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)

The authors report the results of DREZ thermocoagulation in 35 patients since March 1980. This technique was applied not only in patients with deafferentation pain after brachial plexus avulsion, but also for postamputation phantom limb pain and pain caused by injury to the spine and spinal cord, by peripheral nerve lesions, and by multiple sclerosis. Independent of etiology, the duration of the pain syndrome, and the quality and projection of the pain, the overall results have been satisfactory and long-lasting.
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PMID:Thermocoagulation of the dorsal root entry zone for the treatment of intractable pain. 651 71

Percutaneously inserted spinal cord electrical stimulation (PISCES) was carried out in eleven intractable pain cases and in one spastic paraplegic case. The causes of intractable pain constitute subacute myelo-optic neuropathy (SMON) 6 cases, cerebrovascular disease 2 cases, multiple sclerosis (MS) 1 case, Charcot-Marie-Tooth (CMT) 1 case and transverse myelitis (TM) 1 case. The cause of spastic paraplegia was due to the ossification of posterior longitudinal ligament (OPLL). A trial stimulation was performed about two weeks before planning a permanent implantation of PISCES system. For the trial stimulation, epidural electrodes were percutaneously inserted with a guide of fluoroscopy in a X-ray room. The conditions of stimulation were adjusted to give an optimal electric dysesthesia. We employed pulse width 0.1-1.0 msec, pulse rate 1-120 Hz and pulse amplitude 0-10 Volt. If an excellent effect was obtained by trial study, we proceeded to the chronic implantation of PISCES system which were composed of epidural electrodes, a subcutaneous receiver and a surface antenna. The procedure of implantation was carried out in an operating room under local anesthesia. In our series, seven subjects (58%) experienced a rewarding effect by the trial stimulation and three underwent the permanent implantation of PISCES. We summarized the clinical courses of these three cases which were OPLL, CMT and SMON. Compared with the other methods for pain relief, PISCES is most characteristic in its safety and simplicity. To date, PISCES has been applied to various disorders; such as ataxia, spasticity, intractable pain, neurogenic bladder and peripheral vascular disease. But its efficacy has not been established in all these disorders.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Our experiences of PISCES (percutaneously inserted spinal cord electrical stimulation) in SMON and other neurologic disorders]. 661 Nov 63

The clinical appearance of foramen magnum tumor is protean and, even at the stage when serious neurological deficits are present, the lesions are often misdiagnosed as another disease, especially cervical spondylosis and multiple sclerosis, and patients may undergo improper concervative or even surgical treatments. The best guarantee against misdiagnosis, we believed, was to establish a definition of "Foramen Magnum Syndrome" to facilitate the recollection of its peculiar clinical findings. "Foramen Magnum Syndrome" is composed of: 1. Cape distribution of sensory loss; 2. Atrophy of the intrinsic muscles of the hands; 3. Neck or suboccipital pain; 4. Dysesthesia of the hands (numbness, tingling, and cold sensation); 5. Eleventh cranial nerve palsy; 6. Stereoanesthesia. (Remember the mnemonic CANDES or DESCAN) Among these, cape distribution of sensory loss, eleventh cranial nerve palsy and cold dysesthesia (not numbness or tingling sensation) are of great importance for topological diagnosis. We also pointed out the similarities between the clinical picture of syringomyelia and that of the advanced stage of foramen magnum tumor. The syringomyelic syndrome, often seen in Arnold-Chiari malformation and basilar impression, has been attributed to the concurrent syrinx of cervical cord. But the clinical analysis of foramen magnum tumors showed that this is not always true and that compressive lesions at the foramen magnum alone can cause syringomyelic syndrome.
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PMID:[Proposal for the definition of "foramen magnum syndrome"--foramen magnum tumor and abnormalities]. 665 78

The effect of epidural opioids on spinal spasticity is demonstrated in a patient suffering from multiple sclerosis. Flexor reflex spasms are abolished and muscle tone is markedly reduced by the epidural administration of morphine 3 mg or fentanyl 0.1 mg. In contrast, the oligosynaptic motor responses and voluntary movements were unaffected. This is documented by EMG-recordings. Sensory perception thresholds were elevated for pain, but unchanged for touch and vibration sense. Effects on enkephalinergic interneurons on the spinal level are discussed.
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PMID:The effect of epidural application of opioids on spasticity of spinal origin. 666 38

We reviewed the clinical records of all the patients examined at the Mayo Clinic who were operated on and found to have arachnoid diverticula of he cervical and thoracolumbar regions of the spinal column. Only patients whose lesion did not have a traumatic cause were selected for a study. There were 21 patients: 20 had been operated on at the Mayo Clinic and 1 was seen 43 years after surgery done elsewhere. The symptoms associated with the thoracolumbar lesions were, in order of decreasing frequency, pain, weakness, gait disorder, sensory symptoms, and sphincter dysfunction. The conditions associated with thoracic arachnoid diverticula included congenital pigmented nevus, diastematomyelia, multiple sclerosis, Marfan's syndrome, and syringomyelia.
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PMID:Idiopathic ("congenital") spinal arachnoid diverticula. Clinical diagnosis and surgical results. 678 Jul 35

The clinical characteristics of facial pain in patients with trigeminal neuralgia (TN) and associated multiple sclerosis (MS) were studied. Among 900 patients with TN 22 (2.4%) had associated MS. Sixteen patients had typical TN, while six had atypical TN. Facial pain commenced at a younger age (P less than 0.005) and a significantly higher proportion had bilateral facial pain (P less than 0.01) in the group with MS compared to TN patients without MS. In three patients TN was the first manifestation of MS, in the remainder facial pain occurred on an average of 12 years after onset of MS. Seventeen patients had associated signs of brain-stem involvement. The facial pain was, however, indistinguishable from the pain in patients without brain-stem deficits. While sclerotic plaques in the central nervous system probably are of etiological significance for development of TN neither clinical nor neuropathological findings suggest that this is due to affection of trigeminal nuclei complex in the brain-stem.
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PMID:Association of trigeminal neuralgia with multiple sclerosis: clinical and pathological features. 708 Aug 3

Twenty patients suffering from non-neoplastic symptomatic facial pain underwent percutaneous radiofrequency trigeminal thermo-rhizotomy. Fourteen patients had long-standing severe multiple sclerosis, two patients had intracranial aneurysms, three patients had basilar impression secondary to Paget's disease and developmental malformations of the skull, and one patient was suffering from chronic ocular pain that developed after retinal hemorrhage. Pain paroxysms similar to tic douloureux were present in patients with multiple sclerosis and in those with basilar impression, while continuous aching pain was present in the others. After thermo-rhizotomy, pain disappeared in all patients; however, at 1 to 4 years follow-up examination, a high recurrence rate (40%) was present in the multiple sclerosis group, and the percutaneous procedure was successfully repeated. In the patients with intracranial aneurysm not amenable to direct surgery, and in the other non-neoplastic diseases, complete pain relief was found at 4 years follow-up review.
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PMID:Radiofrequency trigeminal rhizotomy in treatment of symptomatic non-neoplastic facial pain. 710 97

Determinations of cerebrospinal fluid (CSF) albumin, IgG, albumin blood brain barrier (BBB) permeability and local IgG synthesis indexes in CNS were carried out on 85 patients with various neck, shoulder and upper extremity pain syndromes. CSF was obtained by lumbar puncture in 29, and by lateral neck puncture in 56 of the patients. The patients were classified into 3 different groups according to varying severity of degenerative changes, or cavitation verified by myelography. CSF protein patterns in these patients were compared with lumbar CSF findings in 18 patients with multiple sclerosis. CSF protein changes in patients with abnormal myelographic findings were slight. Protein values were clearly more abnormal in lumbar CSF than in cervical CSF, probably due to a retardation of the CSF flow. Only 3 of 62 patients with a narrowing of the cervical spinal canal had pathological values for IgG synthesis or BBB permeability indexes. On the other hand 14 of 18 patients with multiple sclerosis had abnormal, high values for the IgG index. Thus the present results suggest that investigation of the CSF protein pattern has value in differential diagnosis between patients with multiple sclerosis and degenerative diseases of the cervical spine.
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PMID:Cerebrospinal fluid protein findings in cervical syndromes classified by myelography, and in multiple sclerosis. 713 99

There is a growing body of evidence that the central nervous system (CNS), even in the adult animal, is capable of adaptation and reorganization not only as a result of partial damage to the CNS but also in response to stimulation. Environmental stimulation produces changes including expansion of visual cortex, increases in dendritic branching, glia and cholinesterase. Environmental stimulation also produces behavioural changes. Experimental electrical stimulation produces changes in synapse size, synaptic vesicle change, dendritic branching and changes in synaptic transmission. In man, repetitive electrical stimulation via epidural electrodes increases plasma levels of norepinephrine, epinephrine, and dopamine, and CSF levels of norepinephrine. Repetitive electrical stimulation in man dates back to 1967 and has been used for the control of pain, to improve spasticity, bladder control, motor deficit and the autonomic hyperreflexia of spinal cord injury. In addition, improvement has been reported in epilepsy, cerebral palsy, torticollis and peripheral vascular diseases. The best controlled studies are in multiple sclerosis and peripheral vascular disease, and these results will be presented in more detail.
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PMID:Rehabilitation following brain damage: some neurophysiological mechanisms. The effects of repetitive stimulation in recovery from damage to the central nervous system. 718 88

Epidural spinal electrostimulation (ESES), as method in the treatment of patients with chronic pain or severe central motor disturbances, especially spastic paresis of spinal origin and bladder dysfunction, is indicated when conservative measures prove ineffectual and before surgical intervention is considered. The biochemical and innervation processes which are brought about by ESES are discussed, as well as the literature on the efficacy and possible complications of the method. Twenty cases were subjected to a test stimulation and in twelve of these the stimulation system was implanted. Spinal spasticity and the range of mobility were improved by 20 to 30% in 8 patients with multiple sclerosis and 3 other patients with myelopathy of varied aetiology. In addition, spastic cramps of abrupt onset, with or without pain, disappeared almost completely following ESES in all cases. Three cases with chronic pain, two after a caudal lesion and one with cervical radicular damage, were markedly improved.
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PMID:[Epidural spinal electrostimulation (ESES) in patients with chronic pain and central motor disturbances (author's transl)]. 732 83


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