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

Six cases with neurovascular complications, previously unreported as a complication of the Hauser procedure, have been presented. The salient features were unrelenting pain during the first 24 hours postoperatively, completely out of proportion to that which might be anticipated, and with concurrent or subsequent numbness. The anatomy involved was presented, and a theory of causation was discussed. A plea is made for early and complete tibial compartment decompression through fasciotomy and/or fibulectomy-fasciotomy.
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PMID:The anterior tibial compartmental syndrome. A complication of the Hauser procedure. 119 80

The constitutional anomayl of a narrow spinal canal was found in a neuroradiological department in 31 cases. The cervical stenosis can be defined in the following way: Inside diameter of cervical canal (anterior-posterior) in relation to diameter of vertebral body. In normal cases the quotient is over 1 - in pathological narrowing under 1. Clinical symptoms mainly appear from 45th year onwards, when reactive-degenerative changes increase the space problem. In wiplash injuries or other adequate cervical trauma 7 cases were seen and described with acute incomplete tetraplegia or/and multilocular lesions of cervical roots, resulting from cervical stenosis combined with degenerative changes in 6 patients. Myelography revealed multilocular deformities of the spinal subarachnoidal space in the abnormal narrow cervical canal. The referred cases were not complicated with forensic aspects. The prognosis quod sanationem was poor. A chronic cervical myelopathy results. Pretraumatic clinical alterations of cervical roots and/or the myelon in the referred cases were absent, existing in other patients. Predominantly men and hard working people with narrow cervical canal became ill. Early symptoms were pain in extremities. Dysesthesia and loss of sensation combined with signs of pyramidal lesion occured later. Defects in nerve roots sometimes overlayed the myelon symptoms. Unspecific CSF-Alterations were common. The EMG showed abnormalities in cases of root involvement. Operative treatment was tried to remove the reactive processes, but could not alter the constitutional anomaly. The resulting immobilisation of myelon and nerve roots involves in the case of trauma a direct mechanical lesion and secondary vascular complications via Arteria vertebralis, spinalis anterior and radicularis, namely in patients with degenerative alterations of the cervical spine, these including a further narrowing behind the constitutional anomaly. Our experience seems to recommend that more attention should be paid a cervical narrow spinal canal in medicolegal implications.
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PMID:[The narrow spinal canal - medicolegal aspects (author's transl)]. 121 6

The subject of spontaneous aortocaval fistula due to a ruptured abdominal aortic aneurysm into the inferior vena cava is reviewed and discussed. An interesting case is presented with particular emphasis on the pre-operative findings which include lower body cyanosis; pain, numbness, and paralysis of the lower extremities; a cyanotic partial penile erection; and moderate shock. The cause of this syndrome is postulated.
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PMID:The large spontaneous aorta inferior vena caval fistula. 122 66

A case of 58 year old female with chronic spinal epidural abscess demonstrating rapid progression of complete spinal cord paralysis without remarkable recovery by laminectomy was reported. Patient had a large subcutaneous abscess on left back, ten years ago. Three months before admission she fell down from stairs and had a compression fracture on the seventh thoracic vertebra. She has been troubled with slight spinal ache and left lower back pain since the fall accident. One month before admission she suddenly noted severe lower back pain with radiation to left side and the pain became more severe. Three weeks after she noted fecal retention without urinary retention. Five days before admission she noted gait disturbance accompanied by numbness of both foots. Three days later she developed inability to urinate and the same day, over the coure of a few hours, she became total paraplegia and anesthesia below the waist. On admission neurological examination and myelography disclosed complete spinal subarachnoid block with flaccid total paraplegia and anesthesia below the lower chest. The clinical diagnosis was spinal epidural mass lesion, probably neoplasm. Laminectomy from Th-6 through Th-9 was performed the next day: three days after complete paralysis. The epidural abscess included pus and soft granulation tissue was found and totally removed. Staphylococcus aureus sensitive to penicillin, chloramphenicol etc. was isolated on becteriologic culture. On seven months after operation, sensory and deep reflexes were considrable improved, but she remained paraplegic without sphincter control. Dicussion were made on the incidence, pathogenesis.
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PMID:[Chronic spinal epidural abscess (author's transl)]. 123 82

Bilateral vasomotor responses and sweat gland activities under the control of cervical sympathetic nerves were examined simultaneously by photo-electric plethysmogram (PTG) and skin potential reflex (SPR) in patients with nonspecific complaints in the head-cervicobrachial regions such as headache, dizziness, tinnitus, pain or stiffness of the neck and shoulder, and dullness or numbness of the arms. 137 out of those 355 patients (38.6%) were revealed to have laterality in vasomotor responses, but it was only 3 in 60 normal control subjects (5%) that showed the laterality in vasomotor responses. These results supported the assumption that the cervical sympathetic dysharmony--imbalance between the right and left sides of cervical sympathetic functions--played an important role in causing their various vegetative complaints in the head-cervicobrachial regions.
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PMID:Plethysmographic study in the patients with non-specific complaints in the head-cervico-brachial regions: with a special reference to laterality in vasomotor responses and "cervical sympathetic dysharmony". 126 64

The pseudoclaudication syndrome, now a well known neurological entity, can simulate intermittent claudication of arterial origin in its clinical appearance. Walking and sometimes simply standing upright for a while can cause transitory pain, numbness or weakness in the legs. The symptoms are caused by entrapment of the cauda equina fibers. Intermittent bladder paresis with total inability of micturition despite urgency to void may sometimes be a prominent feature of the syndrome, a fact that seems to be less well known as seen from a review of the literature.
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PMID:Intermittent bladder paresis in the pseudoclaudication syndrome. 126 26

Migrant sensory neuritis, which was first proposed by Wartenberg, is very uncommon and only a few case reports have ever been published. We described one case of migrant sensory neuritis and discussed the pathogenesis of this disease. A 44-year-old man noticed numbness in the lateral aspect of the dorsum of the left foot in February 1985. Physically, there was hypoesthesia in the region of left sural nerve with positive Tinel's sign. During the next 4 years, pain, tingling sensation or hypoesthesia appeared in the regions of the right superficial radial nerve, right axillary nerve, left intercostal nerve, left lateral plantar nerve, digital nerve of the right second digit, left saphenous nerve, right superficial peroneal nerve, left superficial radial nerve, bilateral ulnar nerves and bilateral median antebrachial cutaneous nerves one after another in a migrating fashion. Tinel's sign was also positive at the right superficial radial nerve. In some occasions, decreased deep tendon reflexes were observed, but there had been no muscle weakness. Some nerves showed complete recovery, but others showed persistent involvement. Some nerves were affected repeatedly. Laboratory examination failed to clarify underlying disease except for mild liver dysfunction. Electrophysiological study showed reduced amplitude of the sensory nerve action potential (SNAP) of right sural nerve, left ulnar nerve, right superficial radial nerve and digital branch of right median nerve with preserved sensory nerve conduction velocity. SNAP of left sural nerve was absent. These findings mean the cause of the sensory disturbance is axonal degeneration rather than segmental demyelination. There were no abnormalities in motor nerve conduction study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Migrant sensory neuritis--electrophysiological and pathological study]. 129 55

Reported is a case of multiple mononeuropathy which appeared during the administration of recombinant interferon-alpha 2a (rIFN-alpha 2a) for treatment of chronic hepatitis C. A 38-year-old man received an intramuscular injection of rIFN-alpha 2a, 6 x 10(6) IU, every one or two days for a nine week period. Seven weeks after the initiation of rIFN-alpha 2a therapy he developed numbness of the tongue and extremities and weakness of the upper extremities. Neurological examination revealed an asymmetrical disturbance of touch and pain sensation in the tongue, trunk, left shoulder and extremities accompanied by painful dysesthesia. Moderate weakness and muscular atrophy were noted in the right hand and left shoulder. Electrophysiological studies showed the amplitude of the compound muscle action potentials and sensory nerve action potentials were significantly decreased, when the right median and ulnar nerves were stimulated. Additionally, the conduction velocities were normal and needle electromyography showed fibrillation potentials suggesting an axonal form of multiple mononeuropathy. Biopsies of the muscle and nerve failed to show pathological changes, however. The clinical and electrophysiological abnormalities reduced gradually with methyl-prednisolone pulse therapy and administration of prednisolone and mizoribine. Therefore, in this case, administration of rIFN-alpha 2a may have induced multiple mononeuropathy of the axonal form.
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PMID:[Multiple mononeuropathy during recombinant interferon-alpha 2a therapy for chronic hepatitis C]. 130 Feb 64

Carpal tunnel syndrome involves classic symptoms of numbness and paresthesias in the radial 3-1/2 digits, most frequently nocturnal, and pain associated with this distribution. Thenar weakness and autonomic dysfunction rarely are seen in this syndrome except in advanced cases. Provocative tests on physical examination such as the wrist flexion test and the local percussion sensitivity test over the median nerve can be extremely helpful in determining and confirming the diagnosis. Nerve conduction velocity and electromyographic studies of the median nerve and its compression can be helpful especially in difficult cases involving a complex differential diagnosis. It has been clearly documented that a negative NCV/EMG study by itself, does not exclude the possibility of carpal tunnel syndrome. The hallmark of the diagnosis remains the history and a careful physical examination. Treatment initially consisting of wrist splint immobilization and steroid injection into the carpal canal can provide initial relief and elimination of symptoms on a long-term basis in several patient groups. Patients without any resolution of symptoms after two to three months of conservative treatment or those with symptoms of greater than one year's duration generally can be considered candidates for surgical decompression of the carpal canal. The likelihood of operative treatment being required for resolution of symptoms is heightened if the patient is involved in daily manual repetitive activities of the hand and/or wrist. Surgical decompression can be accomplished by either a limited open technique or the new endoscopic released technique.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Carpal tunnel syndrome: a review. 132 28

A 38-year-old female presented with a left-sided peripheral N. VI-paresis and negative neuroradiologic work-up. After one year she developed an incomplete N. III paresis, numbness of her face correlating to N. V1 and V2, reduced lacrimal secretion as well as a palpable mass at the lateral orbital rim. Magnetic resonance imaging revealed an orbital tumor extending into the cavernous sinus. Biopsy disclosed an adenoid cystic carcinoma of the lacrimal gland with basaloid, cribriform and tubular pattern. Therefore, an exenteration with postoperative radiation therapy was performed. Immunohistochemical findings included positive reactions for keratin (KL-1 and AE 1 + 3), Vimentin and Egp 34. By determination of Ki 67 the proliferative activity of the tumor was found to be 15%. Our case report demonstrates that even in absence of an exophthalmus or pain a malignant orbital tumor may be assumed as the underlying cause for a combined monolateral oculomotor and trigeminal paresis. Immunohistochemical results support the notion, that the adenoid cystic carcinoma of the lacrimal gland may arise from precursor cells of the terminal duct system.
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PMID:[Adenoid cystic carcinoma of the lacrimal gland]. 132 11


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