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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There are probably 2.5 million patients with Paget's disease in the U.S.; 125,000 of these have severe disease meriting specific treatment. While the diagnosis can often be made by inspection, or by measurement of the temperature of involved limbs, it is often missed. Nonspecific findings include pain, headaches, deafness, heart failure, neurologic deficits and renal stones. A specific diagnosis can usually be established by radiologic examination of the skeleton and measurement of the serum alkaline phosphatase level. Bone scans are often helpful. In moderate-to-severe symptomatic disease, calcitonin limits the unregulated chaotic bone resorption and exerts highly specific and effective suppressive activity.
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PMID:Paget's disease: New treatment for an old disease. 13 63

Paget's disease usually is found in patients past the age of 40. Early presenting symptoms include headache, deafness, tinnitus, and pain due to radicular compression. The diagnosis is confirmed by radiographic features and elevated levels of serum alkaline phosphatase and urinary hydroxyproline. Bony overgrowth results in pressure on nearby soft tissues such as the brain, spinal cord, and certain peripheral nerves. The abnormally soft quality of the calvarial bone permits distortion by the weight of the brain. Dorsal inclination of the plane of the foramen magnum and the projection of the odontoid process into the posterior fossa lead to stretching of the brain stem over the odontoid process and the ventral margin of the foramen. Obstructive hydrocephalus may result. Sarcoma of the crainial vault may develop in cases of Paget's disease. Once cervicomedullary or spinal compression has occurred, surgical decompression may be necessary. Three drugs--calcitonin, disodium etidronate, and mithramycin--have been used with some benefit in the treatment of Paget's disease.
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PMID:Paget's disease and the nervous system. 21 14

17 patients with alterations of the mandibular joint complained of pain of the external auditory canal, the tragal region and the side of the face. In women between 25 and 35 an unphysiologic stress of the joint, in patients over 45 insufficient or missing prosthetics were identified as cause. Other symptoms such as inner ear deafness, vertigo and globus hystericus were not seen.
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PMID:[Ear pains by alterations of the mandibular joint (author's transl)]. 43 90

In a trial of 48 patients with rheumatoid arthritis, enteric-coated aspirin (4.55 g daily( and micro-encapsulated aspirin (4.50 g daily) proved to be equally effective in reducing morning stiffness, relieving pain, increasing grip strength, reducing ESR, and reducing the need for additional analgesic tablets, compared with placebo. Reduction of joint tenderness was also found, but this was not statistically significant. Proximal interphalangeal joint circumference altered little during the trial. Tinnitus and deafness were commoner with enteric-coated aspirin, but gastric side-effects were similar. Of 39 patients completing the trial, there was an equal patient preference for enteric-coated aspirin and micro-encapsulated aspirin. Salicylate side-effects necessitated withdrawal of six patients from the trial and dose reduction in nine patients. It was concluded that the efficacy and side-effects in rheumatoid arthritis of both aspirin preparations were similar.
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PMID:A trial of micro-encapsulated and enteric-coated aspirin in rheumatoid arthritis. 77 89

At a consultation with a 31-year-old man, motivated by painful episodes of joint pain that had started considerably earlier, a familial disease entity was discovered that included the three clinical signs of the Muckle and Wells syndrome : urticarial eruption, intermittent pain in the limbs originating in the joints, and bilateral deafness of perception. In spite of the absnece of renal amylosis, the similarity of the characteristics of these three elements, as well as the nature of the biochemical disturbances, and the mode of transmission, led the authors to consider these observations in the contest of this syndrome. The joint manifestations being indicative, the signs of this intermittent rheumatism are described, as well as the characteristics of the other disorders.
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PMID:[Intermittent rheumatism revealing a familial syndrome. Arthritis--urticarian eruptions--deafness: Muckle-Wells syndrome without kidney amylosis]. 108 54

Clinicopathological reports on infarction in the territory of the anterior inferior cerebellar artery (AICA) are rare. In the present series cerebellar infarcts involved only the AICA territory in 13 cases. They were bilateral in 3 cases. In these pontocerebellar infarcts the middle cerebellar peduncle was the core of the affected territory. It was seldom selectively affected. In a few cases, the infarction extended to the flocculus. Next most frequently involved was a thin band of tissue in the adjacent cerebellar white matter, comprising laterally the neighbouring cerebellar lobules. The largest infarcts extended to the anterior and inferior aspects of the cerebellum. In these cases, the posterior inferior cerebellar artery (PICA) was hypoplastic. In most infarcts, the inferolateral pontine territory was involved, the infarction sometimes extending up to the middle third of the lateral pons and down to the superior part of the lateral medulla. No brainstem compression or tonsillar herniation were observed with infarcts affecting the AICA territory alone. Clinically, involvement of several cranial nerves (facial palsy, multimodal trigeminal sensory impairment, deafness, sometimes with tinnitus, a vestibular syndrome, or lateral gaze palsy) was constant. Cerebellar signs and motor weakness occurred frequently. Contralateral pain and temperature sensory loss was present at times. Horner's syndrome or skew deviation was rare. Study of the arteries showed that arterial occlusion was mainly due to thrombosis superimposed on atheromatous stenosis. In 7 cases, the infarction also involved the PICA territory or the PICA and the superior cerebellar artery territories. These extensive infarcts were often associated with tonsillar herniation and massive paramedian brainstem infarction. The cases in which the territories of the three cerebellar arteries were affected presented in deep coma, together with tetraplegia in some patients. Those in which PICA and AICA territories were involved together presented with similar clinical features as in the cases in which only the AICA territory was involved.
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PMID:Cerebellar infarction in the territory of the anterior and inferior cerebellar artery. A clinicopathological study of 20 cases. 230 29

Fourteen of 80 interpreters (18%) for deaf students at a national center on deafness sought medical care for painful conditions of the upper extremity; 11 others (14%) had less severe or transient symptoms. The conditions were brought on by repetitive use and were relieved by rest. All represented overuse syndromes. Tendinitis, fasciitis, synovitis, and nerve entrapment were encountered most often. Conservative treatment (eg, physical therapy, splinting, medications) was of little or no value. Only rest relieved symptoms. Surgery was rarely indicated. The most reasonable approach to treatment would, therefore, seem to be prevention. Suggested methods for avoidance of pain include limiting the duration of interpreting sessions, technique modification, and resistance exercises to increase endurance.
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PMID:Overuse syndromes of the upper extremity in interpreters for the deaf. 230 80

It was observed that in hypertension hearing is severely damaged. By analysis of the otological symptomatology in 50 hypertonic patients (42 women, 8 men) a bilateral hearing disorder was revealed in 47 subjects, a unilateral one in three subjects, otoscopy revealed dilatation of the artery supplying the handle of the malleus or even hyperaemia of Schrapnell's membrane. The patients reported low-frequency tinnitus, vertigo, pressure in the ears pain in the ears, headache, weather-dependence of complaints. In the initial stages roof-shaped type of audiometric curve was found, in the group were 45% mixed types of deafness. If during hypertension sodium is retained and the extracellular volume is enlarged, then in the inner ear the volume of perilymph increases in particular and this leads to impaired conduction through the inner ear fluids with affection of high and low frequencies, disorders of the conduction function of the fenestrae with the conduction component on the audiogram. Hypertension is for the organ of hearing an important risk factor in pre-disposed subjects with and affection of the inner ear is equally malignant and has a similar pathological background as glaucoma.
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PMID:[The cochleovestibular syndrome in hypertension]. 235 Aug 10

We reported a 51-year-old male with ischemic disturbance of right inner ear resembling Meniere's disease. The patient had a sudden-onset episode of vertigo, right severe hearing disturbance, nausea, vomiting and gait disturbance. Two days after, he had hypersomnia, vertical gaze palsy, double vision, left Horner's sign, and sensory disturbance of pain and temperature of right half body involving face. Brain MRI disclosed high intensity area in T2-weighted image and proton density in bilateral paramedian thalamo-mesencephalic region and right cerebellum (area of the anterior inferior cerebellar artery). Cerebral angiography showed 90% or more stenosis of the right vertebral artery, 50% stenosis of the left vertebral artery before the posterior inferior cerebellar artery (PICA), and 60% stenosis of distal portion of the basilar artery. Furthermore, stem portion of the posterior cerebral artery, and the right anterior cerebellar artery and the left vertebral artery after the PICA were absent or occluded. Right deafness was evaluated to be Jerger type II, namely disturbance of inner ear. Caloric tests showed no response, and right auditory brainstem response showed no waves. Main cause of this vertigo and right deafness was considered to be disturbance of inner ear due to ischemia of right labyrinthine artery, though this patient was not a typical case of the anterior cerebellar artery syndrome. Ischemic disturbances of inner ear have been reported only in patients with the anterior cerebellar artery syndrome, therefore this patient who had only acute ischemic disturbance of inner ear and did not have disturbance of caudo-lateral portion of the pons was considered to be very rare.
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PMID:[A case of ischemic disturbance of inner ear]. 259 43

Galvanic stimulation applied to the head provides important information for differential diagnosis between inner ear and retro-labyrinthine disorders of the vestibular system. So far, galvanic stimulation has been difficult to introduce in routine practice because of side effects such as severe pain around the electrode area. We have developed a new method to record fine body sway elicited by low current stimulation of less than 0.4 mA and to quantitatively evaluate the responses by Fourier transform. During the past 5 years, 502 patients, showing uni- or bilateral canal paresis in the caloric test or findings of central disequilibrium, were tested by this method without producing any side effects. In 122 patients (24.8%), such as sudden deafness, acoustic tumour, vascular disorders of the CNS system and so on, findings of retro-labyrinthine disorders were detected. It has been concluded that this method was easy to perform and very useful for differential diagnosis of diseases of the vestibular system.
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PMID:Retro-labyrinthine disorders detected by galvanic body sway responses in routine equilibrium examinations. 263 31


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