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

Forty patients with chronic pain below the waist level not amenable to conventional medical and/or surgical treatment were randomly assigned to one or two different methods of acupuncture, after studying the underlying pain mechanisms using a Multidisciplinary Pain Clinic approach and the differential spinal block (DSB). One group received acupuncture needling in the classical acupuncture points referred to as meridian loci needling (MLN) and the other group received tender area needling (TAN) with needles inserted in the dermatomal distribution of the painful areas. The responses between the two groups showed no significant difference. Results were then related to the predetermined somatopsychological basis of the individual's pain problems as classified by the DSB. A group of patinets in whom pain relief occurred upon subarachnoid injection of 0.25% procaine followed by sympathetic blockade or 0.5% procaine injection followed by hypalgesia without motor loss, also reported maximum subjective improvement in their pain level following acupuncture therapy performed at a later time. The other group of patients in whom pain persisted despite sensory and motor blockade (1% procaine) responded very poorly to acupuncture therapy. DSB was found to be complimentary to acupuncture therapy in that it facilitated patient selection for the therapy.
Pain 1976 Sep
PMID:Acupuncture and chronic pain mechanisms. 14 Oct 20

After the war of liberation, Mao Tse Tung encouraged an integration of Western and traditional Chinese medicine. Several schools of therapeutic acupuncture have defined different points of puncture, originally assumed to be on an empiric basis but now rationalized as areas where nerve endings congregate. Results of therapeutic acupuncture in China cannog be evaluated because of inadequate record keeping. At the University of Washington Pain Clinic, immediate results (two to three days) are good but never lasting, nor do they decrease concomitant medication. For anesthesia, acupuncture acts to produce only hypalgesia in most patients, although some experience total analgesia. Patient selection and mental preparation are careful. Hence, the method is used in much less than 10% of the operations in China, and in these the analgesia is satisfactory by Western standards in only approximately 30%. Concepts as to the mode of action of acupuncture analgesia range from an attitudinal change towards sensory input to the release of a neurohumoral analgesic substances.
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PMID:Acupuncture analgesia and anesthesia. 32 79

Central nervous system mechanisms of nociception and pain were studied electrophysiologically in the spinal cord of cats. A great proportion of dorsal horn neurons respond to noxious skin stimuli, for instance to heating to 50 degrees C; such stimuli predominantly activate afferent C fibres. These spinal neurons participate in the transmission of nociceptive information to the brain. The heat-evoked discharges of dorsal horn neurons are effectively inhibited by repetitive electrical stimulation of large;, low-threshold cutaneous A fibres. The inhibition reaches its maximum effect after several minutes of nerve stimulation, and declines at a slow rate after the end of stimulation. This long-term suppression is considered to be a neuronal mechanism underlying hypalgesia produced in man e.g. by acupuncture and by transcutaneous nerve stimulation.
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PMID:[Inhibition in the spinal cord: a neuronal mechanism of hypalgesia produced by acupuncture (author's transl)]. 62 32

The effect of acumpuncture on the pain perception threshold of maxillary incisors and canines as determined by a Bofors Pulp Tester was studied in 33 dental students 19-30 years of age. Test teeth were cleaned with pumice and 10% alcohol, air-dried, and insulated at the approximal surfaces with strips of rubber dam. Based on a comparison of bipolar and monopolar stimulation the latter method was chosen, with the cathode placed on the incisal third of the facial surface, the indifferent electrode in the subject's hand. In separate groups of subjects thresholds were assessed four times at intervals of 15 min without acupuncture (1), with acupuncture performed manually (2) and electrically (3), and during electrical stimulation with surface electrodes over acupuncture points (4). On separate days acupuncture and surface stimulation was applied unilaterally at the points S2 (cheek), Li4 (hand), or S44 (foot). Compared with control threshold (8.44 muA) acupuncture was accompanied by a small increase, most pronounced after 45 min (1.51 muA, P less than 0.0005). However, the hypalgesia observed was insufficient to justify acupuncture as a means of pain control in conservative dentistry.
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PMID:Effect of acupuncture on the pain perception thresholds of human teeth. 79 97

A case of spinal cord arteriovenous malformation was reported, in whom serial selective spinal angiogram and pantopaque myelogram showed a successful demonstration of intramedullary nidus. A 25-year-old male was admitted with paraparesis, impotence, hypesthesia and hypalgesia in his legs in 1974. He was diagnosed to have a spinal cord arteriovenous malformation of so-called "glomus type" with intramedullary nidus by the selective spinal angiogram and pantopaque myelogram. The nidus was fed by the anterior spinal artery through the 8th intercostal artery, from which a major draining vein extended caudally, but there was also some cranial drainage. The arteriovenous malformation was treated by surgical excision combined with afferent vessels coagulation in order to prevent the rupture of the remaining intramedullary nidus. After operation the patient develop a transient analgesia and girdle pain at T9-10 level, but after 42 days he regained full muscle power in his legs and could run by himself, while sensory disturbance remained about the same as before surgery.
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PMID:[Treatment of spinal cord arteriovenous malformation by surgical excision combined with afferent vessel coagulation-report of a case (author's transl)]. 94 84

High cervical myelotomy was carried out on 10 patients. Commissurotomy was performed at the C1-3 level by a combined procedure of deep electrocogulation and sharp splitting of the posterior columns. The immediate results were excellent in all patients, but relapse of pain took place shortly in six of them; there was apparently no relation with the location of pain. No long-term favourable results were observed in this series. Only three patients exhibited a well-defined band of mild hypalgesia from C2 to T 10 dermatome, but it lasted for only three to four weeks. Transient lower or four limb ataxia was observed in seven patients. Different pain conducting systems seem to be affected by commissural myelotomy, but not to a sufficient extent to give permanent or long-lasting relief of pain. The indications for high cervical myelotomy are very limited: this procedure should be considered only in patients with unilateral or bilateral arm and/or upper chest pain, respiratory impairment, and short life expectancy.
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PMID:High cervical commissural myelotomy in the treatment of pain. 106 98

The protrusion of cervical intervertebral discs was divided into three pathological entities by Spurling; soft disc, hard disc and spondylosis. We applied these concept to the dorsal intervertebral disc disease and treated two cases of thoracic spondylosis. Case 1. A 41-year-old male entered the hospital because of the gradual progression of weakness of both legs of two months' duration. Since ten days before admission he had not had an errection and had not been to able to walk and micturate. He also complained of paresthesia radiating down the abdomen into both legs. There were no visceral complaints. Neurological examination revealed severe weakness of both legs with bilateral impairment of deep sensations and hypalgesia up to the level of T6. Reflexes in both legs were hyperactive with sustained clonus. Plantar responses were extensor bilaterally. Though plain X-rays showed no changes, tomography revealed a calcified intervertebral spur formation at the T5-6 interspace. A myelogram showed a complete block of the contrast medium at the level of the upper part of T6. The patient underwent a complete laminectomy from T3 through T6 and extradural anterior decompression with the removal of the calcified disc at the T5-6 interspace using an air drill. Postoperatively, he demonstrated an immediate improvement in sensation and a gradual recovery in motor power. At his follow-up examination 14 months after surgery he could walk without assistance. Case 2. A 47-year-old dwarfish woman (130 cm) with a low back pain and difficulty in walking for a few years duration was admitted. A few months before admission she felt pain at her left lateral abdomen. There was weakness of both legs, greater in the left. Reflexes in her left lower extremity were hyperactive with sustained clonus. Plantar responces were flexor bilaterally. Palin X-rays showed scoliosis of thoracic spine with the top at T7 level and calcified intervertebral masses at T10-11, T11-12 and T12-L1, extending into the canal that were confirmed more clearly by tomography. Myelography by a cisternal puncture disclosed a complete block at the level of T10. The patient underwent total laminectomy of T9 through L2 and extradural anterior decompression with the removal of calcified discs. At her follow-up examination 12 months after surgery she could walk for herself with some residual neurological signs, minimal weakness in the right leg and hypesthesia up to the level of T12 in the left. We have discussed the incidental, related diagnostic and operative problems of this disease.
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PMID:[The protrusion of thoracic intervertebral disc-thoracic spondylosis (author's transl)]. 123 40

Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery.
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PMID:Anterior spinal artery syndrome of the cervical hemicord. 131 78

This report concerns the 22-year-old female who has been suffering the paresthesia in the left buttock and thigh for three months. Neurological examination revealed nothing other than hypesthesia and hypalgesia which distributed in the third, fourth and fifth segments of left sacral region with the loss of anal reflex. Pain had not been noticed until when she came to our clinic. Myelography and MRI showed small irregular round mass occupying a third of the spinal canal behind the body of fourth lumbar spine. In the axial view of MRI, the mass was enhanced by the gadolinium (Gd) except for the small portion of its center. She underwent the surgical treatment which revealed the tumor entangling four nerves of cauda equina in its center as imaged in MRI. The tumor was epidermoid cyst which presumably caused the chemical meningitis and involved those nerves. That resulted in the sensory disturbance in the left sacral region, although the tumor was not large enough to compress the nerves.
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PMID:[A case of small epidermoid cyst in cauda equina with manifest regional hypesthesia]. 132 22

In order to clarify the pathogenesis of paraneoplastic syndrome, immunohistochemical studies were performed in a patient with subacute sensory neuropathy secondary to a small cell lung cancer. The case was a 73-year-old ex-farmer, whose chief complaints were pins and needles sensation of distal limbs and gait difficulty. After 6 weeks prodromata of pain in the upper limbs and numbness in all the limbs, he became unable to stand up without assistance. Neurological examinations on admission revealed marked sensory disturbances with glove and stocking type hypalgesia to pin prick and the loss of position and vibration senses in the distal extremities. His deep tendon reflexes also decreased in all the limbs. A chest X-ray showed a mass in the left upper lung field. A transbronchial lung biopsy of the mass revealed a small cell carcinoma. He was treated with anti-cancer drugs and radiation but he died of pneumonia after 8 months illness. Autopsy revealed a marked demyelination of the entire posterior column of the spinal cord. Dorsal root ganglia were infiltrated by lymphocytes with significant neuronal loss. Immunohistochemically, most of the infiltrated cells around the neurons were classified as CD8+ with fewer CD4+ lymphocytes. No B-lymphocytes were detected in the ganglia. The HLA-ABC and HLA-DR positive cells were found only among the satellite cells, not in the neurons. The serum and CSF from the patient were immunohistologically reacted with the nuclei and cytoplasm of all neurons of human as well as of rats, indicating the presence of anti-Hu type antineuronal antibody in the patient's CSF as well as serum.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Immunohistochemical studies of paraneoplastic subacute sensory neuropathy--an analysis of antineuronal antibody and infiltrated lymphocytes]. 132 6


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