- 著者
-
小林 雅文
- 出版者
- Japanese Society of Psychosomatic Dentistry
- 雑誌
- 日本歯科心身医学会雑誌 (ISSN:09136681)
- 巻号頁・発行日
- vol.9, no.1, pp.84-91, 1994-06-25 (Released:2011-09-20)
- 参考文献数
- 11
Cervico-omo-brachial syndrome consists of symptoms that include pain and paralysis extending from the neck, shoulders and arms to the fingers, muscle contracture or hypertonia of these parts and the inhibition of movement at the cervical vertebrae. Although the cause is complicated, it may be produced principally by compression and/or stimulation of the spinal cord and/or nerve root, plexis or periphery. Little literature describes psychogenic intervention in this syndrome. This study describes a case of the syndrome which exhibited psychosomatic influence.Patient: 40 years old housewife.First examination: August 8, 1993Chief complaint: Sensory disturbance of the neck, shoulders and arms together with pain in the mandibular joint produced by “close-bite malocclusion” of metal crowns set on the right and left mandibular molars several years previously.History of present illness: Patient complained of dry mouth, thoracic compression and cardiopalmus in addition to the above-described syndrome, although doctors told her that no abnormal state was found from clinical, physiological and biochemical examinations. Her sickness had changed from stiffness to paralysis after a miscarriage in the previous year, and the paralysis has extended to the arms. The syndrome was not improved during 30 days of taking (p. o.) of tizanidine hydrochloride prescribed by a plastic surgeon.Status praesens: The author advised her to stop taking tizanidine. Her complaint of maladaptation of metal crowns (765 567) was foud to have almost no physical basis when examined orally, including by x-ray. The result of CMI questioning was III.However, the author counseled the patient to accept and bear with her complaint on two occasions for one hour each and also devoted one hour to reassuring the patient that her sickness would heal, making a combined total of 3 hours during the 3 months' therapy. The author also adjusted the occlusion 65 567 65 567 and set the new metal crown at 7 after root canal treatment.Etizolam (0.5mg/tablet) was administered 3 times (1 tablet p. o. every time) per day for 5 days in the first month and 10 days in the second month, and then alprazolam (0.4mg/tablet) was administered twice (1 tablet p. o. every time) per day for 5 days during final week of the second month. Her sickness disappeared for the most part. Three weeks after stopping alprazolam, (0.5mg/tablet) was administered twice (1 tablet each time) per day for 5 days in the third month. Sleeplessness was also improved considerably.Her sickness has not recurred to date, i. e. 7 months since the final treatment.