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

A man, aged 63, had an illness which lasted 11 months from onset with pain under the left costal margin which radiated to the epigastrium, until his death from cardiac failure. His symptoms consisted principally of parasthesias and proximal weakness of both upper and lower extremities with atrophy of the shoulder and pelvic girdles. He developed pyramidal tract signs, became euphoric, emotionally unstable and mentally retarded. There was no clinical evidence of cerebellar dysfunction. Bronchogenic carcinoma was suspected from a tomograph of the thorax, but, in spite of extensive clinical and laboratory studies, the diagnosis was verified only postmortem. The CSF cell count was high at first but diminished as the disease progressed. Muscle biopsies revealed chronic generalized denervation without signs of myopathy. Neuropathologically, encephalomyeloradiculoneuritis concentrated on the spinal cord was combined with severe rarefaction of the ganglion cells of the anterior horns and with bilateral degeneration of the lateral pyramidal spinocerebellar and posterior tracts. A more diffuse process was obvious in the anterolateral tracts of the lumbar region. Polyneuropathy concentrated in the distal region was accompanied by slight inflammatory reaction in the sciatic nerve. Cerebellocortical degeneration which exceeded physiological age-related rarefaction was also present. The findings are discussed in relation to the literature.
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PMID:Carcinomatous encephalomyelopathy in conjunction with encephalomyeloradiculitis. 7 20

Cases of toxic distal polyneuropathy have been studied in a plant producing plastic-coated and color-printed fabrics. After the screenig of 1,157 employees, a total of 86 verified cases were detected. Of these, 11 were moderate to severe in intensity and usually with motor and sensory involvement; 38 were mild, with sensory signs prevailing; and 37 were minimal, but with characteristic electro-diagnostic abnormalities. Muscle weakness and electromyographic abnormalities were predominantly distal. Reflex loss was minimal. Sensory deficits were distal and limited to pain, touch, and temperature discrimination with occasional loss of vibration sense. The distribution of involvement severity of the disorder, and temporal course of the outbreak correlated with exposure with methyl n-butyl ketone. After elimination of this agent improvement was noted in the majority of cases.
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PMID:Toxic polyneuropathy due to methyl n-butyl ketone. An industrial outbreak. 16 46

The efficacy of phenytoin in the treatment of the symptoms of diabetic symmetrical polyneuropathy has been tested in a double-blind, crossover study. Symptoms were evaluated daily by linear analogue self-assessment, while control of blood glucose and plasma phenytoin level were monitored on a weekly basis. There was no significant improvement in symptoms on phenytoin, whether analyzed in aggregate, as pain alone, or on the last 3 days of each treatment week. Blood glucose, however, was elevated in diabetic patients taking phenytoin, and the incidence of undesirable side effects was increased. It is concluded that phenytoin has no role in the treatment of diabetic symmetrical polyneuropathy.
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PMID:Phenytoin in the treatment of diabetic symmetrical polyneuropathy. 32 9

A rare case of criminal, chronic thallium poisoning is described. In spite of the general prohibition of the cosmetics, drugs and rodent exterminators containing thallium thallium intoxications are still observed occasionally. In the reported case typical symptoms as initial pain, dryness of the skin, constipation and insomnia were missing. The clinical picture was dominated by a polyneuropathy more pronounced in the lower extremities, a lesion of the optic nerve and the psychic symptoms of organic damage. A particular feature was the early loss of sensitivity of the anterior rami of the intercostal nerves.
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PMID:[Chronic thallium poisoning (author's transl)]. 46 65

789 patients with diabetes mellitus were studied by clinical and electroneurographical examination. Motor conduction velocity of the median and the tibial nerve and sensory conduction of the median nerve were determined. 81.1% of the patients we suffering from diabetes which began in childhood or adolescence, 13.9% were suffering from maturity onset diabetes. Average duration of the disease was 9.5 years, average age was 26.7 years. Clinical signs of polyneuropathy were found in 19.1%. Typical findings were pain and paraesthesia, lack or abolition of triceps surae reflexes, impaired pallaesthesia on lower extremities. 48.3% of 151 patients with clinical signs of polyneuropathy were suffering from combined angiopathy, 32.5% from microangiopathy, 7.9% from macroangiopathy. Severity of complicating retinopathy and macroangio,athy were found to be correlated with polyneuropathy. 58.2% of 323 diabetics with at least one delayed nerve conduction velocity exhibited signs of angiopathy. In nearly 30% of children and adolescents after comparatively short duration of the disease at least one conduction velocity was delayed. In diabetic children and adolescents metabolic disturbances are assumed to cause peripheral nerve dysfunction.
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PMID:[The diabetic polyneuropathy. II. Polyneuropathy, angiopathy and nerve conduction velocity]. 53 79

Five cases of a chronic neuromuscular syndrome consisted of muscular aching and sometimes burning pain, fasciculations, cramps, fatigue, and occasional paresthesia. The disorder affected the legs and, less commonly, the girdle, trunk, and arm muscles. The symptoms were enhanced by physical activity and were usually improved by rest. Neither muscular wasting nor weakness was found, although the condition was present for an average of 4.7 years and, in one patient, as long as 10 years. Electrophysiologic studies showed motor abnormalities indicative of axonal degeneration and muscle fiber denervation, most marked in the legs. Light microscopy of skeletal muscle and spinal cord in one case disclosed evidence of mild denervation atrophy in muscle, but no loss of anterior horn cells. The findings are compatible with a benign polyneuropathy.
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PMID:The muscular pain-fasciculation syndrome. 56 28

Clinical and electrophysiological studies were performed on 250 patients with carpal tunnel syndrome. Acroparaesthesia was often referred to all digits (64%) and proximal pain was not uncommon (46%). The male patients as a group differed from the female in that nocturnal acroparaesthesia was less frequent and a causal of predisposing factor was identifiable in the majority (76%). The most common associated condition in the females was trigger finger (11%). An associated ulnar nerve lesion was rare. Delay in diagnosis was attributable to cultural factors or lack of awareness of the occurrence of diffuse acroparaesthesia and proximal pain in the syndrome. Sensory signs were commoner (85%) than motor (53%). The most useful clinical finding was digital sensory 'splitting' (ring finger) which was present in 58% of hands and clearly distinguished the condition from a radiculopathy, myelopathy or a diffuse polyneuropathy. In general, the diagnostic yield of any test depends on the duration of the disease. Of the various electrodiagnostic tests employing surface electrodes, the most sensitive was the comparison of the median (index finger) to ulnar (little finger) sensory amplitude. This was abnormal in 73% of hands and was found to be particularly useful in patients with a probable background of polyneuropathy or suspected cervical rib syndrome. Slowing of sensory conduction was demonstrable in 67% of hands, decreased sensory amplitude in 44% and prolonged motor latency 35 to 32%. A combination of the various electrodiagnostic tests yielded a positive result in 91%. Decompression resulted in complete recovery in 85% and some improvement in all the remaining patients. The outcome was adversely affected by the presence of several neurological deficits but apparently not by the presence of a coexisting disease.
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PMID:The carpal tunnel syndrome: a clinical and electrophysiological study of 250 patients. 61 9

A very high prevalence of polyneuropathy was observed in shoe and leather workers from the area of Florence. In addition, normal workers showed abnormally low maximal nerve motor conduction velocity. A linear decrease of motor conduction velocity was observed as a function of age and of the length of exposure to solvents. The worker population showed a steeper decrease with age than controls. A higher prevalence of polyneuropathy was observed when the amount of glue used by each worker per day was higher, and when the air volume of the plant was smaller. The subjective symptoms most frequently associated with polyneuropathy were muscle spasms, leg weakness and pain, and arm paresthesiae. Cases of polyneuropathy were more frequent in the workers exposed to solvents and in the older age group. A solvent aetiology of the disease is suggested, and glue substitution and proper hygienic conditions are recommended.
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PMID:Relationship between clinical and electromyographic findings and exposure to solvents, in shoe and leather workers. 65 42

Vascular and neuropathic complications of diabetes are a significant cause of morbidity and mortality. Symmetric polyneuropathy is the most common diabetic neuropathy. Treatment of the mononeuropathies consists of pain control and physical therapy to maintain muscle tone. Prognosis for recovery is excellent. Renal and retinal microangiopathy produce most of the clinically significant mortality and morbidity in diabetes. Recent advances in chronic hemodialysis and renal transplantation have improved the outlook for diabetics with end-stage nephropathy. The poor prognosis for retention of vision in diabetic malignant retinopathy has led to exploration of various forms of palliative therapy, including pituitary ablation, xenon arc coagulation, and laser treatment. Cardiovascular disease is more prevalent among diabetics than among the general population, according to a recent study, and mortality from this cause is three times higher. Animal studies linking aortic wall metabolism and atherosclerotic changes with hyperglycemia suggest that poor control of diabetes may play a role in the development of vascular lesions.
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PMID:Neuropathic and vascular complications occurring in diabetes. 124 35

A frequent presenting symptom encountered by both neurologists and phlebologists, pain in the lower limbs often results in clinical practice in the suggestion of a neurological disorder. Only pain relating to neurological conditions will be dealt with here. A review of the anatomical pathways of different types of sensation is followed by a semiological review of descriptions of pain and the underlying mechanisms. Mention is then made "from below upwards" of a number of common conditions in which pain is a frequent presenting symptom: firts peripheral: polyneuropathy (alcoholic and diabetic), polyradiculoneuropathy, mononeuropathy, root pain (sciatica, cruralgia), narrow lumbar canal; then central: spinal cord pain, thalamic pain, so-called projected encephalic pain. This merely provides a differential diagnostic approach in relation to phlebological pain of the lower limbs.
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PMID:[Leg pain in neurology]. 132 33


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