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)

Thirty-eight cases of musculoskeletal pain in a pediatric population that defied diagnosis are reviewed. The time between the onset of symptoms and the final diagnosis averaged 11.4 months, but in many cases was greater than 1 year. The most common diagnoses included reflex sympathetic dystrophy, osteoid osteoma, osteomyelitis, intraarticular hemangiomata, slipped epiphyses, and rheumatoid variants. There were several uncommon causes of pain, such as soft tissue hemangiomata, dystonia, and Addison disease. The pitfalls and causes of error are reviewed.
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PMID:Pediatric orthopedic pain of unknown origin. 373 72

Palpation of the chest-covering tissues was performed in 150 patients with neurocirculatory dystonia with complaints of pain in the cardiac region. In all the patients painful muscular consolidations of various size, shape and consistency were detected in the thickness of the pectoral muscles and at the sites of their transition into tendons. Direct correlation between the gravity of cardialgia and expression of the muscular pain syndrome was noted. In 98% of cases therapy aimed at the elimination of the muscular pain syndrome (repeated novocaine-hydrocortisone infiltrations) resulted in the correction or a significant decrease in a degree of cardialgia. The results obtained suggested that the cardiac pain syndrome in patients with neurocirculatory dystonia was mainly caused by local changes in the musculotendinous tissues of the chest.
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PMID:[Genesis of the cardiac pain syndrome in patients with neurocirculatory dystonia]. 382 4

Four patients are described who sustained comparatively minor peripheral injury, the affected area soon becoming the site of segmental dystonia. The movement disorder developed as the symptoms from the injury subsided, and except for the recent trauma, no cause for the dystonia was apparent; litigation was not an issue for any patient. It is suggested that on rare occasions peripheral trauma results in the development of dystonia. Since injury never involved the head, the role of the spinal dopaminergic system and the relevance of pain from the injury are discussed in considering possible underlying mechanisms.
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PMID:The relationship of peripheral trauma and pain to dystonia. 403 15

Stimulation of the thalamus and internal capsule with Medtronic deep brain stimulation electrodes produced improvement in pain, hemiparesis, dystonia, torticollis, tremor. speech impairment and epilepsy. Stimulation at voltages above or below clinically effective levels (e.g., 6 V, 0.3 ms, 74 Hz) resulted in a loss of clinical efficacy. Somatosensory evoked responses (short and long latency) and depth electrode recordings were helpful in localisation and 'biocalibration' of electrical stimulation.
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PMID:Reversibility of chronic neurologic deficits. Some effects of electrical stimulation of the thalamus and internal capsule in man. 697 64

It is established that the strength of both hands is much weaker in patients with angina pectoris than in healthy individuals. Development of an atypical cardiac pain syndrome leads to a significant diminution in the strength of the left hand of patients with angina pectoris and to a considerable reduction in endurance. In patients with cardiac-type neurocirculatory dystonia, the strength in the left hand and the endurance of isometric exertion are diminished. The endurance of dynamic exertion is sharply reduced in patients with chronic coronary insufficiency. Physical working capacity is substantially higher in patients with cardiac-type neurocirculatory dystonia than in those with angina pectoris and lower than in practically health individuals.
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PMID:[Physical work capacity in isometric and dynamic regimens in patients with stenocardia and cardiac-type neurocirculatory dystonia]. 725 91

Algesimetry was used to study the pain sensitivity in 143 subjects (21 healthy individuals, 20 cases with neurocirculatory dystonia, 62 with chronic ischaemic heart disease and 40 with subacute myocardial infarction). The tests were performed for the tactile threshold, pain threshold, threshold of pain endurance and the interval of pain endurance. In a part of patients indices of pain sensitivity were correlated with tolerance to physical exertion. In neurocirculatory dystonia high pain sensitivity was due to the lowering of the pain threshold. In patients with ischaemic heart disease there were three types of pain threshold (low, medium, high) and two variants as concerns the interval of pain endurance (low and high). Low interval of pain endurance corresponded to low tolerance of physical exertion, hence algesimetry can serve as an additional method of objective interpretation of the bicycle ergometry tests.
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PMID:[Algesimetry in ischemic heart disease and neurocirculatory dystonia]. 732 24

Occupational dystonia is a frequent clinical symptom in musicians and has been described as muscle spasms and hand cramps in pianists. Robert Schumann had a neurological impairment of his right hand that was not clinically diagnosed during his life and that impaired his career as pianist from his early 20s. This disturbance was characterized by pain and by rigidity of the fingers, which extended to other segments of his right upper extremity while he was performing and that increased with stress and improved with muscle relaxation. This disturbance produced a progressive impairment of his writing. We here hypothesize that Schumann's neurological problem was consistent with dystonia.
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PMID:Did Robert Schumann have dystonia? 756 19

The "off" painful dystonia (OPD), usually concerning the feet, is a type of abnormal involuntary movement, induced by the chronic use of levodopa. It is mostly observed in the advanced stage of Parkinson's disease (PD), particularly in the early morning, in the evening, and late at night. Indeed, some patients have experienced OPD also during "on" periods when dystonic posture of the foot alternates with dyskinesia. The pain probably is due to sustained muscle contraction, which causes prolonged muscle spasm, as in primary dystonia or torticollis. Dopaminergic drugs like bromocriptine, pergolide, and especially apomorphine (s.c. infusions, or bolus), can dramatically improve the OPD. Anticholinergics baclofen and lithium are alos used in the management of OPD with some benefit. On the other hand, clinical experience shows that in many cases, these therapeutic procedures are not always enough to produce the expected results. Thirty PD patients (22 men and eight women) with OPD of the foot were treated with botulinum toxin (Botox, Btx) using electromyograms to guide injections. Dystonia was evaluated using a quantitative rating scale. The selection of the muscles for Btx treatment was carried out on the basis of foot posture. We injected Btx into tibialis posterior, tibialis anterior, gastrocnemius, flexor digitorum longus, and extensores hallucis longus with a median dose 40 IU for each muscle, distributed in two sites. In all patients, the pain improved within 10 days, whereas in 21 patients, the pain disappeared completely for 4 months (range, 3-7 months); a concomitant improvement in intensity of the dystonic spasm was also observed. No side effects were reported. Seven patients with associated "on" foot dystonia described an improvement of foot posture on walking. In conclusion, in this uncontrolled study, the use of Btx in OPD seemed a promising tool to improve pain linked to foot dystonia; however, because of the well-known underlying dopaminergic defect in OPD, the Btx therapy should be considered only if the dopaminergic treatment established for the management of OPD has failed.
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PMID:"Off" painful dystonia in Parkinson's disease treated with botulinum toxin. 765 52

Motor disorders affecting the orofacial musculature include bruxism, chronic orofacial muscle pain affecting the jaw and neck muscles and the involuntary waking period disorders such as orofacial dyskinesia, oral mandibular dystonia, tremor and others. Research at UCLA has touched these and many other areas. Current results have indicated the usefulness of contingent afferent electrical stimulation of the lip to control bruxism; provided information regarding the fatigue, endurance and recovery faculties of the protrusive jaw muscles; explored the issue of chronic muscle hyperactivity inducing headache pain; and worked with botulin toxin as a method to treat orofacial dystonia and dyskinesia.
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PMID:Oral motor disorders in humans. 768 5

Twenty patients with cervical dystonia were treated during one year with repeated intramuscular injections of botulinum toxin. The outcome was evaluated comparing subjective global rating with relative changes in degree of pain on the Visual analogue scale (VAS), degree of dysfunction due to dystonia, and quality of life according to the Nottingham health profile (NHP). Objective measurement of dystonic position and movement ability was performed using a goniometer, semiquantitatively noted as scores according to Fahn and Tsui. Before treatment, the degree of impaired life quality on the NHP did not correlate with the Tsui score of dystonic posture, but significantly with the Fahn score (p < 0.01) which also includes data on pain. Significant improvement after treatment was seen for all parameters (p < 0.05). Global subjective rating correlated significantly with improved posture according to the Tsui score (p < 0.05), but not with reduced pain or degree of dysfunction. The results suggest that the efficacy of botulinum toxin in cervical dystonia is best evaluated using a combination of the VAS for pain and the Tsui score for dystonic posture and movement ability.
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PMID:Efficacy of botulinum toxin for cervical dystonia. A comparison of methods for evaluation. 787 93


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