Mutlu ATEŞ, Mahmut Taha ÖLÇÜLÜ, Kayhan YILMAZ, Çağatay ÖZSOY, Yasemin BİCER GOMCELİ

Ekstrakorporeal Şok Dalga Litotripsi Tedavisi Sonrası Radikülopatiyi Taklit Eden Nöropati: Olgu Sunumu

Böbrek taşı için ekstrakorporeal şok dalga litotripsi (ESWL) tedavisi uygulanan radikülopatiyi taklit eden nöropatili 57 yaşında bir kadın hasta sunduk. İkinci seans ESWL sonrası hasta, belin sol tarafında ve sol ayağın tabanında şiddetli ağrı, sol ayak tabanında karıncalanma ve yanma olduğunu belirtti. ESWL’den önce hiç şikayeti yoktu. Nörolojik muayeneden sonra, hastaya ESWL’nin omurilik sinir kökleri üzerindeki olası etkileri nedeniyle nöropati teşhisi konuldu. Pregabalin 75 mg p.o günde iki kez başlandı. Altıncı ayın sonunda hastanın sempmtomlarının şiddeti kademeli olarak azaldı. Bu olgu, hedeflenen ESWL bölgesine komşu bölgelerdeki nöronal yapıların şok dalgalarından etkilenebileceğini göstermektedir.

Neuropathy Mimicking Radiculopathy After Extracorporeal Shock Wave Lithotripsy Treatment: A Case Report

We presented a 57-year-old female patient with neuropathy mimicking radiculopathy who underwent extracorporeal shock wave lithotripsy (ESWL) treatment for renal stone. After the second session of ESWL, the patient reported severe pain on the left side of the waist and sole of the left foot, tingling and burning of the sole of the left foot. She had no complaints before ESWL. After neurological examination, the patient was diagnosed as neuropathy due to the possible effects of ESWL on the spinal cord roots. Pregabalin 75 mg twice a day was started and her symptoms were gradually recovered during the six months. This case demonstrates that neuronal structures in the regions adjacent to the targeted ESWL region can be affected by shock waves.

PDF

___

1. Olcucu MT, Teke K, Yalcin S, Olcucuoglu E, Caner V, Turk NS, Tuncay OL. Characterizing the Association Between Toll-like Receptor Subtypes and Nephrolithiasis With Renal Inflammation in an Animal Model. Urology 2018;111:238. e231-238. e235. https://doi.org/10.1016/j.urology.2017.09.026
2. Iqbal N, Malik Y, Nadeem U, Khalid M, Pirzada A, Majeed M, Malik HA, Akhter S. Comparison of ureteroscopic pneumatic lithotripsy and extracorporeal shock wave lithotripsy for the management of proximal ureteral stones: A single center experience. Turk J Urol 2018;44:221-227. https://doi.org/10.5152/tud.2018.41848
3. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016;69:475-482. https://doi.org/10.1016/j.eururo.2015.07.041
4. Yildirim K, Olcucu MT, Colak ME. Trends in the treatment of urinary stone disease in Turkey. PeerJ 2018;6:e5390. https://doi.org/10.7717/peerj.5390
5. Skolarikos A, Alivizatos G, de la Rosette J. Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol 2006;50:981-990; discussion 990. https://doi.org/10.1016/j.eururo.2006.01.045
6. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008;70:1630-1635. https://doi.org/10.1212/01.wnl.0000282763.29778.59
7. Karatas A, Dosoglu M, Zeyrek T, Kayikci A, Erol A, Can B. The effect of extracorporeal shock wave lithotripsy on the rat spinal cord. Spinal Cord 2008;46:627-632. https://doi.org/10.1038/sc.2008.31
8. Yamaya S, Ozawa H, Kanno H, Kishimoto KN, Sekiguchi A, Tateda S, Yahata K, Ito K, Shimokawa H, Itoi E. Lowenergy extracorporeal shock wave therapy promotes vascular endothelial growth factor expression and improves locomotor recovery after spinal cord injury. J Neurosurg 2014;121:1514- 1525. https://doi.org/10.3171/2014.8.JNS132562
9. Lee J-Y, Ha K-Y, Kim J-W, Seo J-Y, Kim Y-H. Does extracorporeal shock wave introduce alteration of microenvironment in cell therapy for chronic spinal cord injury? Spine 2014;39:E1553-E1559. https://doi.org/10.1097/BRS.0000000000000626
10. Shin DC, Ha KY, Kim YH, Kim JW, Cho YK, Kim SI. Induction of Endogenous Neural Stem Cells By Extracorporeal Shock Waves After Spinal Cord Injury. Spine (Phila Pa 1976) 2018;43:E200-E207. https://doi.org/10.1097/BRS.0000000000002302
11. Tasdemir S, Ulas UH, Yucel M, Cetiz A. Meralgia paresthetica after the fragmentation of renal stone using extracorporeal shock wave lithotripsy: a case report. Acta neurologica Belgica 2016;116:423-424. https://doi.org/10.1007/s13760-015-0574-1
12. Newman RC, Hackett RL, Brock KA, Sosnowski J, Blackmore J, Ballinger WE, Feldman J, Finlayson B. Effect of ESWL on canine spinal cord. Urology 1987;29:116. https://doi.org/10.1016/0090-4295(87)90619-4
13. Di Lorenzo N, Maleci A, Williams BM. Severe exacerbation of post traumatic syringomyelia after lithotripsy. Case report. Paraplegia 1994;32:694-696. https://doi.org/10.1038/sc.1994.112
14. Tosi L, Terrini G. Lithotripsy in SCI patients. Spinal Cord 1995;33:364. https://doi.org/10.1038/sc.1995.82
15. Kaul I, Amin A, Rosenberg M, Rosenberg L, Meyer WJ, 3rd. Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: Aretrospective chart review. Burns : journal of the International Society for Burn Injuries 2018;44:414-422. https://doi.org/10.1016/j.burns.2017.07.018