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

There is a lack of prospective studies for the long-term results of percutaneous stereotactic radiofrequency rhizotomy (PSR) in the treatment of patients with trigeminal neuralgia. The authors present results in 154 consecutive patients with trigeminal neuralgia treated by PSR and prospectively followed for 15 years. Ninety-nine percent of the patients obtained initial pain relief after one PSR. Dysesthesia occurred in 31 patients (23%): in 7% with mild initial hypalgesia; in 15% with dense hypalgesia; and in 36% with analgesia. Dysesthesia was mild and did not require treatment in most patients. The corneal reflex was absent or depressed in 29 patients, and keratitis developed in three patients. In 19 of 22 patients with trigeminal motor weakness, the paresis resolved within 1 year. Of 33 patients who had pain recurrence, 10 patients had pain that was mild or controlled with medications, and 23 patients required additional surgical treatment. The authors estimated using Kaplan-Meier analysis that the 14-year recurrence rate was 25% in the total group: 60% in patients with mild hypalgesia, 25% in those with dense hypalgesia, and 20% in those with analgesia. Timing of pain recurrence varied according to the degree of sensory loss. All pain recurrences in patients with mild hypalgesia occurred within 4 years after surgery; 10% more of the patients with dense hypalgesia had pain recurrences within the first 10 years compared with patients with analgesia. The median pain-free survival rate was 32 months for patients with mild hypalgesia and more than 15 years for patients with either analgesia or dense hypalgesia. Of the 100 patients followed for 15 years after one or two PSR procedures, 95 patients (95%) rated the procedure excellent (77 patients) or good (18 patients). The authors conclude that PSR is an effective, safe treatment for trigeminal neuralgia. Dense hypalgesia in the painful trigger zone, rather than analgesia, should be the target lesion.
 ...
PMID:A prospective 15-year follow up of 154 consecutive patients with trigeminal neuralgia treated by percutaneous stereotactic radiofrequency thermal rhizotomy. 749 Jun 43

We report a series of 14 patients who underwent partial or complete trigeminal nerve root section for chronic unremitting migrainous neuralgia. They had all suffered attacks with severe pain for over 18 months without remission (mean duration 5.5 years). Symptoms were refractory to extended medical intervention and had caused prolonged disruption of lifestyle. The sensory root was completely divided in two cases with complete relief of pain (mean follow-up period 5.6 years). In the other 12 patients, 50-90% of the superomedial portion of the sensory root was divided. Of these, five received no further surgery, and experienced complete (n = 2), near complete (n = 2), or incomplete (n = 1) relief of neuralgia (mean follow-up 5.5 years). The remaining seven patients in the partially divided group were not relieved of pain after operation (n = 5) or suffered early recurrence of pain (n = 2). They showed incomplete sensory loss in the first trigeminal division (V1) and had a second operation to extend the nerve division. V1 anaesthesia was established in all cases after the second procedure, and as a result, four are currently completely free of pain and one has near complete relief of pain. The remaining two patients are still experiencing severe neuralgia (mean follow up 4.1 years). Twelve out of 14 patients (85.7%) receiving surgery for chronic migrainous neuralgia experienced adequate pain relief and are able to follow a normal life (mean follow up 5.6 years). Corneal abrasion was the commonest long-term complication, occurring in three cases (28.5%) and progressing to chronic keratitis in one. We conclude that total trigeminal nerve root section is an effective treatment for patients suffering from chronic migrainous neuralgia and can be safely offered as a primary surgical treatment.
 ...
PMID:Trigeminal nerve section for chronic migrainous neuralgia. 750 90

Pain or redness of the eye are frequent symptoms of out patient ophthalmological visit. Diagnosis is based both on the patient symptoms and a careful eyeball examination. After an eye trauma, it is necessary to check the absence of corneal or subpalpebral foreign body, and the absence of an eyeball laceration or an intraocular foreign body. Without traumatism, pain or redness of the eye suggest an anterior segment pathology with various diagnosis: keratitis is mostly due to bacterial infection, a significant intraocular pressure elevation is frequently due to angle closure glaucoma or inflammation of the anterior uvea in case of iridocyclitis. When pain and redness of the eye are associated with visual impairment, it is mostly due to a severe ocular pathology. In that case an ophthalmological referral is mandatory.
 ...
PMID:[Acute painful and red eyes]. 774 51

A retrospective review for bullous keratopathy in our hospital from 1985 to 1992 was studies. Among the cases with bullous keratopathy, 14 were performed with antiglaucoma operation and cataract extraction, 12 that experienced a contusion or penetrating trauma history underwent cataract operation. IOL implantation seen in 3 patients, 4 cases were associated with vitreous contact to cornea after cataract extraction, the other 4 cases had advanced glaucoma. Besides, there were 1 case of Fuch's endothelium dystrophy, ICE syndrome and severe herpes simplex keratitis, respectively. The preoperation visual acuity of them was all less than finger count. The follow-up was 3 months to 5 years. The results showed the grafts of 28 cases (70%) were clear, 7 cases (17.5%) semi-clear, 5 cases (12.5%) opaque. Postoperatively, all of the patients escaped from the pain and 22 cases achieved a visual acuity of 0.02-0.7. Some good advice in treatment of bullous keratopathy were proposed.
 ...
PMID:[Penetrating keratoplasty for bullous keratopathy]. 777 1

Although the primary treatment of chronic cluster headache is medical, surgical treatment is sometimes used. The authors reviewed the charts of seven patients (ages 36 to 68 years) with chronic cluster headache to identify who responded best to percutaneous stereotactic radiofrequency rhizotomy after medical treatment failed. All patients had immediate pain relief after surgery. At follow-up (median 5 years, range 2 to 20 years), two patients remained pain-free 7 and 20 years later (excellent results); three patients had mild pain recurrence that was well controlled on medications (good results) 6 to 12 months after surgery; and two patients had major pain recurrence 4 days and 2 months after surgery (poor results). Six patients had relief of vasomotor symptoms. One patient had transient diplopia and keratitis without permanent sequelae. Both patients with excellent results had preoperative major pain around the eye; both patients with poor results had major pain around the temple, ear, and cheek; and the three patients with good results had pain equally severe in the eye, temple, and cheek. There was no association between patient age or sex, pain duration, preoperative response to lidocaine blockade, or previous surgery with pain relief. No differences occurred in pain relief between patients with dense hypalgesia and patients with analgesia. The authors conclude that (1) some patients with chronic cluster headache treated by percutaneous stereotactic radiofrequency rhizotomy achieve long-term pain relief, and (2) surgery on the trigeminovascular system alone may not cure the condition in patients with major pain around the temple, ear, and cheek.
 ...
PMID:Long-term results of radiofrequency rhizotomy in the treatment of cluster headache. 777 74

We report a series of 12 eyes which underwent phototherapeutic keratectomy with the Excimer laser Aesculap Meditec (model Mel 60). Mean follow up was 11 months (range 3 to 19 months). Six types of corneal pathologic lesions were treated: recurrent corneal erosions, corneal scars after herpetic keratitis, anterior stromal dystrophy, band keratopathy, mucous plaque, and scar after viral infection. Epithelium healed within the first post-operative week in 83.3% of cases. The goal of treatment was achieved in 75% of cases (100% of therapeutic success for recurrent corneal erosions and 66.6% for superficial corneal opacities). The main undesirable effects were postoperative pain, delayed reepithelialization (16.6%). One patient (8.3%) lost more than two lines of visual acuity. The results, the limits and the undesirable effects of phototherapeutic keratectomy are discussed from our experience and data found in the literature.
 ...
PMID:[Results of therapeutic photo-keratectomy using the Excimer laser. Apropos of 12 cases]. 808 8

All eye drops raise problems of local tolerance, but with variable frequencies. They can induce pain on instillation, allergic reactions, delayed healing, punctate keratitis, disturbances of lacrimal secretion, disturbances of accommodation (especially the parasympathomimetics) and local pigmentation after prolonged use. Corticosteroids are associated with 2 major risks: chronic glaucoma and cataract, initially reversible if treatment is stopped. There is still a major risk of corneal herpes with corticosteroids. It is important to be aware of these local problems as they are responsible for poor patient compliance. The systemic effects essentially concern the agonists and antagonists of the autonomic nervous system. beta-Blocker eye drops can cause bronchospasm, heart failure, syncope and psychiatric disorders, especially at high doses and with nonselective beta-blockers. These consequences are usually related to failure to comply with the prescribing precautions. alpha-Adrenergic agonists, which exert dose-dependent effects, can induce hypertensive crises or angina attacks. Apart from patients at risk (children under the age of 30 months and the elderly), parasympathomimetics cause few systemic adverse effects; anticholinesterases, which have curare-like properties, are contraindicated for 6 weeks before general anesthesia. In the very young and the very old, atropinic eye drops carry a risk of cardiovascular collapse and neuropsychiatric disturbances. Problems may also occur with other classes of drugs such as anti-infectives, antispectics, anti-inflammatories and contact lens products. Nevertheless, it is clear that this form of treatment is generally very well tolerated in relation to the volume of eye drops prescribed by ophthalmologists each day.
 ...
PMID:Systemic and local tolerability of ophthalmic drug formulations. An update. 809 91

We treated a healthy soft contact lens wearer who developed Acanthamoeba sclerokeratitis in the left eye. The patient had severe pain and ring-shaped subepithelial infiltrates. The keratitis progressed and scleral nodules developed despite aggressive treatment with topical clotrimazole, dibromopropamidine isethionate, and corticosteroids. Corneal transplantation and cryotherapy were performed. The corneal button demonstrated Acanthamoeba cysts. Cultures of biopsy specimens taken from two different scleral nodules at two separate times were positive for Acanthamoeba. The disease progressed despite a second corneal graft and the addition of polyhexamethylene biguanide eyedrops. Enucleation of the left eye was required. Histopathologic examination of the specimen documented an Acanthamoeba cyst associated with a granulomatous inflammatory response deep in the sclera. Acanthamoeba scleritis may be associated with a poor prognosis, even with intensive medical and surgical treatment.
 ...
PMID:Acanthamoeba sclerokeratitis. 815 29

The natural history of herpes zoster ophthalmicus and aspects of its treatment and prevention are presented. Intraocular complications occur in 50 percent of cases. Anterior uveitis and the various varieties of keratitis are commonest, affecting 92% and 52% of patients with ocular involvement, respectively. Sight-threatening complications include neuropathic keratitis, perforation, secondary glaucoma, posterior scleritis/orbital apex syndrome, optic neuritis, and acute retinal necrosis. Twenty-eight percent of initially involved eyes develop long-term ocular disease (6 months), with chronic uveitis, keratitis, and neuropathic ulceration being the commonest. Acute pain occurs in 93% of patients and is still present in 31% at 6 months. Of patients aged 60 and over pain persists in 30% for 6 months or longer, and this rises to 71% in those aged 80 and over. Current evidence favours the use of topical acyclovir alone for treatment of established ocular complications, with topical steroids being withheld in all but the most severe cases. Stellate ganglion block has proved useful in the treatment of established acute pain. Amitryptiline, and to a lesser extent sodium valproate, are useful in established chronic pain. Evidence of the efficacy of early oral acyclovir on ocular complications is conflicting, with two studies reporting significant improvement in differing disease parameters. A similar situation exists for pain, with published studies showing differing effects on pain at varying times after the onset of disease. The use of systemic steroids to prevent pain is not supported by currently available evidence, but its therapeutic relationship with acyclovir requires further evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Management of ophthalmic zoster. 824 2

A 36-year-old man was stung by a wasp OD. He became delirious and had dyspnea, ocular pain, and severely decreased visual acuity OD. A broken stinger was found in the central deep cornea. Additional ocular findings were keratitis, iritis, cataract, secondary glaucoma, and unrecordable electroretinographic responses.
 ...
PMID:Wasp sting-induced retinal damage. 848 60


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>