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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four hundred and seventy five patients with trigeminal neuralgia underwent cryotherapy (145), radiofrequency thermocoagulation (265) or microvascular decompression 65) and were then followed up for mean time of 45 months. Outcome of treatment was assessed not only by the clinicians but also by a postal questionnaire. The presence of anxiety and depression was determined and compared to 51 patients due to undergo surgery. The median time to recurrence for the cryotherapy patients and the radiofrequency thermocoagulation patients were 6 and 24 months, respectively. At 5 years 38% of the microvascular decompression patients had had a recurrence of neuralgia. There was one operative death in the radiofrequency thermocoagulation group. Patients in all three groups were satisfied with their treatment but the questionnaires showed that clinicians under-report the recurrence of pain and post operative complications. Pre-operatively depression and anxiety are high but post-operatively only 15% were depressed. Patients need careful pre-operative assessment which includes the McGill Pain Questionnaire and they should be given a choice about which surgical method would be most suitable in their case. Printed information should be available to supplement the consultation. This would ensure the patients' expectations matched up with the results as they would be aware of possible outcomes.
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PMID:Patient's assessment of outcome after three surgical procedures for the management of trigeminal neuralgia. 837 12

In this article the authors present a case of a secondary depression in woman, 75 years old, without previous psychiatric anamnesis or heredity. She had post-herpetic intercostal neuralgia and developed symptoms of depression. This case is an example which points to necessity of cooperation of other medical branches with psychiatry.
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PMID:[Case report of a female patient with post-infection depression]. 864 74

Symptomatic treatment of multiple sclerosis (MS) includes a diverse range of drugs intended to relieve the specific symptoms with which a patient may present at a particular point in the progression of the disease. These drugs, not specifically designed for the treatment of MS, may include antispastic agents (e.g. baclofen), drugs to reduce tremor (e.g. clonazepam), anticholinergics (e.g. oxybutynin) which relieve urinary symptoms, anti-epileptics (e.g. carbamazepine) to control neuralgia, stimulants to reduce fatigue (e.g. amantadine), and antidepressants (e.g. fluoxetine) to treat depression. The treatment of acute relapses or exacerbations is dominated by corticosteroids such as methylprednisolone. The most active area of current investigation is the development of drugs which will inhibit the progression of the disease process itself, and in this category the beta- and alpha-interferons are the most effective drugs currently available, although many new treatments are currently in trials, including immunoglobulin, copolymer-1. bovine myelin, T-cell receptor (TCR) peptide vaccines, platelet activating factor (PAF) antagonists, matrix metallo-proteinase inhibitors, campath-1, and insulin-like growth factor (IGF).
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PMID:Recent developments in drug therapy for multiple sclerosis. 1033 20

Glossopharyngeal neuralgia is not just a painful condition. At times, it may be life-threatening as a result of associated cardiovascular consequences. Even in the absence of life-threatening consequences, it can be a severe debilitating disease with depression, suicidal tendencies, fear of swallowing, loss of weight and under-nutrition. The treatment for glossopharyngeal neuralgia and Eagle's syndrome has evolved over time. This review summarises the scientific evidence and philosophy about current management and therapy. Emphasis is placed on the importance of excluding secondary causes of glossopharyngeal neuralgia before embarking on nerve section through the posterior cranial fossa approach. The Eagle's syndrome due to an elongated styloid process is the most important cause of secondary glossopharyngeal neuralgia. Stylectomy is effective and should be considered before embarking on any neurosurgical procedure. Peripheral cervical and trans-tonsillar approaches to the glossopharyngeal nerve are also discussed.
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PMID:The glossopharyngeal nerve, glossopharyngeal neuralgia and the Eagle's syndrome--current concepts and management. 1074 Nov 97

Migraine is a significant pain problem for almost one third of women in the United States. Little previous research has been conducted regarding the effects of migraine headache on the lives of women migraineurs. The purpose of this report is to determine the contribution of coping, depressive symptomatology, and the chronic pain experience on disability and quality of life in women with migraine. Two hundred and forty-seven women responded to a mailed survey about migraine headache, the chronic pain experience, coping, depressive symptomatology, and quality of life. Data were collected with the following: the Classification and Diagnostic Criteria for Headache Disorders, Cranial Neuralgias, and Facial Pain; the McGill Pain Questionnaire; the Chronic Pain Experience Instrument-Headache; the Coping Strategies Questionnaire; the Center for Epidemiologic Studies-Depression Scale; the Henry Ford Hospital Disability Inventory; and the Migraine-Related Quality of Life Questionnaire. Multiple regression analyses were conducted to determine the amount of variance that could be explained by selected predictor variables. Women ranged in age from 18 to 66 years and migraineurs reported suffering from migraine from 1 to 54 years. Nearly half of the migraineurs (41.5%) reported migraine headaches occurring monthly, and almost a quarter of the sample reported weekly migraines. Migraines were reported to last for several hours (53.4%). Results indicate that migraine headache pain was typically severe and throbbing, lasting for hours to days. The coping, depressive symptomatology, disability, and quality-of-life variables were all significantly correlated. Two separate regression analyses that examined predictor variables and the criterion variables, disability and quality of life, showed that a significant amount of both constructs could be explained by the predictor variables in the model tested. In the first regression analysis, depressive symptomatology, the chronic pain experience, and migraine headache pain accounted for 62.9% of the variance in disability. In the second regression analysis, 64.8% of the variance in quality of life was accounted for by depressive symptomatology, migraine headache pain, and the chronic pain experience. The variance in both outcome variables, disability and quality of life, was accounted for by similar predictor variables: depressive symptomatology, the chronic pain experience, and migraine headache pain. Further study is needed to determine specific personal and illness-related factors, pain characteristics, and coping strategies used that may predict outcomes of migraine headache such as disability, quality of life, helplessness, and other as yet unidentified effects of migraine headache.
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PMID:Predicting disability and quality of life in a community-based sample of women with migraine headache. 1170 67

The pineal hormone melatonin is the mediator of external light to physiologic adaptation to day and night rhythms, it regulates reproduction in animals but attempts to utilize melatonin in women for contraception have failed. Melatonin seems to be the natural hormone to facilitate sleep in insomniac patients and causes no hang over. When applied together with benzodiazepine it allows reduction of benzodiazepine without withdrawal effects. It should be applied 2 h before sleeping time in doses between 3 and 5 mg. Melatonin acts via the gamma-aminobutyric acid- and benzodiazepine receptor explaining its success in treatment of seizures in children and in adults. Constant application of benzodiazepine reduced the production of natural melatonin in rats, supporting the evidence that long-term application of benzodiazepine in humans does not restore sleeping habits but reduces natural sleeping habits even more. Low melatonin levels were seen in bulimia or neuralgia and in women with fibromyalgia; replacement reduced pain, sleeping disorders, and depression in fibromyalgia and bulimia. Melatonin profiles are a diagnostic tool to distinguish between several forms of depression, like major depression, winter depression (SAD), unipolar depression, delayed sleep phase syndrome (DSPS). In patients with a major depression success with antidepressants correlated with an increase in their melatonin profiles but only patients suffering from DSPS can be successfully treated with melatonin. In perimenopausal women melatonin administration did produce a change in LH, FSH and thyroid hormones. Some oncostatic properties are supported by cell culture work and studies in animals. In Nordic countries indigenous people suffer less from breast and prostate cancer, winter darkness seems to protect. The supposedly increased melatonin levels created the 'melatonin hypothesis'. Epidemiological studies did show that blind people indeed have half the rate of breast cancers, supporting the hypothesis. Controversial results concerning melatonin and insulin resistance and glucose tolerance have been published. In postmenopausal women application of melatonin reduced glucose tolerance and insulin sensitivity. Pregnant women should avoid melatonin, since its teratogenic effect is not known. Patients suffering from non-hormone dependent tumors, like leukemia, should avoid melanin, since tumor growth was promoted in animal experiments. It can be expected that melatonin will receive wide consideration for treatment of sleeping disturbances, jet lag, and fibromyalgia once an oral formulation becomes available in Europe.
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PMID:Melatonin deficiencies in women. 1195 97

Postherpetic ophthalmic neuralgia is the final stage of a varicella zoster infection. Many years after chickenpox infection, patients can develop herpes zoster in one or more specific dermatomal regions. The ophthalmic branch of the trigeminal nerve and the thoracic nerves are most commonly affected. Younger patients are less prone to postherpetic neuralgia than the older. Patients with a depression in cell-mediated immunity are more susceptible to develop postherpetic pain. Postherpetic ophthalmic neuralgia is a neuropathic pain and can be treated by anticonvulsants and tricyclic antidepressants. Neurodestructive procedures are not recommended as they enhance destruction and neuropathic pain. Sympathetic nerve blocks can be helpful. Neurostimulation is the last therapeutic resort.
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PMID:Postherpetic ophthalmic neuralgia. 1244 39

A 77-year-old woman with hypertension and senile depression had suffered from medically unresponsive trigeminal (left ophthalmic) neuralgia despite microvascular decompression surgery for twice. The patient underwent stereotactic gamma knife radiosurgery (77 Gy) for the neuralgia, resulting in pain relief. However, approximately 20 months after the radiosurgery, she developed left facial palsy with hydrodipsia, left xerophthalmia, and left facial hypesthesia. Oral prednisolone was administered, and these symptoms disappeared in several months. This is the first report of facial palsy following gamma knife radiosurgery for trigeminal neuralgia.
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PMID:[A case of delayed facial palsy following gamma knife radiosurgery for intractable trigeminal neuralgia]. 1616 95

Western medicine was introduced to Taiwan in 1865 when Dr. James L. Maxwell, a missionary doctor of the English Presbyterian Church, established a hospital in nowadays Tainan. The period of the missionary medicine lasted for over 30 years until Japanese took over. During this period, however, official records of diseases in Taiwan that were based on Western medicine were scanty or not available. Fortunately, port surgeons stationing respectively in Tamsui and Kelung in the north and in Takow and Taiwan-fu in the south reported semi-annually diseases seen in the ports, foreign communities and missionary hospitals that they volunteered to work. The diseases reported by port surgeons were either cases or summary of cases with classification and statistics. Their medical reports covered from 1871 to 1900. The data show that neurological diseases and/or disorders in the late 19th century Taiwan were uncommon, comprising only 2-3% of total diseases. The data further show that common neurological diseases were leprosy, opium smoking, syphilitic dementia (GPI), paralysis, hysteria, neuralgia, epilepsy, mania, sciatica, meningitis and ataxia. Stroke was uncommon while Parkinson's disease and Alzheimer's disease were not mentioned, indicating that neurological diseases related to old age and neurodegeneration were not yet a threat to health. Similarly, headache, insomnia, anxiety and depression, hallmark of functional disorders of the modern society, were also not mentioned, suggesting that these disorders were indeed rare or did not cause sufficient concern for patients to seek help from doctors of Western medicine.
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PMID:[Neurological diseases in late 19th century Taiwan--medical reports of the Chinese Imperial Maritime Customs]. 1642 51

Is this elaboration the analysis of a return to gainful work by 76 consecutive suffering from back pain and ischiadic neuralgia due to the lumbar discopathy after rehabilitation has been presented. The following parameters which might have influenced the return to work: age, sex, treatment, employment, education, the length of incapaticy for work has been analysed. The relevancy of the opinion given by doctors at rehabilitation centre on the patients capacity for work in relation to their future return to the gainful work in relation to their future return to the gainful work has been analysed. The utility of measuring activities of daily living (ADL), level of depression and quality of life (HRQoL) for predicting return work has been estimated. As the tools the Functional Index "Repty", Beck's Depression Scale and an own Simple Life Satisfaction Scale has been used.
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PMID:The usefulness of evaluation of Activities of Daily Living for prediciting the return to the gainful job after rehabilitation of patients suffering from lumbar discopathy. 1767 5


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