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)

Review of the various drugs in current clinical use showed that over 50 of them may cause a purely sensory or mixed sensorimotor neuropathy. These include antimicrobials, such as isoniazid, ethambutol, ethionamide, nitrofurantoin, and metronidazole; antineoplastic agents, particularly vinca alkaloids; cardiovascular drugs, such as perhexiline and hydrallazine; hypnotics and psychotropics, notable methaqualone; antirheumatics, such as gold, indomethacin, and chloroquine; anticonvulsants, particularly phenytoin; and other drugs, including disulfiram, calcium carbimide, and dapsone. Patients receiving drug treatment who complain of paraesthesie, pain, muscle cramps, or other abnormal sensations and those without symptoms who are receiving drugs that are known or suspected to be neurotoxic should undergo neurological examination and studies of motor and sensory nerve conduction. This will allow the incidence of drug-induced peripheral neuropathy to be determined more precisely.
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PMID:Drug-induced peripheral neuropathies. 21 31

A case of carnitine palmityl transferase deficiency in skeletal muscle is described. The usual symptoms associated with this disease (recurrent muscle cramps or pain and pigmenturia) were observed but sudden exposure to cold precipitate rhabdomyolysis in this patient.
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PMID:Cold induced rhabdomyolysis in carnitine palmyityl transferase deficiency. 48 29

Chronic lumbar radiculopathy following spinal surgery is reported, in which 7 of 25 patients reviewed developed a postoperative syndrome immediately after their original surgery. Later, sometimes years later, all 7 patients developed severe chronic spinal arachnoiditis. This syndrome was characterized by transient violent spasms in the legs, muscle cramps, increased radicular pain, and often fever and chills. The recognition of this syndrome and a proposed method of treatment is discussed.
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PMID:Chronic spinal arachnoiditis. A postoperative syndrome that may signal its onset. 64 96

Infection of the intervertebral space is a rare complication of operation on the disc (Ford and Key 1955). It occurred in five cases in a series of 650 operations for lumbar disc protrusion done by two of the authors of this paper--an incidence of 0-8%. Symptoms began between seven and twelve days after operation. After initial relief of the original sciatic pain, the patients developed severe back pain and muscle cramps in the legs. Straight-leg raising became much more limited than before operation. The erythrocyte sedimentation rate was raised in all cases. The diagnosis was confirmed by rescreening the Myodil, when an indentation was seen opposite the intervertebral space from which the disc had been excised. Early removal of infected material from the disc space resulted in complete relief of pain and cure of the infection.
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PMID:Infection of intervertebral discs after operation. 127 Apr 87

We studied the reported frequencies of clinical complaints of neuromuscular hyperexcitability (muscle cramps and fasciculations) in random samples of 527 Dutch adults, who were and 253 Dutch adults, who were not suffering from musculoskeletal pain and tenderness. Data were collected by telephone-interview and by self-administered questionnaire. Muscle cramps and fasciculations were recorded more frequently in the category that suffered from musculoskeletal pain (p less than 0.001). This association warrants further investigation into the possible intrinsic role of neuromuscular hyperexcitability in musculoskeletal pain and primary fibromyalgia.
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PMID:Neuromuscular hyperexcitability features in patients suffering from musculoskeletal pain: a neuroepidemiologic survey. 131 3

A 20-year-old man was admitted to our hospital because of generalized muscle cramp with pain. At the age of 12 years, he began to have painful muscle cramps in calf muscles, which gradually extended to all limb and truncal muscles and became more severe and frequent. He also had diarrhea and mild hair loss. On admission he had mild baldness, left shoulder deformity, and hypertrophic muscles. Muscle cramps were observed especially in the extremities. Routine laboratory studies revealed moderately high serum CK and low IgG levels. He had been treated with several muscle relaxants and antiepileptic drugs, but with no favorable effect. During his admission he received high-dose intravenous methylprednisone of 1000 mg/day for three days, followed by oral prednisolone tapered over 4 weeks. Soon after the initiation of the treatment, painful muscle cramps were gradually decreased and his activity of daily life apparently improved. In conclusion steroid pulse therapy is a useful treatment for patients who are not responsive to dantrolene sodium administration, and the effectiveness suggests that a certain autoimmune mechanism plays a role in pathogenetic mechanism.
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PMID:[A case of "syndrome of progressive muscle spasm, alopecia, and diarrhea (Satoyoshi)" treated with steroid pulse therapy]. 142 40

Latrodectism, the clinical syndrome that follows envenomation by the black widow spider, may easily be confused with more common conditions. Acute manifestations are characterized by agonizing pain and muscle spasm. Prolonged symptoms, primarily related to neurologic dysfunction, may occur. Familiarity with the manifestations of latrodectism is the key to diagnosis. Family physicians should consider latrodectism in patients presenting with severe pain and muscle cramps, particularly if the setting and history are consistent with a possible spider bite. Optimal therapy remains controversial. Early use of specific antivenin in severely envenomated patients may prevent the development of lingering symptoms, usually related to neurologic dysfunction.
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PMID:Latrodectism: bite of the black widow spider. 172 88

Hypertonic solutions of dextrose (D), mannitol (M), and saline (S) are effective treatments for hemodialysis-associated muscle cramps, but have not been directly compared to one another. Concern exists that postdialysis retention of M and S may lead to increased thirst, interdialytic weight pain (IDWG), and elevated blood pressure. The authors performed a prospective, randomized, double-blind crossover study to compare the efficacy of D, M, and S in 24 chronic hemodialysis patients. Cramps were treated with 50 ml (126 mOsm) D, 100 ml (138 mOsm) M, and 16 ml (126 mOsm) S. All patients were assigned to each regimen for a 2 week period. For the entire patient group (n = 24), mean cramp duration (+/- SD) was less for M compared to D (9 +/- 5 vs 13 +/- 12 min, p less than 0.05), but not to S (10 +/- 6, p = NS) although not every patient had a cramp episode during each 2 week period of study. In a subgroup of 11 patients with a mean of 3.7 (range 1-6) cramps during each 2 week period, the efficacy of D, M, and S was similar. In both patient groups, IDWG, blood pressure control, and the frequency of adverse effects was similar with the use of all three agents. Mild postdialysis hyperglycemia and hypernatremia during D and S, respectively, were the only significant laboratory abnormalities. The authors conclude: 1) the safety and efficacy of D, M, and S are equivalent, and 2) the nonmetabolized osmotic agents M and S do not lead to increased IDWG or decreased blood pressure control.
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PMID:Comparison of 50% dextrose water, 25% mannitol, and 23.5% saline for the treatment of hemodialysis-associated muscle cramps. 176 4

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

Muscle cramps may occur in healthy individuals without any apparent cause; these are regarded as benign cramps. Cramps may also develop as a symptom of a systemic disease, such as uremia. Cramps probably originate in the distal portion of the motor nerve. It is unclear whether the nerve terminals are hyperexcitable or prone to repetitive activity in the various related conditions. In the cancer patient, muscle cramps may not be a benign complaint because they often represent an unsuspected underlying pathologic condition associated either with the neoplastic process or the undesirable side effects of therapy. Initial evaluation with a detailed neurologic examination, a complete biochemical profile with magnesium levels and muscle enzymes, and electrodiagnostic examination will lead to the diagnosis in the majority of these patients. Recognized etiologies of cramps may be related to neurologic abnormalities or to nonneurologic causes. Treatment decisions should be oriented according to the following classification: (1) reversible causes; (2) potentially reversible causes and (3) irreversible causes. Whereas the remedy in the first category is to attack the underlying process, if possible, pharmacologic suppression of cramps is the primary approach in the others. Membrane-stabilizing agents, such as quinine, phenytoin or carbamazepine, may be selected according to either nocturnal or daytime predominant occurrence of cramps.
J Pain Symptom Manage 1991 Feb
PMID:Muscle cramps in the cancer patient: causes and treatment. 200 96


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