Trigeminal Neuralgia after Bromocriptine Therapy in a Stroke Patient: A Case Report

Rare side effects of bromocriptine, such as, trigermial neuralgia, have been reported in patients with pituitary adenoma but no such case has been reported in post-stroke patients. This case reports on a stroke patient who developed trigeminal neuralgia after bromocriptine therapy. A 48-year-old man, diagnosed with left middle cerebral artery territory infarction and transcortical motor aphasia, was prescribed with 2.5 mg of bromocriptine. After two days, he complained of pain in the right trigeminal nerve distribution. Brain MRI, facial EMG, blink reflex, revealed no abnormalities. His pain showed no relief to various pharmacological agents. However, pain disappeared with discontinuation of bromocriptine and recurred again with readministration. In addition, pain intensity correlated with increase of bromocriptine dosage. Based on these findings, we concluded that patient' trigerminal neuralgia was related to bromocriptine administration. An antidote, which consisted of a dopamine antagonist was prescribed together with bromocriptine and the patient subsequently showed relief of pain and improvement of aphasia.

The Investigation of Faculties and Facilities in Industrial Accident Compensation Insurance Designated Hospitals

OBJECTIVE: To analyze the hospitals related rehabilitation, which were designated for industrial accident compensation insurance, focusing faculties and facilities by administrative district. METHOD: Total 1,031 hospitals having more than 30 beds were included. We investigated the numbers of hospital beds, medical departments, medical doctors, nurses, physical therapists, and occupational therapists of each hospital with official document of industrial accident compensation insurance. And we classified and analyzed all data by administrative district. RESULTS: The average of each objects were estimated as following orders: total number of hospital beds (131.5); medical departments (5.8); medical doctors (11.2); nurses (33.8); physical therapists (4.2); occupational therapists (0.9). The percentage of hospitals with department of rehabilitation medicine was 28.4% in total, 26.7% in hospital and 35.3% in general hospital. Mean numbers of hospital beds, medical departments, medical doctors, nurses and physical therapists did not showed disparity among the administrative districts. However, the percentages of hospitals with department of rehabilitation medicine and of hospitals with occupational therapists showed disparity among the administrative districts. The regional distribution of hospitals with department of rehabilitation medicine showed similar distribution, as that of occupational therapists. CONCLUSION: These results demonstrate faculties and facilities of hospitals under the industrial accident compensation insurance which are related with rehabilitation treatment. We believe that these results would be helpful for constructing certification system of rehabilitation hospital and for further research about rehabilitation treatment associated with industrial accident compensation insurance.