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)

Trigeminal neuralgia (Tr. N.) occurring as tic douloureux usually proves to be senile neuralgia without any etiological background. On the other hand, isolated Tr. N. of the first ramus suggests the process. Bilateral Tr. N. are rare yet most frequently an expression of a multiple sclerosis with attacks first on one side and then on the other. Symptomatic Tr. N. occurs seldom as perhaps in M.S., only as tic douloureux, usually as a continuous pain with more or less acute exacerbations. Tr. N. are therapeutically problematic after operative treatment of the maxillary sinuses, still more so after herpes zoster. Other neuralgias and facial neuralgias (e.g. a glossopharyngeal neuralgia, nasociliary neuralgia, Sluder's neuralgia, Costen's syndrome, Horton's syndrome etc.) must be diagnostically differentiated from Tr. N.
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PMID:[Trigeminal neuralgia and its differential diagnosis (author's transl)]. 30 38

Electrical stimulation is emerging as a new therapeutic and rehabilitative agent. Reviewed are pain control, restoration of lost functions and alteration of abnormal movement and other functions using electrical stimulation. Reported for acute and chronic pain control use are transcutaneous, dorsal column, spinal cord, peripheral nerve, and direct brain stimulation methods and results. Overall success ranges up to 50% for chronic pain problems and up to 80% for acute pain; e.g., postoperative incisional pain, sports medicine, and trauma. Restoration of lost function has broad implications for the future. These include phrenic nerve pacing for respiration, foot drop control, restoration of bladder function, and grasp control in the spinal cord-injured patient. Amelioration of abnormal function includes stimulation for epilepsy and cerebral palsy, certain symptoms of multiple sclerosis and scoliosis. The effects of electrostimulation are completely reversible and nondestructive. Technical details of devices and stimulus waveforms are also briefly considered.
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PMID:Electrical stimulation: new methods for therapy and rehabilitation. 30 12

The results of electrostimulation of the spinal cord for symptoms other than that of pain are recorded in this publication. 50% of patients with multiple sclerosis, primary lateral sclerosis and hereditary spino-cerebellar disorders were observed to have enduring favourable changes in neurological function during the 15 to 27 months they have been followed. The patients who were the least severely disabled had the greatest amount of increased function and were benefitted the most by the stimulation. Those who had the fewest neurological pathways affected make the most rapid progress. For example, the patient with only an ataxic or spastic gait was observed to improve faster than the patient with an ataxic and a spastic gait. The long-term effect of electrostimulation of the spinal cord on patients with these diseases is unknown at the present time. The purpose of the stimulation is to increase neurological function so that the patient can live a better life style. It is not thought that the electrical current is responsible for a 'cure' of the basic disease process. Electrostimulation of the posterior spinal roots and spinal cord, while not new, has not been used extensively for the treatment of patients with arterial disease. The patients who have responded the most dramatically to electrostimulation are those with vasospastic disorders. A larger percentage of patients showed a greater response to implanted stimulation than to transcutaneous stimulation. Electrostimulation of the nervous system is not designed to replace standard therapeutic measures of treatment of patients with vascular disease but to supplement them.
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PMID:Electrostimulation of the nervous system for patients with demyelinating and degenerative diseases of the nervous system and vascular diseases of the extremities. 30 12

A double-blind, five-week, multicenter trial was conducted to compare the effect of baclofen, a unique amino acid derivative, with that of placebo in the treatment of 106 patients with spasticity secondary to multiple sclerosis. A spasticity assessment method that included a neurological examination, physicians' clinical impressions of changes during treatment, and a patient's self-evaluation was used to determine efficacy. This method showed baclofen (70 to 80 mg daily maximum, titrated) is effective relative to placebo in relieving symptoms of spasticity, such as flexor spasms, pain and stiffness, resistance to passive joint movements, and tendon stretch reflexes. Patient self-evaluation results also showed a significant reduction in clonus. Side effects were generally mild and transient.
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PMID:Baclofen, a new antispastic drug. A controlled, multicenter trial in patients with multiple sclerosis. 32 87

Baclofen was used in a double-blind crossover placebo-controlled trial to treat spasticity in patients with multiple sclerosis (MS). While on Baclofen, patients obtained a significant (p less than 0.001) reduction in spasticity compared to controls. The drug was particularly effective in alleviating flexor and extensors spasms, as well as their associated pain. Side effects were common in this study, but were usually well tolerated by the patients. The commonest side effects were sedation, nausea and vomiting. There were no changes in hepatic, renal, or hematological function in any patients. Increase weakness due to loss of spasticity for support was also a fairly common complaint. The drug seems best indicated in patients in whom spasticity is not required for support or other activities of daily living. Careful monitoring of the patient is essential for effective use of this drug.
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PMID:The use of baclofen in treatment of spasticity in multiple sclerosis. 38 32

Eye care professionals can play an important role in the early detection of multiple sclerosis (MS) since the disease often has ocular manifestations such as optic neuritis. In conjunction with optic neuritis, symptoms such as ocular pain, acuity reduction, visual field loss, blurred or edematous discs, nystagmus, and diplopia may be present. Although MS still has no cure, early identification can aid in beginning the treatment of the symptoms.
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PMID:Early identification of multiple sclerosis through ocularly manifested symptoms. 45 99

Remitting paresis of the left leg accompanied by left trigeminal neuralgia led to the diagnosis of multiple sclerosis in a 46-year-old woman. Over the following 6 years, an incomplete syndrome of the spinal cord developed along with bilateral trigeminal pain. Neuroradiological and neurosurgical exploration a neurinoma located ventrolaterally at C1/C2 on the left side. It is emphasized that since trigeminal fibres descend as far as the upper part of the C2 segment, trigeminal neuralgia should not be considered as an exclusively supraspinal symptom.
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PMID:High cervical neurinoma (C1/C2) diagnosed falsely as multiple sclerosis because of trigeminal neuralgia. 49 15

In the reported case unilateral external ophthalmoplegia developed in a young woman, with concomitant pain and anaesthesia in the area innervated by the 1st branch of the trigeminal nerve. After ruling out an expanding lesion of the central nervous system, aneurysm, diabetes, myasthenia, multiple sclerosis and other diseases dexamethasone was administered in a total dose of 30 mg. Complete clinical remission was achieved. In the light of observations and a survey of the peritinent literature it has been accumed that the disease was caused by a non-specific process in the small vessels in the vicinity of the cavernous sinus.
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PMID:[Tolosa-Hunt syndrome (ophthalmoplegia dolorosa)]. 52 41

Fifty-two patients with acute and subacute transverse myelopathy (TM) were evaluated at the Massachusetts General Hospital between 1955 and 1975 and followed for 1 to 23 years (average, 5). Nineteen had symptoms of a recent acute infectious illness, 3 had cancer, and 1 had undergone a recent operation. There were four types of initial symptom. Twenty-four patients had paresthesias at the onset of the illness, 18 had pain, usually interscapular, 7 had leg weakness, and 3 had urine retention. Prognosis depended on the nature of the onset of TM. An acute catastrophic onset was generally associated with back pain and led to a poor outcome in 7 and a good outcome in only 1 of 11 patients. A subacute progressive onset over several days to four weeks, generally with ascending paresthesias or leg weakness, was associated with a good outcome in 15 and fair outcome in 17 of 37 patients. Preceding febrile illness, treatment with corticosteroids, and the nature of CSF abnormalities had no effect on outcome. Multiple sclerosis evolved in 7 patients during the follow-up period. Because of the frequency with which mass lesions were missed, the need for myelography in the diagnosis of TM is emphasized. The distinguishing clinical characteristics of TM provide guidelines for diagnosis and prognosis.
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PMID:The prognosis of acute and subacute transverse myelopathy based on early signs and symptoms. 69 26

Painful tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs primarily in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery--less frequently an arteriovenous malformation or cholesteatoma--which compresses the trigeminal and facial nerve roots in the posterior fossa. In rare instances this syndrome may be caused by disseminated sclerosis. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography and vertebrobasilar angiography should be performed in every case.
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PMID:Painful tic convulsif. 86 84


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