option of patients with comorbid diseases, especially cardiac diseases, in patients with NP.