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

In order to study the effects of improved metabolic control on painful diabetic polyneuropathy, 15 patients were treated with continuous subcutaneous insulin infusion over a 12 month period. Polyneuropathy was assessed by pain score, neurological examinations, nerve conduction studies and determination of sensory thresholds and cardiovascular reflexes. Improved metabolic control was confirmed by significantly improved levels of glycosylated haemoglobin (11.7 +/- 0.3% at entry to the study, to 8.7 +/- 0.3% after 12 months; mean +/- SEM). Symptomatic relief was confirmed by significantly improved pain scores. Thresholds for thermal cutaneous sensation improved significantly from 6.0 +/- 0.8 degrees C at entry to the study to 2.7 +/- 0.7 degrees C after 12 months (mean +/- SEM). These findings suggest a selective improvement of peripheral small nerve fibre function after continuous subcutaneous insulin infusion. The importance of quantitating thermal cutaneous sensation in longitudinal studies of patients with diabetic neuropathy was confirmed.
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PMID:Peripheral nerve function in patients with painful diabetic neuropathy treated with continuous subcutaneous insulin infusion. 368 13

Thermal tests were performed in 117 healthy subjects on the face, wrist and leg; 32 were tested on the legs with different rates of cooling and warming. Additionally 2 groups of diabetics (37 patients) were tested. Thermotesting was most sensitive on the legs using a rate of temperature change of 2.5-2.8 oC/s. Warm and cold perception should be tested separately. Cold perception testing is most sensitive. Combined tests of warm and cold thresholds as well as the testing of cool pain and heat pain do not improve results. Abnormal cold perception may be an early indicator of diabetic small fibre polyneuropathy, leading to cold trauma and ulcers on the feet.
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PMID:Methods of measurement of thermal thresholds. 368 80

Vibratory perception thresholds (VPTs) and thermal discrimination thresholds (TDTs), reflecting large nerve fiber function and small nerve fiber function, respectively, were determined in 20 diabetics with painful sensory polyneuropathy and in 20 diabetics without neuropathic symptoms. VPTs were elevated in 27 patients and proved to be significantly higher in the group with painful neuropathy (p less than 0.01). Yet in three symptomatic patients, VPTs were normal. TDTs were abnormal in 35 cases and the difference between patients with and patients without symptoms was more pronounced (p less than 0.001). All patients with painful neuropathy had elevated TDTs. These findings confirm the relationship between pain in diabetic neuropathy and the affection of small fiber function. When monitoring of peripheral nerve function in patients with painful diabetic neuropathy is required, quantitation of thermal cutaneous sensation provides useful information on the function of small nerve fibers.
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PMID:Large and small nerve fiber function in painful diabetic neuropathy. 372 33

A 52-year-old woman presented with increasing pain, weakness, and paraesthesiae of four months' duration in the lower limbs. She suffered from chronic obstructive airways disease and hypertension. Neurological examination revealed wasting of the quadriceps muscles, weakness of the lower limbs, and absent ankle jerks. The sensory examination was normal. Full blood count, ESR, biochemical, immunological, and viral studies, urinary heavy metal assays, and cerebrospinal fluid examination were normal. Nerve conduction studies were consistent with a sensorimotor neuropathy, and electromyographic sampling was consistent with acute denervation. A sural nerve biopsy showed axonal degeneration and segmental demyelination. One month after admission, she developed carbon dioxide retention. Her weakness spread to affect the upper limbs, and she could not be resuscitated after a cardiac arrest three months after admission. General autopsy examination revealed bronchopneumonia. Neuropathological examination showed a lymphocytic infiltrate in the nerve roots of the cauda equina, the lumbosacral plexus, and the sural and vagal nerves. Increased cellularity and collagen were evident in these nerves. A diagnosis of chronic inflammatory polyneuropathy was made. The neuropathology of this entity is discussed.
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PMID:Neuropathological findings in a case of chronic inflammatory polyneuropathy. 384 15

A controlled clinical trial on the efficacy of a nortriptyline-fluphenazine combination was carried out in patients with painful diabetic polyneuropathy. A visual analog scale was used to evaluate the relief of pain or paresthesia. Significant relief of both pain and paresthesia was obtained with this combination. The differences were statistically significant. Side effects were frequent but not usually severe enough to lead to cessation of these medications.
Pain 1985 Dec
PMID:Nortriptyline and fluphenazine in the symptomatic treatment of diabetic neuropathy. A double-blind cross-over study. 391 Nov 40

The epidemiological and clinical aspects of an unusual type of polyneuropathy which reached epidemic proportion in Sri Lanka in 1977-1978 are reported. 20 young women in Sri Lanka were affected by this illness, characterized by pain in the calves followed by weakness of feet and hands. In addition, some older Moslem women presented during the same time with similar symptoms. In the cases of the younger women, all had just attained menarch, whereas the older women had all just given birth. The etiologic factor in common turned out to be consumption, ritually, of gingili oil, which is used in a ritual at menarch and after childbirth. Gingili oil used in these cases had been contaminated with tri-cresyl phosphate, a substance known to be responsible for outbreaks of similar polyneuropathy in surrounding areas. It is theorized that the contamination occurred during transport of the oil in containers which had previously been used to store mineral oils.
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PMID:Toxic polyneuropathy due to gingili oil contaminated with tri-cresyl phosphate affecting adolescent girls in Sri Lanka. 610 32

Transcutaneous iontophoresis of microtubule inhibitors (Vinblastin, Vincristin, Formyl-Leurosin) in rats induces depletion of fluoride-resistant acid phosphatase (FRAP) and transganglionic degenerative atrophy (trggl. deg. atr.) of the central terminals of primary nociceptive neurons, probably via blockade of axoplasmic transport in the peripheral sensory nerves. Radiochemical experiments prove that about 0.2% of the microtubule inhibitors applied iontophoretically at the skin reach the level of nociceptive axon terminals. 40 out of 48 patients suffering from chronic intractable pain of diverse etiology (postherpetic, paresthetic, ischaemic and trigeminal neuralgia, alcoholic and diabetic polyneuropathy, meralgia, brachialgia, discopathia, arthropathia and terminal pain) were successfully treated with Vinblastin or Vincristin iontophoresis. Iontophoretically applied microtubule inhibitors do not affect the blood cell count, have no side-effects and do not impair the skin at the site of application.
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PMID:Iontophoretically applied microtubule inhibitors induce transganglionic degenerative atrophy of primary central nociceptive terminals and abolish chronic autochtonous pain. 618 18

A patient who had meningoencephalitis and corneal inflammation originating in a herpes virus infection sustained severe pure sensory polyneuropathy with superficial pain sensitivity and proprioceptive sensory deficits. The sensory deficiencies were diagnosed both in clinical and in electromyographic testings. The clinical EMG picture pointed to a pure sensory polyneuroplathy with a viral background according to blood serum and CSF examinations.
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PMID:Pure sensory polyneuropathy of herpes virus origin associated with meningoencephalitis. A case report. 624 4

A syndrome of peripheral polyneuropathy associated with islet cell tumors and hypoglycemia has been reported in 28 patients. Despite varying features in these patients, the clinical characteristics of this syndrome are remarkably similar. These consist of the development of a sensorimotor neuropathy during a protracted course of recurrent severe hypoglycemia, related to underlying insulinoma. Cerebral symptoms dominate the clinical picture and a predominantly or entirely motor, distal and symmetric, peripheral neuropathy ensures. Upper limb involvement is more frequent, accompanied by severe weakness and distal wasting, usually without fasciculations. Painful distal paresthesias without objective sensory loss are characteristic. Direct relationship to a single hypoglycemic insult is often absent. This report describes the clinical features and laboratory investigation of a new case with this condition, reviews the literature and discusses the syndrome with special regard to the etiology.
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PMID:Hypoglycemic peripheral neuropathy in association with insulinoma: implication of glucopenia rather than hyperinsulinism. Case report and literature review. 627 47

Previous studies have shown that brain serotonin is increased and noradrenaline decreased in acupuncture and transcutaneous nerve stimulation (TNS). Increases in available brain serotonin and decreases in noradrenaline enhance pain suppression. The present study tests the possibility that the widespread and prolonged cutaneous vasodilation which can be produced by low-frequency TNS in patients with peripheral circulatory insufficiency is similarly dependent on a central serotonergic pathway leading to sympatho-inhibition. The serotonin receptor antagonist cyproheptadine was given to 4 patients with either Raynaud's phenomenon or diabetic polyneuropathy, who all prior to drug administration responded to TNS with marked and prolonged cutaneous vasodilation in the ischaemic limbs. Cyproheptadine almost completely blocked the vascular response. Contrary to endorphin-serotonin mediated pain inhibition, vasoconstrictor inhibition is not antagonized by conventional, low doses of naloxone (Kaada, 1982a). However, the involvement of more naloxone-resistant opioid receptors in the vascular response cannot be excluded.
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PMID:In search of mediators of skin vasodilation induced by transcutaneous nerve stimulation: II. Serotonin implicated. 666 43


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