以星狀神經節阻斷術治療Terbbinafine導致味覺喪失的病例報告

Treatment with Stellate Ganglion Block for Terbinafine Induced Taste Loss -- a Case Report

Terbinafine是一種口服有效的抗黴菌藥物，自從闖世以來已故廣泛的用於治療皮膚及指甲的黴菌感染，一般的副作用包括胃腸障礙及皮膚反應，除此之外有約0.6%的病人會發生味覺喪失的副作用，治療通常只有停藥，並無特殊的治療方法。我們在此報告一位34歲女性將人，因患指甲黴菌感染（友指甲症）而使用terbinafine來治療，但服藥一個月後，產生味覺喪失，但因不了解味覺喪失是與terbinafine有關，故仍繼續服藥至2個月後才停止，停藥後2星期味覺無恢復，開始接受星狀神經節阻斷術（SGB）治療，在接受5次SGB治療後戲劇性的完全性復，在此一儕探討味覺的生理、味覺喪失的成圓、機串串及SGB對此種病倒治療的可行性。

Terbinafine is an effective antimycotic agent for treatment of dermatomycosis and onychomycosis. It is widely used topically and systemically since first introduced in 1991. In general terbinafine is well tolerated; the common side effects are usually mild with gastrointestinal disturbances and skin reaction. Taste disturbance is a rare side effect and the incidence may be in 0.6% of patients. The only way to manage the taste disturbance is to discontinue the terbinafine but no specific treatment can be used. We reported a 34 year-old female suffered from dystrophic toenails for a long time. Under the diagnosis of onychomycosis, she received terbinafine 250 mg qd to treat the onychomycosis. One month later, she noticed that she was unable to taste food. However she didn' t know the taste loss may relate to terbinafine, she still continued to take terbinafine until 2 months. The sense of taste has not resumed in 2 weeks later after terbinafine stopped. She began to receive stellate ganglion block (SGB) in pain clinic and dramatic complete recovery of her taste was noticed after 5 SGB. The physiology of taste, mechanism of taste loss and the possibility of treatment with stellate ganglion block will be discussed.