Effect of Goreisan in Refractory Neuralgia after Hansen's Disease / 日本東洋医学雑誌

ABSTRACT

Hansen's disease (HD) is a chronic infectious disease caused by the Mycobacterium leprae, which parasitizes skin macrophages and Schwann cells of peripheral nerves. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes due to sensory disturbance and neuritis. Many HD patients suffer from refractory neuralgia for which neither painkillers nor other western medicine are usually effective. Here, we will report the case of an 85 year-old male, whose refractory neuralgia remarkably improved with goreisan. The mechanisms by which goreisan was effective may be as follows (1) neuralgia pathology is an interstitial edema of peripheral nerves, and can explain as a local <I>Sui-doku</I>, a specific <I>Sho</I> for goreisan ; (2) peripheral nerve ischemia, caused by scar formation from chronic inflammation, leads to dysfunction of Na<SUP>+</SUP>/K<SUP>+</SUP> ATPase, and extracellular potassium concentration increases. This environmental change leads a neural hypersensitivity, and goreisan is known to decrease extracellular potassium concentrations. This case suggests goreisan might be worth considering for use in refractory neuralgia, not only in HD patients, but also in other neuropathies.