Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of our own patients, the anamnestic data and the neurological constellation in late radiogenic paresis (the most frequent peripheral nervous condition in treatment of mammary carcinoma) are described. A comparison with the situation in metastatic infiltration of the brachial plexus shows the great difficulties in differential diagnosis. Pain can be observed more frequently in metastatic plexus infiltration. The presence of a Horner syndrome can be regarded as decisive evidence for recurrent growth of a carcinoma. If a Horner syndrome is absent, tumor growth can be demonstrated conclusively only by biopsy or surgical exploration. The most frequent condition which is not connected with mammary carcinoma and its followup treatment, but which can stimulate a late radiogenic paresis of the brachial plexus is the carpal tunnel syndrome. Whereas a certain differentiation is not always possible on the basis of the anamnesis and clinical findings, a clear discrimination is possible by means of electrophysiological investigation techniques.
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PMID:[Lesions of the peripheral nervous system in the treatment of breast cancer]. 618 90

A review of the literature on Spontaneous Dissecting Aneurysms (DA's) of cerebral arteries is presented with 3 personal cases of DA's of the Internal Carotid Artery (ICA). Patients with spontaneous DA's of the extracranial ICA are of middle age (30 to 60 year old) and present with an ipsilateral pain in the neck or face and/or with TIAs (45 p. 100 and 50 p. 100 of the cases respectively). Claude Bernard-Horner's sign is frequent. The clinical, radiological and pathological data suggest that in most cases, if not all, neurological deficits are due to embolism and/or anterograde thrombus. This has led to recommend anticoagulant therapy. Nevertheless, surgery may be indicated is some situations such as in DA's on kinking arteries. The treatment of spontaneous DA's of extracranial vertebral arteries is still a detectable matter, though they have common features with DA's of the extracranial ICA. The DA's of the basilar and intracranial vertebral arteries are often associated with a subarachnoid haemorrhage and most of them have a severe outcome. Lesions of the arterial wall such as cystic medial necrosis and fibromuscular dysplasia play a role in the extent, and presumably in the initiation, of the so-called spontaneous DA's at least in some cases. Minor trauma, high blood pressure (20 p. 100 of the cases), oral contraceptives and coughing have been as well suspected.
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PMID:[Spontaneous dissecting aneurysms of the cerebral arteries]. 636 8

A patient with Stage I systemic sarcoid (affecting the mediastinum and cervical lymph nodes) is presented. This patient had ptosis of the eyelid and miosis (Horner's syndrome) due to involvement of the cervical-thoracic sympathetic nerves by the granulomatous process. Bony destruction simulating periodontal disease occurred in the molar-premolar region and caused pain and paresthesia. Systemic sarcoid may occur more commonly in the jaws than reported cases would indicate. Sarcoidosis should be considered in the differential diagnosis when periodontal disease appears refractory to local therapy.
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PMID:Systemic sarcoidosis presenting with Horner's syndrome and mandibular paresthesia. 695 36

This sequela may be more common than is recognized. Because syringomyelia can progress to advanced stages without overt symptoms, awareness of this entity is vital for early diagnosis. Unexplained pain, numbness and ascending or descending anesthesia, followed by motor loss, point to the diagnosis. Other signs include neurotrophic arthropathy, Horner's syndrome, autonomic dysreflexia and manifestations of brainstem involvement. Computed tomography helps identify the cysts. Operative procedures to promote drainage of the fluid from the syrinx may cure or halt progression of the lesion.
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PMID:Syringomyelia after spinal cord injury. 709 Sep 58

A case of Pancoast's syndrome due to a hydatid cyst is described. The cyst developed secondarily, after intrapleural rupture of an echinococcus cyst situated in the liver. The patient was operated and the cyst excised. After the operation the pain in the shoulder and the arm disappeared immediately. The Horner's syndrome needed longer to subside. Three years after the operation there is still some constriction of the pupil of the right eye. The development of Pancoast's syndrome due to hydatid disease is very rare and this case--caused by a secondary cyst after intrapleural rupture of a similar hepatic echinococcus cyst--is the first described in the literature.
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PMID:Pancoast's syndrome following an intrapleural rupture of a hepatic echinococcus cyst. 717 Jun 17

A previously healthy man presented with burning pain in the chest wall and arm; there was Horner syndrome on the same side. After extensive investigation, the disorder was attributed to a foraminal osteophyte involving the left T1 spinal root.
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PMID:Horner syndrome with causalgia. 718 58

The clinical results in a series of 131 patients with 134 brachial plexus injuries were analysed to determine the factors affecting prognosis. Isolated injuries to the upper trunk had the best prognosis, but the prognoses of isolated injuries to the cords, upper roots and lower trunk were not as good. Complete injuries of the plexus had the worst prognosis. Pain which persisted for more than six months was a bad prognostic sign for neurological recovery regardless of the location of the lesion. Horner's syndrome was not always accompanied by a bad prognosis. Operation did not affect the prognosis except in open lacerations. A pseudomeningocele detected by myelography usually precluded recovery in the root at the level of the pseudomeningocele.
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PMID:Factors affecting the prognosis of brachial plexus injuries. 726 55

A 52-year-old man presented with unilateral left periorbital and frontotemporal pain associated with a partial ipsilateral Horner's syndrome of the postganglionic type and representing a pericarotid syndrome. MRI demonstrated a perivascular subacute hematoma at the level of the cervical portion of the left internal carotid artery with a markedly reduced flow-void signal. MR angiography confirmed the narrowed lumen of the dissected cervical internal carotid artery. There was also a right-sided precavernous carotid aneurysm. Three months later the left-sided pain had subsided, with complete resolution of the hematoma and incomplete restoration of the left carotid lumen seen on MR angiography. Dissection of the carotid wall may cause the oculosympathetic paralysis by producing a lesion of the superior cervical ganglion, the internal carotid nerve, or the perivascular sympathetic plexus. Whereas in pericarotid syndrome the most common cause is cervical carotid dissection, Raeder's syndrome additionally involving parasellar cranial nerves, may be caused by any paracavernous/cavernous lesion, including neoplasms and intracranial carotid aneurysms. The clinical distinction is useful to determine the appropriate diagnostic investigation, in view of the different pathoanatomical localization and different disease spectrum. As demonstrated in the present case, the combination of MRI and MR angiography is a reliable noninvasive tool to investigate the differential diagnosis of pericarotid syndrome, accurately depicting occlusive, stenotic or aneurysmal lesions of the carotid artery. We suggest that intraarterial angiography is no longer necessary.
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PMID:Noninvasive investigation of pericarotid syndrome: role of MR angiography in the diagnosis of internal carotid dissection. 772 79

We describe herein the successful treatment of four patients with ischemic ulcers or gangrene of the fingers due to Buerger's disease by thoracoscopic sympathectomy, a new method of surgery which eliminates the difficulties associated with the traditional "open" approaches to the thoracic sympathetic chain, such as poor exposure, risk of damage to the adjacent structures, and postoperative pain. After the patients were placed in the lateral decubitus position with unilateral pulmonary ventilation, the thoracic sympathetic ganglia (T) from the lower third of T1 to T3 were resected endoscopically. The operative results were excellent, with improvement or complete resolution of the ulcer being achieved in all four patients. All of the patients were satisfied with the results in terms of ulcer healing, postoperative pain, and cosmetic appearance. Although a postoperative air leakage developed in one patient with a history of pulmonary tuberculosis, it was successfully treated with an adhesive agent. None of the patients developed Horner's syndrome. Thus, because thoracoscopic sympathectomy is easier to perform with a lower risk of complications than conventional thoracic sympathectomy, we recommend this operative approach as the procedure of choice for surgical thoracic sympathectomy.
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PMID:Thoracoscopic sympathectomy for Buerger's disease: a report on the successful treatment of four patients. 777 25

A comparative study of the effects of sympathetic blockade by stellate ganglion block (SGB) and intravenous phentolamine infusion (PhI) was carried out in 24 patients with presumed sympathetically maintained pain of an upper extremity. A total of 15 SGBs and 16 PhIs were performed, with seven patients undergoing both procedures. All patients developed a Horner's syndrome with SGB and nasal stuffiness and cardiovascular changes with PhI. Similar pain relief was obtained with SGB and PhI in six of the seven who underwent both procedures. Pre-procedure patient characteristics including age, sex, duration of pain, historical and physical examination features suggestive of the reflex sympathetic dystrophy syndrome, and sensory disturbances such as allodynia and hyperpathia did not predict pain relief from either procedure. Changes in skin temperature following the sympatholytic procedure did not correlate with pain relief. For PhI, pain relief correlated with the magnitude of decrease in systolic blood pressure. After SGB, changes in quantitative thermal sensory testing (QST) suggestive of a partial deficit in thermal sensation correlated with pain relief. In 20 normal controls, water bath immersion to cool the hand passively by 7 degrees C and warm the hand passively by 4 degrees C had small and selective effects on thermal QST thresholds, but did not produce a general impairment in thermal sensation. In conclusion, the diagnosis of sympathetically maintained pain based on the history and physical examination alone cannot be made with confidence and therefore a sympatholytic procedure is necessary. When SGB produces pain relief but PhI does not, systemic absorption of local anaesthetic and/or sensory blockade by spread to somatic nerves may be the reason. Thus, PhI appears to be a less sensitive but more specific test than SGB. These two procedures provide complementary information and both may be needed to establish the diagnosis of sympathetically maintained pain.
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PMID:The interpretation of pain relief and sensory changes following sympathetic blockade. 782 May 81


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