Tolosa Hunt Syndrome - Intractable pain treatment with acupuncture?

Purpose: The Tolosa Hunt Syndrome (THS) is a painful granular inflammation of the cerebral vessels followed by pain and disorders of the extrabulbar m uscles. The therapy consists of corticosteroids and analgetics. There was a 70 year old woman who suffered from painful paresis of the abducent and oc ulomotor nerves following an infection with Borrelia Burgdorferi - but with out ocular symptoms. The treatment with corticosteroids reduced the palsy b ut she complained of excessively painful attacks in the region of the first branch of the trigeminal nerve. Opiold analgetic therapy did not bring abo ut any relief. Acupuncture is an irritative method with a physical effect o n the nervous system: its pain-reducing effect is caused by the activation of transmitters like endorphins in thalamus and brain stem: Knowing this ef fect, the THS patient, after informed consent, was treated with acupuncture . To measure the extent of pain, a visual analog scale (0: no pain - 10: ma ximum pain) was used. Acupuncture was performed according to the empirical rules of the Traditional Chinese Medicine (TCM), during a period of 10 week s and 12 weeks. There was a significant pain relief after acupuncture from VAS 10 to VAS 5. The effect vanished during the next four months. After a s econd series of 12 sessions pain reduction was reported from VAS 10 to 4. O ne year after the last Tolosa Hunt Syndrome - intractable-pain pain strengt h ranged between VAS 4 - 6. Therefore acupuncture seems to be a good additi onal method for reduction of intractable pain.