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Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused by Subacute Myelo-Optico-Neuropathy: A Case Report.
Case Rep Neurol. 2020 May-Aug; 12(2):169-174.CR

Abstract

Subacute myelo-optico-neuropathy (SMON) is caused by the ingestion of clioquinol (5-chloro-7-iodo-8-hydroxyquinoline), which is an intestinal antibacterial drug. Patients with SMON typically suffer from abnormal dysesthesia in the lower limbs, which cannot explain the mechanism only in pathology and electrophysiology. Neuromodulation therapies are increasingly being investigated as a means of alleviating abnormal sensory disturbances. We report here the response to repetitive transcranial magnetic stimulation (rTMS) for dysesthesia in a patient with SMON. The patient underwent rTMS treatment once per week for 12 weeks. rTMS was administered at 10 Hz, 90% of the resting motor threshold over the bilateral primary motor cortex foot area, for a total of 1,500 stimuli per day. After the treatment had finished at 12 weeks, the abnormal dysesthesia gradually declined. At first, there were improvements only in the area with a feeling of adherence. Later, this sensation was eliminated. Three months following the application, most of the feeling of adherence had disappeared and the feeling of tightness was slightly reduced. In contrast, the throbbing feeling had not changed during this period. Dysesthesia may indicate a process of central sensitization, which would contribute to chronic neuromuscular dysfunction. This case suggests that rTMS is a promising therapeutic application for dysesthesia.

Authors+Show Affiliations

Department of Neurology, Nara Medical University, Kashihara, Japan.Department of Neurology, National Hospital Organization Suzuka National Hospital, Suzuka, Japan.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32595479

Citation

Mano, Tomoo, and Satoshi Kuru. "Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused By Subacute Myelo-Optico-Neuropathy: a Case Report." Case Reports in Neurology, vol. 12, no. 2, 2020, pp. 169-174.
Mano T, Kuru S. Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused by Subacute Myelo-Optico-Neuropathy: A Case Report. Case Rep Neurol. 2020;12(2):169-174.
Mano, T., & Kuru, S. (2020). Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused by Subacute Myelo-Optico-Neuropathy: A Case Report. Case Reports in Neurology, 12(2), 169-174. https://doi.org/10.1159/000507650
Mano T, Kuru S. Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused By Subacute Myelo-Optico-Neuropathy: a Case Report. Case Rep Neurol. 2020 May-Aug;12(2):169-174. PubMed PMID: 32595479.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repetitive Transcranial Magnetic Stimulation for Dysesthesia Caused by Subacute Myelo-Optico-Neuropathy: A Case Report. AU - Mano,Tomoo, AU - Kuru,Satoshi, Y1 - 2020/06/09/ PY - 2020/01/09/received PY - 2020/03/26/accepted PY - 2020/6/30/entrez KW - Dysesthesia KW - Neuromodulation KW - Subacute myelo-optico-neuropathy KW - Transcranial magnetic stimulation SP - 169 EP - 174 JF - Case reports in neurology JO - Case Rep Neurol VL - 12 IS - 2 N2 - Subacute myelo-optico-neuropathy (SMON) is caused by the ingestion of clioquinol (5-chloro-7-iodo-8-hydroxyquinoline), which is an intestinal antibacterial drug. Patients with SMON typically suffer from abnormal dysesthesia in the lower limbs, which cannot explain the mechanism only in pathology and electrophysiology. Neuromodulation therapies are increasingly being investigated as a means of alleviating abnormal sensory disturbances. We report here the response to repetitive transcranial magnetic stimulation (rTMS) for dysesthesia in a patient with SMON. The patient underwent rTMS treatment once per week for 12 weeks. rTMS was administered at 10 Hz, 90% of the resting motor threshold over the bilateral primary motor cortex foot area, for a total of 1,500 stimuli per day. After the treatment had finished at 12 weeks, the abnormal dysesthesia gradually declined. At first, there were improvements only in the area with a feeling of adherence. Later, this sensation was eliminated. Three months following the application, most of the feeling of adherence had disappeared and the feeling of tightness was slightly reduced. In contrast, the throbbing feeling had not changed during this period. Dysesthesia may indicate a process of central sensitization, which would contribute to chronic neuromuscular dysfunction. This case suggests that rTMS is a promising therapeutic application for dysesthesia. SN - 1662-680X UR - https://www.unboundmedicine.com/medline/citation/32595479/Repetitive_Transcranial_Magnetic_Stimulation_for_Dysesthesia_Caused_by_Subacute_Myelo-Optico-Neuropathy:_A_Case_Report L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32595479/ DB - PRIME DP - Unbound Medicine ER -
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