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J Acupunct Res > Volume 32(2); 2015 > Article
Jo, Kwon, Kim, Choi, Han, Nam, Choi, and Lee: Treatment of Traumatic Brachial Plexus Injury with Traditional Korean Medicine Focusing on Warm Needling and Bee Venom Injection: A Case Report

Abstract

Objectives:

The purpose of this report is to show the effect of complex traditional Korean medical care focused on warm needling(WN) and bee venom(BV) injection for a patient suffering from traumatic brachial plexus injury(BPI).

Methods:

A 51-year-old female patient with BPI was suffering from paresis and hypoesthesia with upper-extremity impairment. The patient had been treated once a day from 4 Feb to 11 Apr of 2015 mainly with WN and BV injection on the acupoints near the distribution of the brachial plexus. Improvement of the symptoms was measured by range of motion(ROM), manual muscle test(MMT) grip strength, and with the numeric rating scale(NRS) of tactile and pain sensitivity.

Results:

After 67 days of treatment, all obtained results showed remarkable improvement. The patient’s satisfaction declaration was recorded through an interview at the end of the treatment.

Conclusions:

The results suggest that anatomically concerned WN and BV treatment can be a valuable option in reducing or normalizing pains from traumatic BPI.

Fig. 1.
MRI images of brachial plexus
With the evidence of preserved neural continuity and mildly stretched nerve roots in this image, patient can be diagnosed as subacute stage of traumatic brachial plexopathy, left
acupunct-32-2-229f1.gif
Fig. 2.
Changes in range of motion of shoulder and elbow joints
Bar-graph indicates the counted numbers of the patient’s flexing and extending her own elbow, which was first executed on February 23th.
The ranges of movement of shoulder medial rotation, lateral rotation, elbow extension, wrist extension, wrist flexion were full almost from the start, Feb 7th, thus those results were emitted from this graph.
acupunct-32-2-229f2.gif
Fig. 3.
Changes in grasping strength of patient
Proportions of the power between intact right hand and impaired left hand was measured. The fact that the one’s strengths are fluctuating everyday makes these measurements reflect patient’s condition better
acupunct-32-2-229f3.gif
Fig. 4.
Changes in numeric rating scale score of tactile sensation
acupunct-32-2-229f4.gif
Fig. 5.
Changes in numeric rating scale score of pain sensitivity
acupunct-32-2-229f5.gif
Table 1.
Manual Muscle Test
Gr Definition
5 Normal strength
4 Muscle holds the joint against a combination of gravity and moderate resistance
3 Muscle can‘t hold the joint against resistance, but moves the joint fully against gravity
2 Muscle moves the joint when gravity is eliminated
1 A flicker of movements is seen or felt in the muscle
0 No movement
Table 2.
Records of Muscle Manual Test before and During Treatment Period
Motion Date * 1. 16 * 1. 26 2. 4 2. 10 2. 17 2. 23 3. 2 3. 8 4. 10
Shoulder Flexion n.r 1 2 3 3 3+ 3+ 3+ 3
Extension n.r 1 2 2 3 3+ 3+ 3+ 3+
Medial Rotation n.r n.r 2 3 3 3+ 4 4 4
Lateral Rotation n.r n.r 2 3 3 3+ 5 5 5
Abduction 1 1 2 2 2 2 3 3 3
Elbow Flexion 1 2 2 2 3 3 3+ 4 4+
Extension 1 2 1 4 4 4 4+ 4+ 4+
Wrist Flexion 3 3 4 3 4 5 5 5 5
Extension 3 3+ 4 4 4 5 5 5 5

* tests in these days are executed and recorded in another place, Asan Medical Center in Seoul. n.r: not recorded.

V.
V.

References

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Appendices

Appendix 1.

Time-table of Present History
acupunct-32-2-229a1.gif

Appendix 2.

Record of the Interview
acupunct-32-2-229a2.gif


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