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

Forty-three of 101 outpatients with parkinsonism reported that they regularly experienced primary sensory symptoms, i.e., spontaneous abnormal sensations not caused by somatic disease. This is in contrast to similar symptoms reported by only 8 percent of a control population. The most striking and severe symptom was burning of the trunk and proximal extremities, occurring in 11 patients. Twenty-nine patients reported spontaneous pain; a variety of other paresthesialike sensations, e.g., tingling, numbness, and formication, occurred in 32 patients. These subjective sensory phenomena were not associated with sensory loss or autonomic or motor signs. In 20 percent of affected individuals (9 percent of the total), sensory symptoms preceded the onset of the movement disorder, causing difficulty in diagnosis. It is concluded that at least some sensory symptoms originate within the nervous system as a manifestation of the disease process and are not secondary effects of the motor disorder.
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PMID:Primary sensory symptoms in parkinsonism. 94 93

The effects of buspirone and verapamil on spasmodic torticollis were investigated in two double-blind, placebo-controlled crossover studies. Buspirone was given in doses of 20-100 mg/day for 4 weeks to 14 patients; verapamil was given in doses of 40-100 mg/day for 3 weeks to 8 patients. Neither drug improved symptoms of the movement disorder (posture, motility, rigidity, tremor), pain, perceived stress, or mood, either in the whole group or in any individual patient.
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PMID:Failure of buspirone and verapamil to improve spasmodic torticollis. 162 68

Twenty-five writer's cramp patients have been attending the Movement Disorder Clinic at the Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok during three years period (between January 1988 - January 1991). There were 17 male subjects and the male to female sex ratio was 2.125:1. The mean age of the patient was 36.80 (SD 10.21) years with the range of 18-60 years. The mean duration of illness of all patients was 5.88 (SD 7.14) years with the range of 1 to 30 years. Eighteen patients (72.0%) were classified as simple writer's cramp and seven patients (28.0%) were dystonic writer's cramp. The mean age of the patients of both groups was not different while the duration of illness in the dystonic group was statistically significantly longer than the simple group, i.e. 12.0 (SD 12.1) versus 3.9 (SD 3.1) years. Fourteen patients (56%) had associated pain during writing and 6 patients (24%) had hand tremor. All patients were right handed and had a history of various pharmacological treatments without any consistent benefit. They included muscle relaxants, tranquillisers, antiepileptic drugs, and betablockers. Fourteen patients from 17 available history records (82.4%) had been spending at least 4-10 hours writing each day. Twenty-one patients (84%) had botulinum toxin injections, 40-80 international mouse units were given in 2-4 divided doses over the overactive forearm muscles observed during writing without the electromyographic glidance. There was no loss to the follow-up. Fourteen of the 21 subjects (66.7%) showed definite improvement in hand writing, 4 patients (19.0%) improved minimally and 3 patients (14.3%) revealed no improvement. Arm pain in all 12 patients associated during writing was abolished after the injections. There were complications in 7 patients (33.3%) presented as transient finger drop (5 patients, 23.8%) and easily fatigued arm (2 patients, 9.5%). These preliminary results confirm that botulinum toxin injections is a successful treatment for many patients with writer's cramp without performing complex electromyographic recordings while the patients are writing. The constraints of this treatment are its high cost (i.e. 1 vial of 100 units costs 300 US dollars) and its benefit lasts for only 4-6 months.
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PMID:Writer's cramp: the experience with botulinum toxin injections in 25 patients. 178 71

We studied 300 patients, 61% women, with mean age 49.7 years and mean duration of dystonia 7.8 years, to determine the demographic and clinical characteristics of cervical dystonia (CD) and its relationships to other movement disorders. Torticollis was present in 82%, laterocollis in 42%, retrocollis in 29%, and anterocollis in 25%; however, the majority (66%) had a combination of these abnormal postures. Scoliosis was present in 39%, local pain reported by 68%, and 32% had evidence of secondary cervical radiculopathy. In addition to CD, 16% of patients had oral dystonia, 12% mandibular dystonia, 10% hand/arm dystonia, and 10% had blepharospasm. Tremor was noted in 71% of patients; head-neck tremor was present in 60%, and tremor in other body regions was present in 32%. A family history of a movement disorder was present in 44% of the CD patients. Tardive dystonia was the cause in 6%; 11% had posttraumatic dystonia. Anticholinergic drugs provided moderate improvement in 33% of patients, but local intramuscular botulinum toxin injections relieved CD, local pain, or both in over 90% of all treated patients.
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PMID:Cervical dystonia: clinical findings and associated movement disorders. 206 38

We present 43 patients with reflex sympathetic dystrophy (RSD) who manifested abnormalities of movement. The patients have focal dystonia, weakness, spasms, tremor, difficulty initiating movement, and increased tone and reflexes. These motor signs and symptoms may precede other manifestations of the illness by weeks or months. They most frequently, but not invariably, occur concomitantly with sudomotor or vasomotor changes and pain. Lioresal is effective in reducing spasms. Early in the course of RSD, the motor manifestation may be alleviated by intense sympathetic blockade or sympathectomy. In many patients, the movement disorder becomes independent of sympathetic innervation.
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PMID:The movement disorder of reflex sympathetic dystrophy. 239 45

A 49-year-old man developed a syndrome of crural-axial dystonia combined with segmental myoclonus 3 months after the onset of meralgia paraesthetica of the left leg. The association of this remarkable movement disorder with the pain syndrome is discussed.
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PMID:Crural and axial myoclonic dystonia following meralgia paraesthetica. 322 4

10 cases are presented in which a posterior cerebral artery (PCA) deficit developed suddenly in dramatic fashion with headache, visual symptoms, sensory and motor deficits, and signs of 3rd nerve involvement. There were 9 females and 1 male, ranging in age from 18-51 years with 7 cases under age 35. In 9 of the 10 patients, headache was prominent at the onset; 6 patients reported being dramatically stricken with a severe, sharp localized pain in the forehead or occiput. Visual symptoms were prominent at the onset in 7 patients -- 4 patients experiencing blindness and 3 patients a hemianoptic deficit. Hemisensory symptoms or deficit occurred in 6 instances, a hemiparesis in 3, combined weakness and sensory deficit in 1. Evidence of a 3rd nerve palsy was found in 3 cases. A persisting neurologic deficit occurred in 10 cases -- visual field defect, 6 cases; hemiplegia, 1; slight weakness, 1; and a sensory deficit, 2. A movement disorder developed on the involved side in 7 cases. Evidence of infarction in 1 or both occipital lobes was obtained in 6 patients. 1 patient did not have impaired visual fields, and the other 3 were examined before the days of nuclear medicine and CT scanning. Conventional angiography was performed in 8 patients with the following results: retrothalamic occlusion of 1 PCA (1 patient); distal occlusion of 1 PCA (1 patient); retrothalamic narrowing of 1 PCA (1 patient); irregularity of the wall of the upper basilar artery and both PCAs (1 patient); and in 4 angiography was normal. A digital subtraction angiogram in 1 patient was normal; 1 patient did not have an arteriogram. A history of accompanied migraine was obtained in 3 patients. 1 patient was pregnant; 1 patient was 3 months postpartum. 1 patient was taking oral contraceptives; 1 patient had taken 1 contraceptive pill, and 1 patient was receiving injections of estrogen. These cases represent involvement of the territory of the PCA. They share the same features in varied combinations. The onset or evolution is dramatic, distinctive, or alarming. The cases do not fall easily into any commonly recognized category of cerebrovascular disturbances. The process that most likely applies to this group of cases is migraine. If that is so, the term "catastropic migraine" or "cataclysmic migraine" may have some currency. If it is assumed that the process is ischemic and since vascular obstruction was found in 2 cases, the possibility of using heparin therapy might be considered. In most of the present cases, steroid therapy was used to control brain swelling. If the pathologic process is temporary vasospasm, the use of hemodilution or hyperbaric oxygen could be an option.
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PMID:Unusual vascular events in the territory of the posterior cerebral artery. 395 50

Four patients are described who sustained comparatively minor peripheral injury, the affected area soon becoming the site of segmental dystonia. The movement disorder developed as the symptoms from the injury subsided, and except for the recent trauma, no cause for the dystonia was apparent; litigation was not an issue for any patient. It is suggested that on rare occasions peripheral trauma results in the development of dystonia. Since injury never involved the head, the role of the spinal dopaminergic system and the relevance of pain from the injury are discussed in considering possible underlying mechanisms.
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PMID:The relationship of peripheral trauma and pain to dystonia. 403 15

Depression, anhedonia, state anxiety (A-state), trait anxiety (A-trait), and self-reported pain estimate were measured in almost 500 facial pain patients. These patients were divided into 3 diagnostic categories: myofacial pain dysfunction syndrome (MPD) [18], arthritis of the temporomandibular joints (TMJ arthritis), and trigeminal neuralgia. Three control groups were measured for comparison. They consisted of an normal, or non-patient group, a group of arthritis patients, and a group of movement disorder patients attending a neurology clinic. Among the facial pain patients and the normal controls few differences were found with regard to anhedonia and depression, The arthritis and neurology patients produced significantly higher depression and anhedonia scores than did several of the facial pain groups. Pain estimate ranged from 0 for control, to a mean of 67.6 +/- 31.3 for the trigeminal neuralgia patients with the MPD (means = 56.2 +/- 32.5) and the TMJ arthritis patients (means = 46.7 +/- 30.8) somewhat lower. Clinical variables such as duration of pain, help seeking behavior and total number of symptoms were correlated with depression but not with anhedonia scores, It is hypothesized that anhedonia is a measure separate from depression and may be more closely linked to suffering behavior that to pain behavior. Psychological variables did not discriminate among facial pain patients and in particular did not distinguish between so-called functional and organic illness.
Pain 1981 Aug
PMID:Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. 730 2

Experimental studies indicate that deafferentation results in reorganization of the somatosensory map at various levels of the CNS, such that the representation of a body part adjacent to a region that is denervated expands into the deafferented area. Recent data suggest that in the human this occurs at the cortical level, but subcortical structures have not been systematically investigated. To test the hypothesis that the human thalamus is capable of significant reorganization as a result of changes in afferent input, microelectrode recording and stimulating techniques were used to define thalamic somatotopy in 61 patients undergoing stereotactic procedures. Five groups were compared: those with pain in the deafferented body part, face (n = 9), arm/hand (n = 4), leg/foot (n = 8) and hemibody (n = 5) and those with neither pain nor deafferentation, i.e., movement disorder (n = 24). Trunk representation, as determined from receptive fields, was significantly larger in patients with leg/foot deafferentation than in patients without deafferentation (1.8 +/- 0.7 vs. 0.5 +/- 0.2 mm; p < 0.01). Also, microstimulation induced paraesthesiae in the face from a significantly larger region of thalamus in the facially denervated group compared to the movement disorder group (13.8 +/- 2.8 vs. 3.7 +/- 0.6 mm; p < 0.001). There were no significant differences in the representation of other body parts in the five groups. The results in the leg-deafferented group agree with conclusions reached from animal studies; however, the human situation is more complex. There appear to be different patterns and degrees of somatotopic reorganization in the human, all of which may be associated with pain syndromes.
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PMID:Plasticity in human somatosensory thalamus as a result of deafferentation. 763 Oct 60


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