Levetiracetam (LEV) is a widely used antiepileptic drug, which work by inhibiting synaptic vesicles. LEV often causes irritability as adverse effect, which disturbs the adherence of medication. In this study, we examined whether the combined use of yokukansan can improve the irritability without reducing or withdrawal of LEV.

Five patients were included in this study. Four patients were suffered from focal epilepsy and the other was generalized epilepsy. LEV achieved seizure free in all patients, however, irritability appeared soon after the start of LEV administration. After the addition of yokukansan, irritability significantly decreased in Numerical Rating Scale (NRS; 76%; p<0.01). All patients continued LEV medication without reducing doses or withdrawal. In conclusion, yokukansan add–on therapy was effec­tive in reducing the irritability caused by LEV and may contribute the adherence.

We continued to adopt Kampo medicine therapy for treatment of trigeminal neuralgia patients by mainly using keishikajutsubuto since our case report published in 2019. Kampo medicine therapy was spread to a kind of cervical pain such as great occipital neuralgia, and glossopharyngeal neuralgia. We examined the efficacy of Kampo medicine therapy for those pain in neuralgia. Eight of 9 trigeminal neuralgia patients experienced pain relief. Three cases of them got relief from pain without Kampo medicine. The efficacy of a glossopharyngeal neuralgia patient was unclear because of no next visit to our department. One patient with great occipital neuralgia used “Ku-oketsu” medicine prior to “Bushi” medicine, and the pain disappeared after the treatment. Kampo medicine therapy mainly with keishikajutsubuto had sufficient effectiveness for pain in neuralgia.

The pain and swelling associated with head bruises may sometimes cause anxiety and distress to the patient —thus requiring treatment. Jidabokuippo is a traditional Chinese medicine that has been shown to be effective against swelling and pain from trauma. In this retrospective study, we investigated the efficacy of jidabokuippo in treating patients with painful swelling due to head trauma. The results showed that the administration of jidabokuippo reduced pain and swelling without any side effects, and short–term oral administration was considered safe. The use of an appropriate study design, such as a randomized trial, was considered necessary.

Herbal medicine keishikajyutsubutou (TJ–18), which was created by Todou Yoshimasu, a famous Kampo medicine doctor in the Edo period, is suitable for pain or numbness in the limbs, torso pain or joint pain that often gets worse with cold temperature. We asked inpatients or outpatients with various types of pains about their current condition such as pain location, pain characteristic, cold sensitivity, gastrointestinal condition, shoulder stiffness and history of varicella zoster. We also looked at their tongue and touched their abdomen. When we judged it suitable, we prescribed keishikajyutsubutou to the patients. As a result, the medicine was effective in all 10 cases. Keishikajyutsubutou is useful for the relief of the chronic pain such as neuralgia, joint pain, symptom of stroke sequelae or et al. From an East Asian medical point of view, and according to our reports, keishikajyutsubutou indicates effectiveness in certain medical conditions.

Objectives: We investigated the relationship between headache and climate conditions among patients complaining of climate–related headaches. In addition, the clinical effects of goreisan in these patients was prospectively investigated.

Patients: Three patients with primary headache who complained of headache with climate deterioration were evaluated.

Methods: Patients were asked to record a detailed headache diary before and after the prescription of goreisan, and the contents were compared with meteorological data.

Results: The patients’ reported headaches irrespective of the climate conditions, but the frequency decreased after starting to take goreisan. No clear relationship between headache and climate conditions was observed.

Conclusion: Goreisan was effective against primary headache, even though climate conditions were not found to be related.

With the super–aging society becoming reality, dementia has rapidly increased, and the burden on caregivers and medical expenses have become major social problems. In particular, BPSD manifests a variety of symptoms ranging from apathy, depression, anxiety, frustration to excitement, delusions, wandering, and weakness due to severe anorexia, and requires a great deal of effort for family members and medical staff. This time, from the stage of MCI to the state of late dementia, we experienced a case in which Kampo medicine was selectively administered according to symptoms and a favorable course was recognized. It was suggested that appropriate use of Kampo medicines could improve patients’ QOL and reduce the burden on people involved in nursing care.

Patients having malignant gliomas experience nausea and vomit (N ⁄ V) when the tumor invade into brainstem or cerebellum, or they undergo chemo–radiotherapy. Usually those symptoms relief by the usage of antiemetics such as 5HT3 receptor inhibitors or steroids. We have experienced a case in which recurrent malignant glioma involved brainstem and cerebellum, and the patient suffered from severe N ⁄ V that was alleviated not by antiemetic drugs or steroids but by rikkunshito. We report this case with relevant literature.

9 cases of urinary tract infection occurred in stroke patients in 2017. All strains were ESBL–producing bacteria. 8 of the 9 patients had indwelling urinary catheters. In 3 urinary tract infections caused by ESBL–producing bacteria, appropriate management of a urinary catheter, administration of a susceptible antibiotic, and treatment with hochuekkito were performed. ESBL producing bacteria disappeared.

PRES is caused by endothelial injury related to endogenous ⁄ exogenous factors, which leads to breakdown of the blood–brain barrier and subsequent brain edema, however the patho­physiological changes underlying PRES are not fully understood. Goreisan maintaines bodily fluids as risui drug and there are some reports that goreisan can improve brain edema. We report a patient with PRES due to lumbar puncture and following cerebrospinal fluid hypovolemia in whom brain edema improved following administration of goreisan.

The treatment method for dialysis headache is not fixed, and the headache medical treatment guideline does not describe the treatment of dialysis headache. We report a case in which dialysis headache was safely treated with goshuyuto and goreisan. Kampo medicines are compatible with headaches and are often effective. Kampo treatment with excellent safety is a treatment that should be tried.