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Background@#Supracondylar humerus (SCH) fractures in children have been traditionally categorized according to the Wilkins-modified Gartland classification scheme, which is solely based on the degree of displacement. As this classification does not consider fracture patterns in the coronal or sagittal plane, the relationship between the fracture pattern and prognosis in SCH fractures remains unclear.Therefore, the purpose of this study was to evaluate the relationship between the fracture level and prognosis of pediatric SCH fractures. @*Methods@#Medical records and radiographs of 786 patients with SCH fractures who underwent surgical treatment between March 2004 and December 2017 were reviewed. A total of 192 patients were included in this study. Anteroposterior elbow radiographs taken at the time of injury were evaluated to obtain the level of fracture. Functional outcomes were evaluated based on modified Flynn grading at the last follow-up. @*Results@#Of 192 patients included in this study, 24 (12.1%), 148 (74.8%), and 20 (10.1%) had fractures in zone 1 (metaphyseal-diaphyseal area), zone 2 (between zones 1 and 3), and zone 3 (metaphyseal-epiphyseal area), respectively. There were significant differences in age at the time of injury (p = 0.011), direction of fracture displacement (p = 0.014), and loss of carrying angle (p < 0.001) between fractures in zone 3 and those in zone 1 or zone 2. Zone 3 fractures and classic zone 2 fractures also showed significant difference in outcomes, with zone 3 fractures having more unsatisfactory outcome than classic zone 2 fractures (p = 0.049). @*Conclusions@#For SCH fractures, varus deformity of the elbow was more common in zone 3 (metaphyseal-epiphyseal area) than in the other zones. Thus, pediatric orthopedic surgeons should be mindful of the possibility of cubitus varus deformity when treating SCH fractures in zone 3. A thorough postoperative follow-up is required.
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Objectives@#Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry. @*Methods@#Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining. @*Results@#BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues. @*Conclusions@#BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.
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Background@#Only a few studies have evaluated the differences between varying concentrations of a fixed dose of local anesthetics. This study was conducted to compare the effects of two different concentrations of a fixed dose of ropivacaine used in ultrasound-guided interscalene brachial plexus block. @*Methods@#This prospective, randomized, double-blind study included 62 patients who underwent arthroscopic surgery under general anesthesia. The patients were randomly assigned to receive ultrasound-guided interscalene block with 75 mg of ropivacaine at one of two concentrations: 0.75% (10 ml; group C) or 0.375% (20 ml; group V). Time to onset of sensory blockade, degree of blockade, pulmonary function changes, analgesic duration of the interscalene block, postoperative opioid requirement within 24 h, postoperative pain scores, satisfaction, and incidence of complications were recorded. @*Results@#Although the time to onset of sensory blockade was shorter for group C (P = 0.015), successful blockade was achieved at 30 min after the interscalene block in both groups. The analgesic duration of the interscalene block was not significantly different between the groups. The amount of opioid used within 24 h after surgery was significantly reduced for group V compared with group C (P = 0.016). The rest of the parameters did not show any significant differences between the two groups. @*Conclusion@#Compared with 10 ml of 0.75% ropivacaine, interscalene block with 20 ml of 0.375% ropivacaine could be effective for the reduction of postoperative opioid requirement within 24 h after surgery despite it might not prolong the analgesic duration.
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Objectives@#Body protective compound-157 (BPC-157) is a stable gastric pentadecapeptide that has been effective in trials aiming to increase wound healing capabilities and decrease inflammatory cell influx, including studies on the healing of muscles and tendons. There are no studies about the effect of BPC-157 on pain transmission via nociception. This study examined the antinociceptive effects of BPC-157 using formalin tests and immunohistochemistry. @*Methods@#Rats were randomly divided into the control, morphine and BPC-157 groups. Pain behavior was quantified periodically at 5- and 35- min intervals (representative values of phases 1 and 2) by counting the number of flinches exhibited by the injected paw after injection. The dorsal root ganglia (DRG) and spinal cords (SC) were collected, and then, the number of cytokine-positive cells was determined via immunostaining. @*Results@#BPC-157 dose-dependently decreased the number of flinches during phase 1 but did not decrease the number of flinches during phase 2. During phase 1, interleukin-1β (IL-1β) in the DRG tissue was significantly different in the morphine, 10 μg/kg BPC-157, and 20 μg/kg BPC-157 groups. During phase 2, statistical significance was achieved in the DRG tissue in the morphine, 20 μg/kg BPC-157, and 40 μg/kg BPC-157 groups. During phase 1, interleukin-6 was significantly different in the DRG tissue in the morphine group and the SC tissue in the 10 μg/kg BPC-157 group. During phase 2, statistical significance was achieved in the morphine group and the BPC-157 20 μg/kg group in both the DRG and SC tissues. There were no significant differences in tumor necrosis factor-α between the DRG and SC tissues. @*Conclusions@#BPC-157 was effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 decreased the expression of IL-1β in the DRG tissue in phases 1 and 2.
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Background@#Only a few studies have evaluated the differences between varying concentrations of a fixed dose of local anesthetics. This study was conducted to compare the effects of two different concentrations of a fixed dose of ropivacaine used in ultrasound-guided interscalene brachial plexus block. @*Methods@#This prospective, randomized, double-blind study included 62 patients who underwent arthroscopic surgery under general anesthesia. The patients were randomly assigned to receive ultrasound-guided interscalene block with 75 mg of ropivacaine at one of two concentrations: 0.75% (10 ml; group C) or 0.375% (20 ml; group V). Time to onset of sensory blockade, degree of blockade, pulmonary function changes, analgesic duration of the interscalene block, postoperative opioid requirement within 24 h, postoperative pain scores, satisfaction, and incidence of complications were recorded. @*Results@#Although the time to onset of sensory blockade was shorter for group C (P = 0.015), successful blockade was achieved at 30 min after the interscalene block in both groups. The analgesic duration of the interscalene block was not significantly different between the groups. The amount of opioid used within 24 h after surgery was significantly reduced for group V compared with group C (P = 0.016). The rest of the parameters did not show any significant differences between the two groups. @*Conclusion@#Compared with 10 ml of 0.75% ropivacaine, interscalene block with 20 ml of 0.375% ropivacaine could be effective for the reduction of postoperative opioid requirement within 24 h after surgery despite it might not prolong the analgesic duration.
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We experienced a case of crush injury of the hand for which we performed a flap surgery and treated the necrotic parts placement using cultured allogeneic keratinocytes (Kaloderm® ) with good results. The patient was a 31-year-old woman whose left middle finger was caught in a door, causing a crush injury. Although primary repair was performed, a 2 × 2.5-cm-sized necrosis developed, and a V-Y advancement flap was performed after the removal of dead tissues. However, a 1 × 2-cm-sized partial necrosis occurred and was treated using Kaloderm ® . After the use of Kaloderm® , the patient’s wound was healed, and no complications, except for mild pain, were observed for 1 year after the surgery. If a necrotic site appears after flap placement of fingertip, its treatment is difficult. If used well, Kaloderm® may be a good option for necrosis of the fingertips and other areas that are difficult to cure.
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BACKGROUND: Gender and age are known factors that affect postoperative pain. The purpose of this study was to investigate the effect of gender and age on postoperative pain and analgesic consumptions after laparoscopic cholecystectomy. METHODS: We studied 240 adult patients (120 female patients and 120 male patients) who underwent elective 3-port laparoscopic cholecystectomy under general anesthesia. The numerical rating scale (NRS) scores were assessed before surgery, when the patient arrived in the recovery room, and at 8, 16, and 24 h after surgery. Analgesic consumptions in the recovery room and at 24 h postoperatively were evaluated. We compared the NRS scores and quantity of analgesics between the gender groups and the age groups (20–45, 46–64, and ≥ 65 years old). RESULTS: Compared to male patients, female patients had higher NRS scores (6 [5, 7] vs. 5 [4, 6]; P = 0.001) and required a higher dose of fentanyl (0.94 ± 0.47 µg/kg vs. 0.79 ± 0.41 µg/kg; P = 0.011) in the recovery room. The younger female patients (20–45 and 46–64 years old) required a higher dose of fentanyl than those older than 65 years of age in the recovery room. CONCLUSIONS: Female patients exhibit higher NRS scores and greater consumptions of analgesics than male patients immediately postoperatively. Younger female patients require more analgesics than elderly patients in the recovery room.
Subject(s)
Adult , Aged , Female , Humans , Male , Analgesics , Anesthesia, General , Cholecystectomy, Laparoscopic , Fentanyl , Observational Study , Pain, Postoperative , Prospective Studies , Recovery RoomABSTRACT
BACKGROUND: The current evidence on the safe use of supraglottic airway for pediatric laparoscopic surgeries is limited. Although i-gel has been successfully used in adult laparoscopic surgeries, to our knowledge, no studies have compared it to the endotracheal tube (ETT) in pediatric laparoscopic surgeries. This study evaluated the effectiveness of i-gel over ETT with regards to the respiratory and hemodynamic parameters during pediatric laparoscopic surgeries. METHODS: A total of 60 pediatric patients undergoing elective laparoscopic surgeries were randomly allocated to either the i-gel or ETT groups. Anesthetics used included ketamine, sevoflurane, and rocuronium. The primary outcome measured was the peak airway pressure (PAP) and the secondary outcomes measured were leak fraction, end-tidal CO₂, respiratory rate, insertion time, heart rate, blood pressure and perioperative complications. RESULTS: The PAP during surgeries was higher in the ETT group than in the i-gel group. There were no statistically significant differences in the leak fraction, end-tidal CO₂, and respiratory rate. The i-gel group had a shorter insertion time compared with the ETT group. The changes in heart rate were comparable in both groups. However, systolic and diastolic pressures were higher in the ETT group following intubation, before and after the creation of pneumoperitoneum. The incidence of perioperative complications was similar in both groups. CONCLUSIONS: The i-gel provided adequate ventilation with lower PAP compared with ETT. In addition, it provided minimal hemodynamic changes compared with ETT. Therefore, the i-gel may provide a suitable alternative to ETT in pediatric laparoscopic surgeries.
Subject(s)
Adult , Humans , Anesthetics , Blood Pressure , Heart Rate , Hemodynamics , Incidence , Intubation , Intubation, Intratracheal , Ketamine , Laparoscopy , Pediatrics , Pneumoperitoneum , Respiratory Rate , VentilationABSTRACT
BACKGROUND: Woake's syndrome (WS) is a recurrent nasal polyposis, accompanied by broadening of the nose, frontal sinus aplasia, dyscrinia, and bronchiectasis. There has been no previous report on anesthetic management in patients with WS. CASE: We describe a case involving a 13-year-old male patient with WS who was scheduled for septorhinoplasty for necrotic ethmoiditis. Anesthesia was induced and maintained with propofol and remifentanil using a target-controlled infusion device. The anesthetic considerations of this rare syndrome and the advantages of an intravenous infusion method over local and volatile anesthesia for these patients are discussed. We report on caveats, such as pulmonary dysfunction during the anesthetic management, and nasal structural problems encountered in WS patients. CONCLUSIONS: Given that conventional inhaled anesthesia reduces ciliary movement and that local anesthesia with sedative has several disadvantages, perioperative control and precautions against respiratory infections by using antibiotics, and preventing cilio-depressant actions, are important for anesthetic management.
Subject(s)
Adolescent , Humans , Male , Anesthesia , Anesthesia, Local , Anti-Bacterial Agents , Bronchiectasis , Frontal Sinus , Infusions, Intravenous , Methods , Nasal Polyps , Nose , Propofol , Respiratory Tract InfectionsABSTRACT
Tracheostomy is increasingly performed in children for upper airway anomalies. Here, an 18-month-old child (height 84.1 cm, weight 12.5 kg) presented to the emergency department with dyspnea, stridor, and chest retraction. However, exploration of the airways using a bronchoscope failed due to subglottic stenosis. Therefore, a surgical tracheostomy was successfully performed with manual mask ventilation. However, pneumomediastinum was found in the postoperative chest radiograph. Although an oxygen saturation of 99% was initially maintained, oxygen saturation levels dropped, due to sudden dyspnea, after 3 hours. A chest radiograph taken at this time revealed a left tension pneumothorax and small right pneumothorax. Despite a needle thoracostomy, the pneumothorax was aggravated, and cardiac arrest occurred. Cardiopulmonary-cerebral resuscitation was performed, but the patient was declared dead 30 minutes later. This study highlights the fatal complications that can occur in children during tracheostomy. Therefore, close monitoring, immediate suspicion, recognition, and aggressive management may avoid fatal outcomes.
Subject(s)
Child , Humans , Infant , Bronchoscopes , Constriction, Pathologic , Dyspnea , Emergency Service, Hospital , Fatal Outcome , Heart Arrest , Masks , Mediastinal Emphysema , Oxygen , Pediatrics , Pneumothorax , Radiography, Thoracic , Respiratory Sounds , Resuscitation , Thoracostomy , Thorax , Tracheostomy , VentilationABSTRACT
BACKGROUND@#Woake's syndrome (WS) is a recurrent nasal polyposis, accompanied by broadening of the nose, frontal sinus aplasia, dyscrinia, and bronchiectasis. There has been no previous report on anesthetic management in patients with WS.CASE: We describe a case involving a 13-year-old male patient with WS who was scheduled for septorhinoplasty for necrotic ethmoiditis. Anesthesia was induced and maintained with propofol and remifentanil using a target-controlled infusion device. The anesthetic considerations of this rare syndrome and the advantages of an intravenous infusion method over local and volatile anesthesia for these patients are discussed. We report on caveats, such as pulmonary dysfunction during the anesthetic management, and nasal structural problems encountered in WS patients.@*CONCLUSIONS@#Given that conventional inhaled anesthesia reduces ciliary movement and that local anesthesia with sedative has several disadvantages, perioperative control and precautions against respiratory infections by using antibiotics, and preventing cilio-depressant actions, are important for anesthetic management.
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CHARGE syndrome is a rare genetic disorder with CHD7 gene mutation. CHARGE is an acronym for coloboma (C), heart disease (H), atresia of choanae (A), retardation of growth (R), genitourinary malformation (G), and ear abnormalities (E). Patients with CHARGE syndrome need to undergo many surgeries due to their various congenital anomalies. Since airway abnormalities frequently accompany CHARGE syndrome, general anesthesia remains a challenge. Here we report a case of difficult intubation in a 35-month-old boy with CHARGE syndrome during general anesthesia and the experience of successful intubation using D-blade of C-MAC® video laryngoscope.
Subject(s)
Child , Child, Preschool , Humans , Male , Airway Management , Anesthesia, General , CHARGE Syndrome , Coloboma , Ear , Heart Diseases , Intubation , Laryngoscopes , Nasopharynx , PediatricsABSTRACT
A 72-year-old man underwent spinal anesthesia for artificial urinary sphincter placement for urinary incontinence. After the block level was confirmed below T6, 1 g of cefotetan, which had not shown any reaction on skin test, was administered as a prophylactic antibiotic. The patient began complaining of chest discomfort and dyspnea shortly after injection. ST elevation appeared on the electrocardiogram and the patient's pulse could not be palpated. Accordingly, cardiopulmonary resuscitation was performed for 5 minutes; the patient recovered spontaneous circulation. The patient was diagnosed as experienced coronary artery spasm by coronary angiography with spasm test. Because coronary artery spasm can also develop in patients with no history of coronary artery disease and under spinal anesthesia, careful observation, suspicion of coronary artery spasm and prompt response to hemodynamic and electrocardiogram changes are necessary.
Subject(s)
Aged , Humans , Anesthesia, Conduction , Anesthesia, Spinal , Cardiopulmonary Resuscitation , Cefotetan , Coronary Angiography , Coronary Artery Disease , Coronary Vasospasm , Coronary Vessels , Dyspnea , Electrocardiography , Heart Arrest , Hemodynamics , Skin Tests , Spasm , Thorax , Urinary Incontinence , Urinary Sphincter, ArtificialABSTRACT
The symptoms of restless legs syndrome (RLS) usually involve legs and can extend to other body parts. However, isolated body parts other than leg have rarely been involved. A 32-year-old woman had abnormal sensations of both forearms and face during night, which caused a difficulty falling in sleep. The symptoms were relieved by shaking and rubbing. She experienced a clear benefit from pramipexole, but a recurrence of restlessness was followed in both arms subsequent to pramipexole withdrawal. Finally, she had been prescribed a dose of 0.375 mg, which was well tolerated for 6 years. We report a case of nocturnal restless arms and face without leg involvement, which was like RLS in terms of clinical criteria except lesion site.
Subject(s)
Adult , Female , Humans , Accidental Falls , Arm , Dopamine Agonists , Dopamine , Forearm , Human Body , Leg , Psychomotor Agitation , Recurrence , Restless Legs Syndrome , SensationABSTRACT
BACKGROUND: This study aimed to retrospectively evaluate the use of sugammadex in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. METHODS: Data were obtained from medical record review of patients who underwent VATS lobectomy from January 2013 to November 2014. Fifty patients were divided into two groups: the sugammadex group (group S, n = 19) was administered sugammadex 2 mg/kg, while the pyridostigmine group (group P, n = 31) received pyridostigmine 20 mg with glycopyrrolate 0.2 mg or atropine 0.5 mg. The primary endpoint measure was the overall incidence of postoperative pulmonary complications including prolonged air leak, pneumonia, and atelectasis. The secondary endpoint measures were the length of postoperative hospital stay and duration of chest tube insertion. RESULTS: The overall incidence of postoperative pulmonary complications in patients in group S was significantly lower compared with that of group P (5 [26.3%] vs. 17 [54.8%]; P = 0.049). Also, the durations of chest tube insertion (5.0 [4.0–7.0] vs. 7.0 [6.0–8.0] days; P = 0.014) and postoperative hospital stay (8.0 [8.0–10.0] vs. 10.0 [9.0–11.0] days; P = 0.019) were shorter in group S compared with group P. Administration of sugammadex was associated reduced with postoperative pulmonary complications (OR: 0.22; 95% CI: 0.05–0.87; P = 0.031). CONCLUSIONS: The use of sugammadex, compared with pyridostigmine, showed a significantly reduced overall incidence of postoperative pulmonary complications and decreased duration of chest tube use and postoperative hospital stay in patients undergoing VATS lobectomy, suggesting that sugammadex might be helpful in improving clinical outcomes in such patients.
Subject(s)
Humans , Atropine , Chest Tubes , Glycopyrrolate , Incidence , Length of Stay , Lung Neoplasms , Lung , Medical Records , Pneumonia , Pulmonary Atelectasis , Pyridostigmine Bromide , Retrospective Studies , Thoracic Surgery, Video-AssistedABSTRACT
BACKGROUND: The clinical features of spinal anesthesia may differ between young and old patients because of the anatomical and physiological changes that occur with an increase in age. This study was performed retrospectively to compare the clinical aspects of spinal anesthesia between the non-elderly and elderly patients. METHODS: We investigated the medical records of 1,180 adult patients who received spinal anesthesia during a one-year period. They were divided into two groups on the basis of 65 years of age; the non-elderly patient group (Y group, n = 813) versus the elderly patient group (E group, n = 367). Pre-, intra-, and postoperative data related to spinal anesthesia were collected. The data about satisfaction and causes of dissatisfaction with the procedure were evaluated. RESULTS: There were significant differences between the two groups in terms of age, height, and weight, except for sex. Significantly more than two attempts at spinal puncture were performed in the E group (37.6%) than in the Y group (21.4%). There were no statistically significant differences in perioperative complications after spinal anesthesia between the two groups. There were no significant differences in the reported causes of dissatisfaction between the two groups. The rate of wanting to undergo spinal anesthesia in the future was 96.4% in the Y group and 97.5% in the E group, which showed no statistically significant difference. CONCLUSIONS: Although the elderly patients had to undergo more spinal puncture attempts, more than 90% of the elderly patients were satisfied with spinal anesthesia and wanted to undergo spinal anesthesia again for similar surgeries in the future.
Subject(s)
Adult , Aged , Humans , Anesthesia, Spinal , Medical Records , Retrospective Studies , Spinal PunctureABSTRACT
BACKGROUND: There are few information about the differences of the effective dose (ED) of cisatracurium between the adult and the elderly. We investigated the ED and the onset time of cisatracurium in the adults and the elderly. METHODS: We studied two hundred patients of the adults aged 20 through 64 years and the elderly aged ≥ 65 years, with American Society of Anesthesiologists physical status I or II. Each 100 patients with 20 patients of each dose group, randomly selected from 30, 40, 50, 60 or 70 µg/kg of cisatracurium, were randomly allocated to the adults and the elderly groups. We recorded the 0.1 Hz single twitch responses of the adductor pollicis and the onset times to maximal blockade. The magnitude of muscle relaxation was recorded by using an acceleromyography. The effect of cisatracurium on single twitch was calculated as percent reduction. After converting each drug dose into logarithm and percent reduction of the muscle reduction into probit, the EDs representing the muscle relaxation effects of 5%, 25%, 50%, 75% and 95% were estimated using the linear regression analysis. RESULTS: No significant differences were found in age, weight, height, or body mass index within or between the groups. The ED₅₀ and ED₉₅ of the adult group were 35.39 and 59.58 µg/kg. The ED₅₀ and ED₉₅ of the elderly group were 34.89 and 55.50 µg/kg, respectively. The onset times were 375.4 ± 76.9 seconds in the adult group and 369.1 ± 70.0 seconds in the elderly group. CONCLUSIONS: The ED and the onset time were not significantly different between the adult and the elderly.
Subject(s)
Adult , Aged , Humans , Body Mass Index , Linear Models , Muscle RelaxationABSTRACT
Treatment-induced neuropathy in diabetes (also referred to as insulin neuritis) is considered a rare iatrogenic small fiber neuropathy caused by an abrupt improvement in glycemic control in the setting of chronic hyperglycemia. The prevalence and risk factors are unknown. It presents with neuropathic pain, symptoms of autonomic dysfunction, or a combination of both. We present a case that illustrates the range of presentations of the acute treatment-induced small fiber neuropathy in a patient with diabetes mellitus.
Subject(s)
Humans , Acute Pain , Blood Glucose , Diabetes Mellitus , Diabetic Neuropathies , Erythromelalgia , Hyperglycemia , Insulin , Neuralgia , Prevalence , Risk FactorsABSTRACT
Hemichorea have been reported in patients with nonketotic hyperglycemia. Usually, hemichorea and hyperglycemia are concomitant. A 73-year-old woman was admitted for investigation of an acute hemichorea. T1-weighted brain magnetic resonance imaging showed hyperintensity in the right putamen. Although she was a diabetic patient, she had no hyperglycemia. Interestingly, 4 weeks earlier, the patient was admitted due to nonketotic hyperglycemia. However, there were no hemichorea at that time. Although pathophysiologically controversial, a delayed hemichorea without nonketotic hyperglycemia should be considered as one of many different causes when evaluating acute hemichorea in diabetic patients.
Subject(s)
Aged , Female , Humans , Brain , Chorea , Hyperglycemia , Magnetic Resonance Imaging , PutamenABSTRACT
The symptoms of restless legs syndrome usually involve legs, but can extend to other body parts. However, isolated body parts other than the leg are rarely involved. A 36-year-old woman presented for evaluation with a tingling and burning sensation in the both hands for one year. These abnormal sensations appeared in the evening and night, resulting in difficulty in falling asleep. The symptoms were relieved by shaking and bending of hands and wrists. Pramipexole was increased to 0.375 mg, and 75 mg of pregabalin was added, but her abnormal nocturnal sensation was not improved. Overt hyperthyroidism was revealed by thyroid function test: free thyroxin 2.99 ng/dL and thyroid-stimulating hormone 0.009 µIU/mL. One month later, her symptom showed much improvement after taking methimazole 5 mg twice a day. We report a case of abnormal nocturnal sensation of hands in the patient with hyperthyroidism who responded with methimazole.