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)

Heat stimuli, applied to the skin by non-contact radiation pulses emitted by a CO2-laser, activate simultaneously both A-delta (mean conduction velocity 14 m/s) and C-fibres (0.8 m/s), which terminate in the most superficial skin layers. Correspondingly, brief heat stimuli elicit two pain sensations with mean reaction times of about 500 ms and 1400 ms. Similarly, two evoked potential waveforms were observed in the electroencephalogram: the late components N240/P370 and the ultralate components N1050/P1250. The shape of the two components was reproducible in independent samples of healthy volunteers. In patients with dissociated sensory loss, the laser evoked cerebral potentials are affected, depending on the kind of disturbed nerve and tracts. This is shown in patients with syringomyelia, encephalomyelitis disseminata, myelitis, Brown-Sequard syndrome, Wallenberg syndrome. In cases with hereditary motor and sensory neuropathy type I or with neurosyphilis, ultralate potentials are observed as correlates of delayed pain perception in the affected body areas. The laser evoked cerebral potentials reflected the clinical disorder of pain sensitivity in most cases, whereas somatosensory evoked potentials in response to conventional nerve stimuli failed in objectifying the diagnosis. As such, evoked cerebral potentials in response to laser heat stimuli applied to the hairy skin can be used for an overall examination of the functional integrity of peripheral small fibres, anterolateral tracts and thalamocortical projections.
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PMID:Laser-evoked cerebral potentials in the assessment of cutaneous pain sensitivity in normal subjects and patients. 176 52

Recovery of voluntary motor function after incomplete spinal cord injuries is attributed to a variety of physiological mechanisms, such as resolution of conduction block in injured axons, and neuroplasticity mechanisms in spared axons. To better understand these recovery mechanisms, we have examined motor recovery in one type of incomplete cord injury, the Brown-Sequard Syndrome. This syndrome is observed in patients with unilateral injury of the spinal cord and is manifested as asymmetric weakness and pain/temperature sensory loss contralateral to the weakest extremity. We have followed the course of motor recovery in two patients and reviewed the literature in an additional 59. Common features of this motor recovery include: 1) recovery of ipsilateral proximal extensor muscles before ipsilateral distal flexors, 2) recovery of any weakness in the extremity with pain/temperature sensory loss before the opposite extremity, and 3) recovery of voluntary motor strength and a functional gait by 1 to 6 months. We discuss these observations with respect to three hypotheses to explain motor recovery and suggest that neuroplasticity mechanisms functioning in spared descending axons may mediate much of the observed recovery after Brown-Sequard cord lesions.
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PMID:Temporal course of motor recovery after Brown-Sequard spinal cord injuries. 398 46

Reported is a case of Brown-Sequard syndrome following attempted heroin injection into the right external jugular vein. A right-sided hemiparalysis with a contralateral sensory loss of touch, pain, proprioception, and temperature developed over several hours to the C3 dermatome level. A myelogram showed a vasculitis pattern in the lower cervical region. Treatment was with high-dose dexamethasone for ten days. After six weeks of inpatient physical therapy, only minimal motor and sensory return was seen. Although this syndrome is usually due to lateral hemisection of the spinal cord by a stab wound or a gunshot wound, in this case we believe it resulted from chemical transection due to the heroin or quinine diluent or both.
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PMID:Brown-Sequard syndrome following heroin injection. 661 16

The authors report a rare case of acute cervical epidural hematoma caused by the hemorrhage from extradural arterio-venous malformation. The patient was a 74-year-old Japanese man with a past history of total gastrectomy after being diagnosed as having gastric cancer 12 years before. Six hours prior to admission, the patient had experienced a sudden episode of severe nuchal pain radiating to both scapular areas, followed by rapid development of left-side Brown-Sequard Syndrome below the C4 cord level, and urinary incontinence. Plain cervical X-ray films did not show any destructive lesion suggesting a metastatic tumor. T1 and T2 weighted images of MRI demonstrated a high intensity mass lesion, suggesting an acute epidural hematoma, extending from C3 to C6 and compressing severely the left side spinal cord posteriorly. Twelve hours after the onset of symptoms, emergency laminectomy from C3 to C6 was performed and a fresh epidural clot with small vascular tissue was totally removed. Histological examination of the small vascular tissue in the hematoma revealed arterio-venous malformation. The postoperative recovery of the patient was dramatic. He regained full muscle strength and there was complete disappearance of sensory deficits 2 weeks after the operation. Although acute spinal epidural hematoma caused by extradural arterio-venous malformation is a rare clinical entity, MRI is the most helpful diagnostic tool for this condition. It should be stressed that accurate neuroradiological diagnosis and prompt surgical decompression of the spinal cord are essential to obtain an excellent surgical outcome.
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PMID:[A case of acute cervical spinal epidural hematoma caused by extradural arterio-venous malformation]. 809 Feb 67

Two patients with a non-traumatic hematomyelia at T9 and C3-C7 respectively, are presented. Both patients presented with pain and a Brown-Sequard syndrome. The preoperative diagnosis was made by magnetic resonance imaging, while myelography and computerized tomography were not helpful. Surgical evacuation of the hematomas and in one patient removal of a vascular malformation were performed. The neurological symptoms and signs, after a temporary worsening, progressively improved. The prompt surgical treatment of this entity and the usefulness of magnetic resonance imaging in the preoperative diagnosis and on the planning of the surgical strategy is particularly emphasized.
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PMID:Spinal cord dysfunction caused by non-traumatic hematomyelia. 896 73

Brown-Sequard syndrome (BSS) is a unilateral cord injury characterised by an ipsilateral motor deficit with contralateral pain and temperature hypoaesthesia. Although there are a variety of causes, the majority of cases are generally of neoplastic origin or are traumatic in origin. We describe a rare cause of Brown-Sequard syndrome as a result of post-traumatic arachnoiditis. Magnetic resonance imaging with the use of thin-slice high-resolution constructive interference in steady state (CISS) and T2-weighted spin-echo sequence were used to demonstrate the cause and appearance of the lesion in the spinal canal and was useful in the assessment and management of the patient. This case illustrates the usefulness of the CISS sequence in MRI for elucidating arachnoiditis.
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PMID:Post-traumatic arachnoiditis: an unusual cause of Brown-Sequard syndrome. 1170 36

Symptomatic congenital intraspinal cysts are uncommon but not rare. Since these cysts may have various manifestations, a careful differential diagnosis is needed. We retrospectively reviewed findings in 3 women and 2 men (age range, 10-50 years) with 6 symptomatic cysts of the thoracic or thoracolumbar spine. In addition, we statistically analyzed the patients' Nurick myelopathy grades before and after treatment. Pain and spastic paraparesis were the most frequent manifestations. Radiographs showed the widening of the spinal bony canal in 3 patients with extradural arachnoid cysts. All patients received limited laminectomy and appropriate surgical procedures. Pathology reports indicated neurenteric (n = 1), arachnoid (n = 4), and epidermoid (n = 1) cysts. Their functional status significantly improved by a mean of 2.6 Nurick points (p = 0.0002). Our findings confirm that these cysts have various manifestations. Congenital intraspinal cyst should be included in the differential diagnosis for patients with back pain, radiculopathy, cauda equina syndrome, Brown-Sequard syndrome, or myelopathy. The advent of MR imaging and increased knowledge about the pathogenesis of these cysts have improved the ease and accuracy of their early diagnosis; in addition, postoperative prognoses are excellent if surgery is performed early.
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PMID:Surgical experience in symptomatic congenital intraspinal cysts. 1560 89

Spinal tumors may present with symptoms such as pain and motor and sensory deficits. Sphincter dysfunction may also occur. The clinical picture depends upon the size and localization of the tumor in relation to the cross section and the height along the longitudinal axis of the spinal cord. Typical symptoms due to transverse damage of the spinal cord are complete lesion, Brown-Sequard syndrome, a lesion of the central spinal cord, and posterior cord syndrome. Tetraparesis, spastic, or flaccid paraparesis result from lesions at the cervical spine, thoracic spine, or below the first lumbar vertebral body, respectively.
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PMID:[Clinical picture of spinal tumors]. 1699 58

Because of distinct pain symptoms in the presence of an ascending partial paralysis-Brown-Sequard Syndrome-from T 5/6 upward in a 56-year-old patient, therapy with paravasalic injections of bupivacaine 0.125% in the area of the femoral artery (right) was given. The patient kept a pain diary with entries every 2 h for 61 weeks. Evaluation of the documentation demonstrates the success of the therapy and shows the possibilities of different kinds of evaluation of well-documented pain data.
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PMID:[Treatment of a high-grade pain syndrome in partial paralysis by series of paravasalic sympathetic nerve blockade.]. 1841 30

A 42-year-old woman suddenly developed weakness in her left extremities when stretching her neck two days after the onset of a nuchal pain. Because computed tomography (CT) of the brain did not show any apparent lesion, the patient had initially been treated as having a cerebral infarction until magnetic resonance imaging (MRI) of the cervical spine revealed a presence of a cervical epidural hematoma the next day. She was therefore transferred to our hospital, and a neurological examination showed moderate left hemiparesis, dissociated sensory loss under C6 on the right side, urinary incontinence, and left miosis and ptosis. A CT of the cervical spine demonstrated an anteriorly located left-sided epidural hematoma extending from C4 to C7. The T2-weighted MRI revealed hyperintense lesions around the gray matter on the left side that were compressed by the epidural hematoma. The patient underwent an emergent laminoplasty from C3 to C7. Although her neurological signs were consistent with Brown-Sequard syndrome, which was associated with left-sided Homer's sign, they gradually and completely subsided following surgery. The authors therefore emphasize that cervical lesions should be considered in the differential diagnosis in patients with acute onset of hemiparesis.
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PMID:[Spontaneous cervical epidural hematoma presenting with hemiparesis following neck extension: a case report]. 1870 May 37


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