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

Cervical radiculopathy unaccompanied by pain or sensory disorder but manifested only by paresis, atrophy, fasciculation, and reflex loss is unusual. Three such cases are presented. Considerable diagnostic difficulty may arise in distinguishing patients presenting with these features from those who have primary motor neuron disease. Two additional case reports demonstrate that this distinction is not always possible. Diagnosis, management, and prognosis are discussed. Differentiation between motor neuron disease and spondylosis will avert needless surgery in the former group and will result in beneficial, sometimes curative surgery in the latter group.
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PMID:Cervical spondylotic radiculopathy producing motor manifestations mimicking primary muscular atrophy. 53 45

Our follow-up of 250 gynaecology patients and 100 dental patients who had received anaesthesia for elective outpatient surgical procedures indicates: (1) The practice of outpatient anaesthesia in proper facilities with proper selection of patients appears to be safe. (2) There is widespread patient acceptance of surgery and anaesthesia on an outpatient basis. (3) Complications are frequent but minor. (4) Many of the complications may be minimized: (i) Adequate depth of anaesthesia preferably with a volatile agent will do away with awareness during operation. (ii) Methoxyflurane should be avoided to minimize late arousal. Volatile agents such as enflurane or halothane would seem to be preferable to intravenous agents. (iii) Post-fasciculation pain could be minimized by avoiding succinylcholine for short procedures like D & C and using adequate depth instead. For dental procedures requiring tracheal intubation, one could perhaps use non-depolarizing muscle relaxants, like pancuronium, with reversal at the end of the procedure. (5) Nausea, vomiting, dizziness and headache are complications that occur very frequently in all series reported and this is an area where more research is indicated.
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PMID:An evaluation of the anaesthetic techniques used in an outpatient unit. 87 44

Two distinct lesions affect the articular cartilage of the patella. Surface degeneration occurs particularly on the odd facet; it is age dependent, often present in youth and it becomes more frequent with increasing age. It probably does not occasion patello-femoral pain in youth, but may predispose to degenerative arthritis in that joint in later years and is regarded as a consequence of habitual disuse. The term "basal degeneration" is used to describe a lesion in which there is a fasciculation of collagen in the middle and deep zones of cartilage without, at first, affecting the surface. It was found astride the ridge separating the medial from the odd facet in twenty-three adolescents who had complained of prolonged patello-femoral pain. They were treated by excision of the disc of affected cartilage, with relief of pain in most cases. The pathogenesis of basal degeneration is related to the functional anatomy of the patella.
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PMID:Patello-femoral joint mechanics and pathology. 2. Chondromalacia patellae. 95 44

Post-poliomyelitis syndrome refers to new symptoms that may occur years after recovery from poliomyelitis. The most common of these symptoms are new weakness, fatigue, and pain. This article describes electrodiagnostic studies--conventional electromyography (EMG), single fiber electromyography (SFEMG), and macroelectromyography (macro-EMG)--that have provided information on the post-polio motor unit and on the possible etiology of some post-polio syndrome symptoms. Muscular fatigue, and indirectly, general fatigue, may be due to neuromuscular junction transmission defects in some post-polio individuals, as suggested by reduction of the compound motor action potentials on repetitive stimulation, and increased jitter and blocking on SFEMG. Progressive weakness and atrophy in post-polio syndrome is probably due to a distal degeneration of post-polio motor units with resultant irreversible muscle fiber denervation. Electrodiagnostic evidence of ongoing denervation includes fibrillation and fasciculation potentials on conventional EMG, increased jitter and blocking on SFEMG, and smaller macro-EMG amplitudes in newly weakened post-polio muscles. However, even though electrodiagnostic studies have provided insight into the possible causes of some post-polio syndrome symptoms, no specific electrodiagnostic test for the syndrome is currently available.
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PMID:Electrophysiology and electrodiagnosis of the post-polio motor unit. 178 51

A nationwide two-phase survey was carried out of the adult population of the Netherlands regarding fasciculation, muscle pain and muscle cramp. We conducted a population-based telephone interview with 780 Dutch adults, followed by a questionnaire covering more clinical details, filled out by 311 subjects, who had been interviewed by telephone previously. From these data the frequencies of fasciculation (men 50%, women 61%), muscle cramp (men 28%, women 42%) and muscle pain (men 48%, women 60%) in the Dutch adult population in 1988 were estimated. The combined occurrence of frequent fasciculation and frequent muscle cramp as well as of frequent fasciculation and frequent muscle pain was reported only sporadically. Although the muscular pain-fasciculation syndrome and the muscular cramp-fasciculation syndrome represent combinations of common neuromuscular phenomena, their occurrence in the general population proved to be rare. This finding supports their clinical identity as distinct motor unit hyperactivity syndromes rather than mere coincidences of fasciculation, muscle cramp and muscle pain.
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PMID:Estimation of the frequency of the muscular pain-fasciculation syndrome and the muscular cramp-fasciculation syndrome in the adult population. 183 78

Nine patients who developed 11 brachial plexopathies after a radiation therapy for cancer have been studied. They clinically showed heterogeneity in the common criteria used to establish the differential diagnosis between post-radiation and tumoral brachial plexopathies (PRBP and TBP) and specially within the period free of symptoms from the end of radiation, and the presence and intensity of pain. Neurophysiological studies showed a diffused neurogenic lesion with muscular denervation associated to motor and sensory nerve conduction impairment on proximal segments of the arm. Somatosensory evoked potentials were frequently abnormal with absence of N9 potential in 6 out of 7 explored plexuses. The most characteristic findings were, however, the presence of fasciculation potentials and myokymic discharges in 73 per cent of cases, and the motor nerve conduction blocking with proximal -supraclavicular and cervical spine- stimulation in all of them. Both of these phenomena, when analyzed in the same neuromuscular territory, were highly correlated, supporting a probable causal relationship. The neurophysiological data may contribute to the proper differentiation between brachial plexopathies of radiation or tumoral origin. The also would permit to consider a similar physiopathological basis of PRBP with some other infrequent neuropathies where they have been described as relevant features.
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PMID:[Post-radiation brachial plexus disease. Clinical and neurophysiological study]. 216 63

The case of a patient with spontaneous painful muscular activity is described. We diagnosed the muscular pain fasciculation syndrome. Biopsy of the sural nerve and electrophysiological examination provided evidence of the neurogenic nature of the disturbance showing a remarkable axonal degeneration. In addition, when immunohistochemical studies were performed, the detection of immunoglobulins and complement components suggested an immunological process in the etiology of the disease. The patient made a good response to carbamazepine therapy. This effect is found in various syndromes of abnormal continuous muscle activity. Clinical, neurophysiological and morphological features of this case are discussed in relation of pathogenesis, possible drug effects and related diseases.
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PMID:[Syndrome of painful muscle fasciculations. Case report and differential diagnostic review]. 304 39

The effectiveness of four pretreatment regimens in decreasing succinylcholine-induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety-five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg X kg-1 of succinylcholine: normal saline IV three minutes and again immediately prior to succinylcholine; 0.06 mg X kg-1 d-tubo-curarine (dTc) IV three minutes prior and normal saline IV immediately prior; normal saline IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior; 0.06 mg X kg-1 dTc IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lidocaine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, lidocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Decreasing post-succinylcholine myalgia in outpatients. 355 77

Muscle fasciculations and pain following the administration of suxamethonium were assessed in a group of patients who performed a series of stretch exercises approximately 1 h before operation. Comparison was made with a group who received suxamethonium but no pretreatment. Fasciculations were significantly reduced in the exercised group, and the incidence of muscle pain decreased from 52% in the untreated group to 12% in the exercised group. A significant relationship was shown between the severity of visible fasciculations and muscle pain.
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PMID:Effect of stretch exercises on suxamethonium induced fasciculations and myalgia. 358 Feb 40

Muscle pain associated with single-bolus administration of suxamethonium is reported to be one of the common complications of this technique. Since suxamethonium is the most commonly used relaxant in our department and priming with nondepolarizing muscle relaxants is also reported to be linked with complications, while the literature concerning this problem is very contradictory, we wondered if the so-called "self-taming" method represents an alternative to pretreatment with nondepolarizing muscle relaxants. One hundred thirty-two patients (69 male, 63 female) were randomly allocated to three groups. Anesthesia was induced with thiopentone 7 mg/kg body weight. Group 1 (n = 44) was pretreated with 2 mg pancuronium bromide 3 min prior to full relaxation with suxamethonium 1.5 mg/kg. Group 2 (n = 43) received no pretreatment. Group 3 (n = 45) received 4 mg suxamethonium i.v. after induction. One minute later the remaining dose of suxamethonium was applied ("self-taming"). Muscle fasciculation and postoperative myalgia were verified by means of a score. Neuromuscular transmission was recorded on a monitor after controlled train-of-four stimulus and time of onset of neuromuscular blockade was measured. With regard to muscle fasciculation, postoperative pain, and onset of neuromuscular blockade, "self-taming" with suxamethonium yielded results identical to pretreatment with pancuronium bromide. It may therefore be considered as an alternative to pretreatment with nondepolarizing muscle relaxants.
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PMID:["Self-taming": an alternative to the prevention of succinylcholine-induced pain]. 366 53


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