2026 Volume 2 Issue 1 Pages 463-467
Background: Orofacial pain may involve interactions between pain-modulatory mechanisms and nu tritional status, and evaluation from a nutritional psychiatry perspective may be important.
Case: A woman in her 40s developed traumatic trigeminal neuropathic pain and idiopathic orofaci al pain after orthognathic surgery and had comorbid depression and appetite loss. Mecobalamin (1, 500 μg/day) with Kampo formulas (juzentaihoto, keishikaryojutsubuto, and rikkosan) initially impro ved pain and sensory disturbance, but pain relapsed. Laboratory findings showed AST 17 U/L, AL T 12 U/L, total protein 6.6 g/dL, BUN 6.0 mg/dL, total cholesterol 144 mg/dL, and hemoglobin 11.8 g/dL. Marked insufficiency of meat and vegetable intake was identified, and nutritional guida nce focusing on protein and B vitamins, vitamin C, magnesium, and zinc was added. Pain VAS i mproved from 70 to 19, and body weight increased from 41.0 to 43.2 kg.
Conclusion: In cases with nociplastic pain, combining Kampo treatment with appropriate nutritiona l assessment and intervention may be useful.
