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

Spontaneous pneumomediastinum is a relatively rare disease, the clinical signs of which may be misleading, and the physiopathology is still unknown. The authors report 7 cases collected over a period of 3 years and note the etiology, the clinical findings and the X-ray findings. The disease often affectsyoung sybjects, without any sex predominance. The initial symptom is thoracic pain and is often accompanied by dispnea. Subcutaneous emphysema only appears secondarily and may be mild. The association with pneumothorax is not rare. Among the etiological circumstances, pneumomediastinum often occurs after an effort or a respiratory infection with dyspnea. The diagnosis depends on the discovery of subcutaneous emphysema and on radiological signs in A.P. and lateral chest views. Treatment should be as conservative as possible in the usual benign forms. It should be limited to bed rest, analgesics and sedatives. In severe cases, supra-sternal drainage permits decompression of the mediastinum. The physiopathological mechanisms are discussed, but the usually accepted theory is rupture of an alveolus into the pulmonary interstitial tissue. The pressure gradient necessary for this rupture may be due to variations in alveolar or vascular pressure.
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PMID:[Spontaneous pneumomediastinum]. 17 Jun 84

Phantom urinary phenomena are a relatively rare disease entity. Literature search has revealed only one case following cystectomy, seven cases following spinal cord injury and several other cases in hemodialysis patients. This report presents a case of painful phantom bladder following cystectomy for chronic kidney and urinary tract infection. Treatment was directed toward sensory hyperstimulation for suppression of the subjective experience of the painful phantom. Lumbar sympathetic blocks and transcutaneous electrical stimulation were used. Competent coping mechanisms were increased through relaxation training and assertiveness training to deal with a medical problem which has no standard solution. The patient's response to the Comprehensive Pain Control Program was excellent with an estimated 75% reduction in painful phantom perceptions. A brief discussion of the medical literature on the subject is presented.
Pain 1979 Oct
PMID:Phantom urinary bladder pain--case report. 39 10

Twenty-five cases of multiple sclerosis (MS), including 2 autopsy cases, collected during the past 20 years from amongst the Chinese of Taiwan, are reported. These cases fulfilled all the clinical diagnostic criteria of MS. The following observations were made: (1) Multiple sclerosis does exist among Chinese in Taiwan. It is uncommon, but is by no means a very rare disease. The prevalence rate in northern Taiwan near Taipei is estimated as 0.8/100.000 population. (2) Female preponderence was conspicuous (F:M = 3.2.:1) in our MS cases as well as in other demyelinating diseases. (3) On the whole, the onset of the disease was earlier in female patients, and those who had their initial symptoms before the age of 20 years were all females. (4) The optic nerve was most frequently involved at the onset, and it was involved in the majority of patients during the whole clinical course. (5) Involvement of the optic nerve and spinal cord, with or without the brain stem, was the commonest form of our MS cases, especially among female patients. (6) More malignant forms of MS, with acute onset and rapid clinical course leading to severe incapacity or fatality, were more common among female patients. (7) Painful tonic spasms were relatively frequently encountered, and they were usually seen in patients with severe spinal cord involvement. (8) Marked elevation of the CSF total protein and of leukocytes was relatively frequent during severe relapses in patients with spinal cord lesions. (9) Severe and extensive demyelinating lesions, both old and recent, in the optic nerve and spinal cord were seen in 2 autopsy cases. The relationship between MS and NMO in Oriental patients is briefly discussed. (10) It seems likely that cases of MS which are atypical as compared with Western MS are more frequently seen in Oriental countries, and perhaps also in tropical regions where MS is known to be rare.
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PMID:Multiple sclerosis amongst Chinese in Taiwan. 126 5

Erythromelalgia is a rare disease characterized by intense erythema, burning pain and increased temperature in the distal of the extremities. Primary forms and secondary forms have been described, most commonly with essential thrombocythemia and policythemia vera. The authors describe a fifteen year old patient with primary erythromelalgia and discuss the pathogenic, clinical and therapeutic features of this disease.
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PMID:[Primary erythromelalgia]. 134 Mar 83

Glossopharyngeal neuralgia is a rare disease which is characterized by severe paroxysmal pain attacks in the distribution of the 9th cerebral nerve. Although uncommon, the condition has to be considered in the differential diagnosis of various craniofacial neuralgias. The purpose of this study was to describe 3 cases of glossopharyngeal neuralgias and to discuss its diagnosis and therapy. Various surgical therapeutic procedures have been described, including neurotomy of the glossopharyngeal nerve in the frontal neck, thermocoagulation of Andersch's ganglion, and para-pontine neurotomy (Dandy). Because of its good results and low incidence of recurrences, microvascular decompression (Jannetta) is considered the procedure of choice.
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PMID:[Surgical treatment of glossopharyngeal neuralgia]. 141 22

Hereditary angioedema is a rare disease resulting from a lack of functional C1 esterase inhibitor (C1 INH). Several genetic defects can cause decreased production of the protein or the synthesis of a biologically inactive form. A similar, acquired condition is occasionally seen, associated with malignancies or as an autoimmune process. Disease severity varies greatly among affected individuals. Most patients have cutaneous, laryngeal, or gastrointestinal edema, often in combinations. The symptoms may appear spontaneously or result from a stimulus, usually trauma. When clinical suspicion exists, measurement of the C4 level screens for the disease. An assay showing low serum C1 INH function confirms the diagnosis. When disease severity warrants, symptoms can be controlled with anabolic steroids or antifibrinolytics. Doses should be increased before symptom-provoking events. Emergencies are treated with plasma infusions, fluids, and pain control. Where available, C1 INH concentrate is the treatment of choice. Therapy can usually be monitored by control of symptoms. With appropriate therapy, most cases remain well controlled.
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PMID:Hereditary angioedema. 143 45

Sternocostoclavicular hyperostosis is a rare disease characterized by recurrent pain and skeletal swelling in the upper part of the chest. The clinical manifestations are closely linked to pustulosis palmo-plantaris but the etiology is still obscure. We present three cases of sternocostoclavicular hyperostosis with a follow-up period of 9-22 years at our department.
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PMID:Sternocostoclavicular hyperostosis. Presentation and long-term follow-up of three cases. 147 17

Maffucci's syndrome is a congenital nonfamilial syndrome combining dyschondroplasia, (enchondromatosis) and hemangiomatosis. It is a rare disease; only 200 cases have been reported throughout the world in the past 140 years. Over the past 20 years, four patients have been admitted with signs and symptoms consistent with Maffucci's syndrome. Three were children ages 3, 7, and 9 years. The fourth was 23 years old. Two were male and two female. All had hemangiomas at birth, and all had skeletal deformities and enchondromas. All complained of pain and heaviness of the involved extremity. Three patients had the arterial inflow evaluated with arteriograms, and one had magnetic resonance imaging. Two also had venograms. Two patients had excision of their hemangiomas, and one had sclerotherapy and compression therapy. All had bone biopsies performed. None of the enchondromas or the soft tissue lesions had undergone sarcomatous transformation.
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PMID:Maffucci's syndrome (hemangiomatosis osteolytica): a report of four cases. 152 38

The syndrome of the anterior spinal artery is a rare disease with a diagnosis based an its characteristic clinical features. Until the widespread use of the Magnetic Resonance (MR) the lesional confirmation required an anatomopathological study. We report a 49-years-old male with lacinating interscapular pain and sudden asymmetrical tetraparesia, in whom MR scan disclosed a plurisegmental anterior spinal lesion and a posterolateral disk protrusion at C6-C7 level. We discuss the etiological and pathogenetical relation between degenerative vertebral disk disease and spinal infarctions.
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PMID:[Anterior spinal artery syndrome caused by cervical disc protrusion. Diagnosis by magnetic resonance]. 176 45

Disk herniation lateral to the intervertebral foramen is defined as extraforaminal. Its particular anatomical site makes its clinical and neurologic features completely different from those of posteromedial and posterolateral disk herniations. Prior to the advent of computerized tomography, only diskography was capable of preoperatively identifying this rare disease. We present 5 cases of extraforaminal disk herniation, the clinical and tomographic diagnosis of which was confirmed at surgery. All patients had severe motor deficit and reported sciatica as prevalent over low back pain. The herniated disk was L4-5 in 2 cases and L5-S1 in 3 cases. The CT scan suggested disk protrusion in 2 cases, extrusion in 2 cases, and sequestration in 1 case. Four of these findings were confirmed intraoperatively. Diskectomy was done after hemilaminectomy and partial or total facetectomy. The clinical result was excellent in 2 cases and good in 3 cases after an average follow-up of 10 months. The use of CT scan as part of the routine diagnostic procedure in patients with radicular pain has lowered the number of cases which the surgical findings were inexplicably negative for disk herniation without having to resort to more complex and invasive diagnostic techniques such as myelo-CT and disk-CT. Moreover, preliminary tomographic localization of the extraforaminal disk herniation makes it possible to operate on the affected level using more conservative techniques. In any case, thorough clinical examination is essential for both correct interpretation of the CT scan and appropriate choice of treatment.
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PMID:Extraforaminal lumbar disk herniation. Clinical features and computerized tomography. 178 49


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