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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 30-year-old man with chronic abdominal pain was treated with high doses of hydromorphone intravenously and developed severe and frequent myoclonic contractions. Several medications including lorazepam failed to control the contractions; however, clonazepam in normal doses reduced the myoclonus dramatically.
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PMID:Clonazepam treatment of myoclonic contractions associated with high-dose opioids: case report. 128 11

Propriospinal myoclonus is one type of myoclonus that is proposed to originate in the spinal cord and spread up and down via propriospinal tract. There are a few reports describing the detailed electrophysiological findings of this myoclonus. In this communication, we present the results of electrophysiological analysis of a patient with propriospinal myoclonus. A 23-year-old woman suddenly noticed abdominal pain, which spontaneously faded in a few hours. Irregular involuntary flexion jerks of the trunk appeared spontaneously without pain or hiccups after this episode. It involved the bilateral axial muscles; sternocleidomastoid muscles (SCM), paravertebral muscles (PVM), abdominal muscles (ABD), and intercostal muscles (ICM), but not the limb muscles. It was worsened by the mental stress, but not by her posture or position. While she slept, the jerks were not observed. Routine laboratory examinations were all normal. Magnetic resonance imaging of the spinal cord revealed no abnormalities. The electrophysiological studies done on this patient are polymyography, back-averaging of the EEG activity preceding spontaneous jerks (jerk-locked averaging (JLA), and movement related cerebral potential (MRCP) preceding the involuntary jerks and voluntary abdominal movements. No EEG activities preceding the myoclonus were demonstrated by JLA or MRCP. No MRCP recorded preceding the myoclonus suggests that the jerk is not a self-initiated or externally triggered voluntary movement. Polymyography revealed that the jerks involved the bilateral axial muscles including SCM, PVM, ICM, and ABD, but not the limb muscles. Homologous muscles were activated synchronously. The duration of EMG bursts was variable ranging 50 to 250 ms in these muscles.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Propriospinal myoclonus--a case report]. 825 30

The disease is named after George H. Whipple who, in 1907, was the first to describe an intestinal "lipodystrophy". Although Whipple's disease is generally recognized as a multisystem chronic granulomatous disease, primarily involving the digestive system, it can also appear as a primary neurological disorder in rare cases. Most often it is manifested with loss of weight, diarrhea, malabsorption, abdominal pain, lymphadenopathy, cardiopathy, hyperpigmentation and hypotension. The presence of periodic acid-Schiff (PAS)-positive macrophages in biopsy specimens (not only jejunal) and demonstration of "Whipple's bacilli" visible by electron microscopy, are diagnostic signs of active Whipple's disease. Whipple's disease confined to the CNS is rare. It is rarely found in the differential diagnosis of patients with progressive neurological deterioration. The most common neurological picture includes progressive dementia, external ophalmoplegia, myoclonus, seizures, ataxia, hypothalamic dysfunction (sleep disorders, hyperphagia, polydipsia) and meningitis. Oculofacial-skeletal myorhythmia as a movement disorder, associated with Whipple's disease, is reported. Fulminant course of cerebral Whipple's disease is unusual and unfavourable. The confusing and nonspecific clinical appearance is typical for primary CNS involvement. It has recently been suggested that CNS involvement occurs in all cases, although only 10-20% of patients may show it. The CNS is the most common site of disease relapse. The CT scans and MRI of the brain are often normal, but may show cortical/subcortical atrophy, hydrocephalus, focal or intracerebral mass lesions. The cerebrospinal fluid can sometimes contain PAS-positive macrophages. Brain biopsy is suggested as a diagnostic method in cases of high suspicion of CNS Whipple's disease. However, the lesions are frequently inaccessible and false negative. Without extended antibiotic therapy, the course of Whipple's disease is lethal. Now, the prognosis is good, although the optimal antimicrobial regimen is not clearly established. Initial parenteral therapy (tetracycline, penicilline, streptomycine, chloramphenicol, ampicilline) and peroral long-term treatment with trimetoprime-sulphametoxasole, are recommended. As CNS relapse of Whipple's disease may occur after several years, long-term treatment should include antibiotics that are able to cross the blood-brain barrier. The CNS relapse, in contrast to the systemic ones, is resistant to the treatment. Appropriate therapy instituted earlier in the course of the disease is associated with a better neurological outcome. Early recognition can be critical in Whipple's disease because of irreversible neurological sequelae seen later in the course of this potentially treatable condition. In cases with high clinical suspicion in which Whipple's disease cannot be diagnosed with procedures such as jejunal biopsy, antibiotic therapy is recommended. Recovery of an established neurological deficit may rarely occur. Longterm follow-up studies would help to identify the optimal antibiotic regimen and duration of treatment.
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PMID:[Neurologic disorders in Whipple's disease]. 910 28

We report on a patient with segmental rhythmic myoclonus resembling belly dance. This patient developed the myoclonus in temporal and anatomical association with chronic abdominal pain. No structural or metabolic abnormalities were found. EMG recordings suggested the presence of a spinal cord central pattern generator (CPG). We hypothesize that pain-related spinal plasticity might have contributed to the hyperactivity of a spinal CPG, thus leading to the myoclonic jerks in our patient.
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PMID:Belly dancer's myoclonus and chronic abdominal pain: pain-related dysinhibition of a spinal cord central pattern generator? 1704 97