Neurotropin が奏効した小児難治性慢性頭痛の2例 [in Japanese] Effect of Neurotropin on Chronic Headaches in Children [in Japanese]
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ノイロトロピン<sup>®</sup> (Neurotropin, ワクシニアウイルス接種家兎炎症皮膚抽出液) は頸肩腕症候群や帯状疱疹後疼痛に有効であり, 成人の一次性頭痛に対する効果も報告されている. 今回, 他の各種薬剤に効果が乏しかった慢性頭痛の小児2例で本剤が有効であった. いずれも中学生女子, 片頭痛を発症して2～3年後に増悪をきたし, 不登校にいたった経過で, 起立性調節障害の併存, 間欠的な四肢・背部の疼痛, MRI上の大脳白質散在性病変も共通していた. Neurotropinには他の鎮痛薬にはない下降性疼痛抑制系の増強効果があり, 小児の難治な慢性頭痛にも有効と示唆された.
We report the cases of 2 girls, aged 13 and 15 years, who experienced exacerbation of migraine at 2-3 years after its onset. The chronic headaches were refractory to various anti-migraine and analgesic agents, persisted for 3-6 months in each patient, and rendered them unable to attend school. These headaches commonly manifested with symptoms of orthostatic dysregulation and paroxysmal back/limb pain. In addition, T2-weighted magnetic resonance images showed dots of highly intense signals in the bilateral cerebral white matter. Neurotropin, a non-protein extract isolated from the dermis of rabbits and inoculated with the vaccinia virus, induced prompt significant effects on the headache and back/limbs pain in both the girls. The symptom of orthostatic dysregulation was also gradually ameliorated after the resolution of the headache. Neurotropin has an analgesic action that is not common to other drugs since it enhances the descending pain inhibitory systems, and its effect has been reported in cases of post-herpetic and other neuralgia as well as in cases of primary headaches in adulthood. This agent may also be promising for the treatment of intractable primary headaches during childhood.
- NO TO HATTATSU
NO TO HATTATSU 44(6), 477-481, 2012-11-01
The Japanese Society of Child Neurology