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

Spontaneous pain was one of many complaints on initial examination of 845 patients with maxillary sinus carcinoma. The pain was analysed; cheek, teeth, head and eye pain were compared with the T-classification and the anterior-posterior direction of invasion. The incidence of the cheek, teeth, head and eye pain was 48, 39, 29 and 23 per cent respectively. The incidence of both the cheek and teeth pain was increased according to the advancement of T-classification and invasion towards the posterior. Head and eye pain was often referred. In the localized posterior group which tend to be diagnosed late, spontaneous pain occurred in 15 to 48 per cent of the patients. Maxillary sinus carcinoma should always be a differential diagnosis in patients with unclear cheek, teeth, head and eye pain. A careful investigation should be performed in order to diagnose malignant diseases as early as possible.
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PMID:Spontaneous pain in patients with maxillary sinus carcinoma in relation to T-classification and direction of tumour spread. 143 18

We have designed a screening system to diagnose unruptured aneurysms, including the use of digital subtraction angiography (DSA). We surveyed 115 patients who had undergone clipping procedures after subarachnoid hemorrhage (SAH) and questioned them with regard to the subjective symptoms. Sixty-eight of 92 patients who returned the questionnaire reported, prior to rupture, headache, eye pain, and neck pain most frequently, and also impairment of extraocular movements, ptosis, visual field defects, and motor and sensory disturbances. Nineteen (47.5%) of 40 patients who had complete pain relief after surgery complained of headache from 1 week to 1 month before SAH. In addition, nine patients (22.5%) complained of headache for several years, and were also pain-free after surgery. For the indication of DSA, we employed an expert system based on fuzzy set theory. Seven groups of parameters are: Group 1, a basic questionnaire concerning age, sex, and past and family histories; Group 2, 15 warning signs selected on the basis of retrospective study; and Groups 3-7, detailed questions concerning each sign. Scoring weights assigned to each condition based on the results of the retrospective study, and threshold values were determined by several neurosurgeons. The certainty factors for intermediate hypotheses were calculated from these weights and threshold values and summed up, from which the conclusion was obtained. Twelve new cases of unruptured cerebral aneurysm were diagnosed using this screening system. This system may improve the ability to diagnose cerebral aneurysms before rupture.
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PMID:New screening system for unruptured cerebral aneurysms--combination of an expert system and DSA examination. 170 35

In 101 eyes with either anterior or retrobulbar optic neuropathy of ischemic or inflammatory origin, ocular pain occurred significantly more often with retrobulbar optic neuropathy. The association of pain with posterior optic nerve lesions supports Whitnall's hypothesis that the pain of optic nerve inflammation is caused by traction of the origins of the superior and medial recti on the optic nerve sheath at the orbital apex. Eye pain reflected neither severity nor origin of optic neuropathy.
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PMID:The origin of pain in optic neuritis. Determinants of pain in 101 eyes with optic neuritis. 185 3

Transitory eye pain occurred during sleep in a 62 year-old patient, who complained of being often awoken during the second half of the night. Diurnal ophthalmologic examinations did not reveal any abnormality. Three consecutive nocturnal polysomnographic recordings were performed to determine whether these pain crises were related to any sleep stage. The patient woke up three times during the recordings because of the usual pain occurrence. On the three occasions, the crisis occurred during of immediately after a REM sleep phase. The brievity of the pain episode (4 to 5 min) did not allow a quick eye pressure measurement to demonstrate a possible increase in ocular tension. However, the role of the REM sleep myosis and vegetative manifestations are discussed regarding the determination of eye pain.
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PMID:[Transitory eye pain during sleep]. 221 9

Periocular pain may result from local pathology or be referred from distant sites. Ophthalmic examination will detect most local disease, although a careful search may be needed to determine the cause of subtle entities. Painful ophthalmoplegia results from a variety of neoplasms and inflammations, often in the area of the cavernous sinus. Cluster headache should be differentiated from more sinister causes of painful Horner's syndrome. Systemic diseases that cause periocular pain and migraine and other classic headache syndromes that may present with eye pain alone are also discussed.
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PMID:Ocular and periocular pain. 268 63

We investigated whether ocular response to topical anesthetic could assist the physician in distinguishing between patients with simple corneal injury and those with iritis, conjunctivitis, or other causes of acute eye pain. Seventy-one patients who presented to the emergency department filled out visual analog pain scores (range, 0 to 10) before and after use of topical anesthetic (proparacaine 0.5%). Mean initial pain scores were higher (6.3 +/- 3.0 vs 4.8 +/- 2.8, P less than .05), final pain scores were lower (1.1 +/- 1.7 vs 3.5 +/- 2.5, P less than .001), and changes in scores were greater (5.2 +/- 3.0 vs 1.3 +/- 1.3, P less than .001) in patients who had simple corneal injury compared with those who had other causes of acute eye pain. By defining response to topical anesthetic as a reduction in pain score by more than 5 (on a scale of 1 to 10) or as a final pain score of less than 1, we found the sensitivity of this test for simple corneal injury to be 80% and the specificity to be 86%. This information is useful to physicians, either with or without a slitlamp, attempting to diagnose the cause of acute eye pain.
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PMID:Topical anesthesia of the eye as a diagnostic test. 281 64

A clinical analysis of 68 patients diagnosed as suffering from Ernest's syndrome revealed: Injury to the stylomandibular ligament is a real and frequent disorder causing craniomandibular pain. Ages and sex differences, although variable, correspond to those reported elsewhere in the literature for craniomandibular pain. A diagnosis of Ernest's syndrome may be based on an adequate history, palpation of the insertion of the stylomandibular ligament, and a diagnostic local anesthetic block of the affected ligamentous insertion. Symptoms of Ernest's syndrome, in decreasing order of occurrence, are: TMJ and temporal pain, ear and mandibular pain, posterior tooth sensitivity, eye pain, and throat pain. In addition, shoulder pain may be involved. Of the patients in this study, 77.94% were treated successfully via nonsurgical management of their complaints. Resolution of this disorder is usually accomplished by a combination of a diagnostic injection of local anesthetic at the insertion of the ligament, localized injection of cortisone substitute, and placing the patient on a soft diet. Surgical management, if necessary, is best accomplished by a radiofrequency thermoneurolysis procedure in the involved ligamentous insertion.
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PMID:Ernest syndrome as a consequence of stylomandibular ligament injury: a report of 68 patients. 347 63

Forty -seven of 79 patients with sinus and paranasal tumors had clinical, radiographic or operative evidence of orbital involvement. Seventy percent of those patients with orbital extension had clinical or radiographic involvement of the orbit at the time of initial presentation. Common presenting signs and symptoms included proptosis, nasal obstruction or discharge, nasal mass, facial and/or eye pain, visual loss, facial and/or lid edema and diplopia. The most common tumor seen was squamous cell carcinoma. The maxillary sinus was the most frequent site of origin. Three patients were misdiagnosed as having sinusitis on initial evaluation. A diagnosis of sinusitis is tentative and should be reevaluated early with repeat roentgenographic studies and biopsy, especially in the presence of protracted facial and eye pain. When ordering CT scans, one must specifically request cuts of the base of the sinuses and skull as routine brain CT scans do not evaluate those regions. Two of four patients with intractable pain unrelieved by narcotics obtained pain relief with cisplatinum.
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PMID:Sinus tumors invading the orbit. 671 9

Pain originating from ophthalmic disease has been well documented. A series of patients presenting with eye or periorbital pain attributed to cervical region dysfunction were diagnosed and treated with injections of subcutaneous lidocaine followed by triamcinolone acetonide. Twelve patients, 11 women and 1 man, ranging in age from 20 to 82 years had an evaluation including a complete eye examination, and laboratory tests and neuroimaging as dictated by the history to exclude structural abnormalities or systemic disease. All patients had marked focal suboccipital tenderness ipsilateral to the side of their headache and eye pain. A subcutaneous injection with 2% lidocaine followed by triamcinolone acetonide 40 mg was administered directly to the site of focal tenderness. After injection, five patients described total relief of pain, five patients described some degree of pain relief, and two patients had no relief of headache. Duration of pain relief ranged from several hours to 3 months. Patients may present with periorbital or eye pain as a result of disease affecting the cervical sensory roots with subsequent stimulation of the trigeminal apparatus. Subcutaneous injection of lidocaine and triamcinolone acetonide may be of help in the diagnosis of these patients and provide temporary relief.
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PMID:Referred ocular pain relieved by suboccipital injection. 767 65

Ocular pain is often treated with systemic analgesics, which are associated with some undesirable side effects. Because nonsteroidal anti-inflammatory drugs are thought to be peripheral analgesics, we decided to evaluate the local analgesic effect of flurbiprofen. After an initial study in 29 patients demonstrated that 0.03% flurbiprofen ophthalmic solution did not affect corneal sensitivity, a second trial was designed to test the analgesic efficacy and safety of this agent. In a multicenter, randomized, double-masked, parallel-group clinical trial, topically applied 0.03% flurbiprofen sodium ophthalmic solution was compared with its vehicle in 105 patients (53 females, 52 males) undergoing elective unilateral radial keratotomy. All patients received flurbiprofen or its vehicle before and every four hours after surgery for 14 days. Mean pain intensity variables were lower in the flurbiprofen group than the vehicle group after surgery. Clinically significant differences in pain relief (mean difference > or = 1 unit), favoring flurbiprofen, were seen at hours 2, 3, and 4, and on days 1 through 4, and on day 7. Statistically significant differences were seen at hours 2, 3, and 4. Sixteen patients (eight in each group) had adverse effects, most commonly transient burning. These studies suggest that topical 0.03% flurbiprofen safely and effectively relieves ocular pain without affecting corneal sensation.
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PMID:Ocufen (flurbiprofen) in the treatment of ocular pain after radial keratotomy. 804 80


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