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)

Four cases of suprascapular nerve injury following various types of trauma are reported. This nerve is subject to damage where it passes through the suprascapular notch. Initially, main complaints are vague shoulder area pain, weakness in shoulder abduction and external rotation, followed by atrophy of the shoulder girdle muscles innervated by the suprascapular nerve. Electromyography confirms the diagnosis. The literature was reviewed for possible mechanisms of the suprascapular nerve injury, which should not be confused with cervical radiculopathy, brachial plexopathy, or rotator cuff injury. Early active and passive range of motion exercises are recommended, to retard muscle atrophy and prevent secondary joint problems. If regeneration does not occur, surgical exploration should be considered.
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PMID:Suprascapular nerve injury following trauma to the shoulder. 726 37

Peripheral, cervical and cortical somatosensory evoked potentials after median or ulnar nerve stimulation were recorded in 21 patients with cervical spondylosis with radiculopathy or myelopathy. The test was normal when pain and paraesthesias were the only symptoms, while pathological in radiculopathy with objective neurological signs. The results varied in patients with cervical myelopathy.
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PMID:Somatosensory conduction times and peripheral, cervical and cortical evoked potentials in patients with cervical spondylosis. 743 Oct 29

A number of operative techniques have been described for the treatment of herniated thoracic discs. The transfacet pedicle-sparing approach allows for complete disc removal with limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, development of thoracic microdiscectomy instrumentation, and establishment of morphometric measurements. This approach was used to remove eight thoracic discs in six patients. Levels of herniation ranged from T-7 through T-11. Preoperatively, all patients had moderate to severe axial pain, and three (50%) of the six had radicular pain. Myelopathy was present in four (67%) of the six patients. Through a 4-cm opening, the ipsilateral paraspinal muscles were reflected, and a partial facetectomy was performed. The disc was then removed using specially designed microscopic instrumentation. Postoperatively, the radiculopathy resolved in all patients. Axial pain and myelopathy were completely resolved or significantly improved in all patients. The minimal amount of bone resection and muscle dissection involved in the operation allows for: 1) decreased operative time and blood loss; 2) diminished perioperative pain; 3) shorter hospitalization time and faster return to premorbid activity; 4) avoidance of closed chest tube drainage; and 5) preservation of the integrity of the facet-pedicle complex, with potential for improvement in outcome related to axial pain. This technique appears best suited for the removal of all centrolateral discs, although it has been used successfully for treating a disc occupying nearly the entire ventral canal. The initial experience suggests that this approach may be used to safely remove appropriately selected thoracic disc herniations with good results.
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PMID:The transfacet pedicle-sparing approach for thoracic disc removal: cadaveric morphometric analysis and preliminary clinical experience. 868 73

Fifty patients with 63 symptomatic vertebral metastases (18 sites: pain only, 28 sites: radiculopathy with pain, 17 sites: myelopathy) were treated by radiotherapy. Primary lesions were located in the lung (9 cases), breast (9 cases) colorectal area (9 cases), prostate (7 cases) and so on. We correlated the radiologic findings, symptoms and clinical effects with metastatic features which were classified into 4 types by MR imaging: non-deformity, expanding, vertebral collapse, and destructive mass. Each type of metastasis was accompanied with or without epidural tumor. Osteolytic metastases were apt to create features of deformity (expanding type: 18 vertebrae, vertebral collapse type: 17 vertebrae, destructive mass type: 9 vertebrae). The features of osteoblastic metastases were no deformity (18 vertebrae) and expanding type (2 vertebrae). The symptom of pain only occurred most frequently in the lumbosacral spine. The vertebral body deformity of symptomatic sites was relatively slight (non-deformity type: 6 sites, expanding type: 6 sites, vertebral collapse type: 6 sites), and epidural tumors were seen at only 2 sites. The effect of radiotherapy was excellent (complete pain relief: 64.7%, partial pain relief: 29.4%). Radiculopathy occurred most frequently in the lumbar spine. Vertebral body deformity was noted in most symptomatic sites (expanding type: 9 sites, vertebral collapse type: 10 sites, destructive mass type: 2 sites). Complete relief was obtained in 6 sites (22. 2%), partial relief in 18 (63.0%). Myelopathy occurred most often in the thoracic spine, followed by the lumbar spine. The vertebral body deformity was severe (expanding type: 3 cases, vertebral collapse type: 3 cases, destructive mass type: 6 cases). Epidural tumors were also present in all but one case. Six of 13 patients treated with radiation alone improved. These 6 patients had non-deformity or expanding types with epidural tumor. No improvement was seen in the vertebral collapse type with epidural tumor or destructive mass type.
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PMID:[Radiotherapy for vertebral metastases: analysis of symptoms and clinical effects by MR imaging]. 759 66

The role played by the epidural fat has been reported in lipomatosis induced by exogenous glucocorticoids and in severe obesity with lipomatosis. The role played by the "normal" posterior epidural fat (PEF) in lumbar canal stenosis (LCS) is less well known. The purpose of this study was to determine the part taken by PEF in LCS patients without endocrine disease, corticosteroid therapy or obesity. For this, we tried to specify the amount and distribution of PEF among the soft tissues in the vertebral canal, to demonstrate the involvement of PEF in dural sac compression, to describe the radiological features observed in cases of LCS and to look for associated morphological factors. The records of 30 LCS patients without exogenous or endogenous lipomatosis and in whom the essential pathogenic factor in 40 levels was PEF were reviewed retrospectively. At disc level, PEF was evaluated in the lower part of the mobile segment by means of CT or MRI axial sections cut through one or two spaces between L2-L3 and L4-L5. Measurements were made in 25 men (80%) and 6 women (20%) aged from 33 to 83 years (mean: 58 years). Most patients were suffering from lumbar pain, radiculopathy and/or neurogenic intermittent claudication. The data measured were: antero-posterior (AP) diameter of the dural sac, AP diameter of the bony lumbar canal (BLC), interligamentous distance (ILD) opposite the articular facets, and surface of PEF. The soft elements present on the midline--anterior epidural space (AES) and posterior epidural (PEF)--were expressed as percentage of the AP diameter of the bony lumbar canal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Posterior epidural adipose tissue and the narrow lumbar canal: replacement tissue or cause of impingement?]. 762 71

The vast majority of patients with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) have symptoms or signs involving the feet and lower extremities. Patients presenting to podiatrists with foot complaints may, in fact, have neurologic complications of HIV originating in any level of the neuraxis, and multiple levels may be involved. These include multiple classes of peripheral neuropathy and myopathy, inflammatory radiculopathy, myelopathy, and central nervous system lesions caused by direct HIV infection or opportunistic infections. Common complaints such as pain, numbness, burning, tingling, weakness, cramps, unsteady gait, and others should be systematically evaluated with both podiatric and neurologic etiologies in mind for early diagnosis and intervention.
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PMID:Neurologic conditions affecting the lower extremities in HIV infection. 764 14

Although the mechanical and positional stresses of pregnancy are the primary inciting factors contributing to lumbosacral pain accompanying gestation, in approximately 1:10,000 cases a herniated disk (HNP) can be identified as the proximal cause of pain. Six patients are described, all of whom without antecedent history of pain presented with acute, disabling, gestational lumbosacral, and sciatic radiculopathy. Their ages ranged from 29 to 36, their parity from 0 to 1, and their gestational age at onset of symptoms from 6 weeks to 32 weeks. Each by magnetic resonance imaging (MRI) was identified as having an HNP, 2 at the L4-5 level and 4 at the L5-S1 level. During pregnancy, an MRI evaluation permits a detailed spinal examination without the ionizing effects of x-ray and its acknowledged biological risk to the developing fetus. This potential for an immediate and accurate diagnosis has significant implications for the management and subsequent planning of delivery.
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PMID:The lumbar herniated disk of pregnancy: a report of six cases identified by magnetic resonance imaging. 774 22

Trauma and compression along the course of the median, ulnar or radial nerve from the brachial plexus to the fingers may cause pain, weakness, numbness or tingling of the upper extremity. Diabetes, smoking, alcohol consumption, rheumatoid arthritis and hypothyroidism are risk factors for nerve entrapment, although these disorders typically produce bilateral symptoms. Carpal tunnel syndrome, the most common nerve entrapment condition, results from median nerve compression at the wrist. The diagnosis is suggested by decreased pain sensation and numbness in the thumb and index and middle fingers; symptoms are reproduced by wrist hyperflexion and median nerve percussion. Volar splinting and steroid injection often ameliorate symptoms. Decreased sensation of the little finger and the ulnar aspect of the ring finger, along with intrinsic muscle weakness, may be caused by cervical radiculopathy, thoracic outlet syndrome or compression of the ulnar nerve above the elbow (cubital tunnel syndrome) or at the wrist (ulnar tunnel syndrome). Electromyography and radiography may help differentiate these conditions. Radial tunnel syndrome occasionally accompanies inflammation of the common wrist extensors and lateral epicondylitis ("tennis elbow"). A radial nerve block can help exclude concomitant radial tunnel syndrome in patients with symptoms of lateral epicondylitis.
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PMID:The numb arm and hand. 776 75

A previously independent 95-year-old woman had acute, disabling left lumbosacral radiculopathy diagnosed by clinical findings and imaging studies. Significant side effects of oral nonsteroidal and narcotic medications led to treatment with epidural steroids (triamcinolone acetonide). These injections provided pain relief, allowing a short course of inpatient rehabilitation that improved the patient's function and facilitated return to independent living. At 1-year follow-up, she continued to live independently and remained free of pain. We believe that epidural steroids coupled with a comprehensive rehabilitation program can lead to restoration of function in some elderly patients unable to tolerate the side effects of standard pain medications.
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PMID:Epidural corticosteroid injections for acute radiculopathy in a 95-year-old woman. 783 67

The activity of myorelaxant sirdalud (tizanidine) was studied in 36 patients aged 20-79 with pain syndrome (reflex muscular-tonic, myofascial, acute compression radiculopathy). The condition of the patients was evaluated according to the visual analog scale where the scores were assigned to the intensity of muscular spasm, pain at rest, exercise and at altitude tension and functional decline. Pain symptoms diminished as early as the treatment day 3. The same was true for muscular spasms. The highest effect of sirdalud occurred in acute phases of the diseases. Pain relief was so material that 20 patients were able to discontinue analgetics and tranquilizers. For 12 patients the doses of nonsteroid antiinflammatory drugs were noticeably reduced. Side effects of sirdalud were minimal: slight sleepiness and xerostomia.
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PMID:[The efficacy of sirdalud in the drug therapy of pain in the spine]. 786 33


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