Painful Post-traumatic Trigeminal Neuropathy Improved with Seungmagalgeun-tang-gamibang and Acupuncture: A Case Report

Do-Hwan Kim; Ki-Won Um; Kim, Do-Hwan; Um, Ki-Won

doi:10.13048/jkm.26031

JKM > Volume 47(2); 2026 > Article

Kim and Um: Painful Post-traumatic Trigeminal Neuropathy Improved with Seungmagalgeun-tang-gamibang and Acupuncture: A Case Report

Case Report

The Journal of Korean Medicine 2026; 47(2): 234-243.

Published online: June 1, 2026

DOI: https://doi.org/10.13048/jkm.26031

Painful Post-traumatic Trigeminal Neuropathy Improved with Seungmagalgeun-tang-gamibang and Acupuncture: A Case Report

Do-Hwan Kim¹^{, *}

, Ki-Won Um²

¹Chief Korean Medicine Doctor, Doochung Korean Medicine Clinic

²Staff Korean Medicine Doctor, Doochung Korean Medicine Clinic

^*Correspondence to: Do-Hwan Kim, 2F, 250, Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea, Tel: +82-2-574-1075, Fax: +82-2-574-1076, E-mail: dohwan2k@naver.com

Received March 16, 2026 Revised May 9, 2026 Accepted May 14, 2026

Abstract

Objectives

Painful post-traumatic trigeminal neuropathy (PPTTN) is a chronic neuropathic facial pain condition that occurs after trigeminal nerve injury. This study aimed to report the clinical outcomes of Korean medicine treatment including Seungmagalgeun-tang-gamibang and acupuncture in a patient with PPTTN following dental implant surgery.

Methods

This study retrospectively reviewed the medical records of a patient diagnosed with PPTTN who was treated at a Korean medicine clinic. The patient received a Seungmagalgeun-tang-gamibang herbal prescription and acupuncture once weekly during the treatment period. Pain intensity was evaluated using the Numeric Rating Scale (NRS). Clinical progress was assessed through patient interviews, functional observations including eating and lip movement, and changes in pain distribution.

Results

At the initial visit, the patient reported severe pain in the right lower lip and mandibular region with an NRS score of 10. During treatment, pain gradually decreased to NRS 2–3 during the mid-treatment period and improved to NRS 1 at the final follow-up visit. Functional improvements were observed, including increased food intake, improved lip movement, and recovery of daily activities. The pain distribution also progressively decreased from the mandibular region to a small localized area of the lower lip.

Conclusions

This case suggests that Korean medicine treatment including Seungmagalgeun-tang-gamibang and acupuncture may contribute to symptom improvement in patients with PPTTN.

Keywords: Painful post-traumatic trigeminal neuropathy, Trigeminal neuropathy, Acupuncture, Korean medicine, Seungmagalgeun-tang-gamibang, Case report

Fig. 1

Changes in numeric rating scale (NRS) scores during treatment

Fig. 2

Changes in pain distribution during treatment

(A) At the initial visit (2024-10-19), the patient reported diffuse neuropathic pain involving the right lower lip and mandibular area (V3 distribution).

(B) During the mid-treatment period (2025-04-05), the pain distribution began to centralize, with a marked reduction in mandibular involvement.

(C) At the final follow-up (2026-01-10), the affected area was significantly minimized to a stable 1 cm focal region on the lower lip.

Table 1

Prescription of Seungmagalgeun-tang-gamibang (1Day)

Name of Natural Medicine (Herbal Medicine)		Weight(g)
龍骨	Fossilia Ossis Mastodi	2.8
鹿茸	Cornu Cervi Parvum	2.8
白芍藥	Paeoniae Radix Alba	2.8
當歸	Angelicae Gigantis Radix	1.87
黃芪	Astragali Radix	1.87
桂枝	Cinnamomi Ramulus	1.87
人蔘	Ginseng Radix Alba	1.87
防風	Saposhnikoviae Radix	1.87
柴胡	Bupleuri Radix	1.4
升麻	Cimicifugae Rhizoma	1.4
牡丹皮	Moutan Cortex	1.4
熟地黃	Rehmanniae Radix Preparata	1.4
白朮	Atractylodis Rhizoma Alba	1.4
陳皮	Citri Unshius Pericarpium	1.4
大棗	Zizyphi Fructus	0.93
甘草	Glycyrrhizae Radix et Rhizoma	0.93
荊芥	Schizonepetae Spica	0.93
香附子	Cyperi Rhizoma	0.93
川芎	Cnidii Rhizoma	0.93
白芷	Angelicae Dahuricae Radix	0.93
	Total Amount	32.67

Table 2

Clinical Observation of Functional Changes during Treatment

Date	Eating Function	Lip Movement/Speech	Daily Activity
2024-10-19	Severe discomfort during chewing	Difficulty in lip movement	Daily activities limited
2024-12-14	Increased food intake	Partial improvement	Activity level increased
2025-02-08	Soft diet due to discomfort	Dysesthesia persisted	Activities mostly possible
2025-03-15	Discomfort only during eating	Lip movement improved	Near-normal daily function
2025-05-10	Normal eating most days	Minimal difficulty	Increased symptom-free days
2025-11-15	Discomfort only with spicy food	Normal speech and movement	Normal daily activity
2026-01-10	Normal eating	Normal lip movement	Fully independent daily life

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