Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical features and outcome of idiopathic acute transverse myelopathy were reviewed for 21 children aged between seven months and 14 years. Pain, most commonly in the back, was the initial symptom for 12 patients; for another six it was weakness and for two urinary retention. All patients had weakness of the legs, and 11 had arm weakness as well. Five patients had very acute onset of severe weakness and were unable to walk within three hours of onset of symptoms. Two children made no significant recovery; for the remainder onset of recovery was evident within two to 17 days. 12 patients later were normal or had only minimal neurological deficit, but nine had a poor outcome with major disturbance of motor or sphincter function. Only one of the five with very acute onset had a good outcome. Over-all, the prognosis after acute transverse myelopathy in childhood is a little better than that reported for adults.
 ...
PMID:Acute transverse myelopathy in childhood. 370 89

The acute syndromes and CT findings are described in 26 cases of spontaneous cerebral hemorrhage. Occipital hemorrhage (11 cases) caused severe pain around the ipsilateral eye and dense hemianopia. Left temporal hemorrhage (7 cases) began with mild pain in or just anterior to the ear, fluent dysphasia with poor auditory comprehension but relatively good repetition, and a visual deficit subtending less than a hemianopia. Frontal hemorrhage (4 cases) caused a distinctive syndrome beginning with severe contralateral arm weakness, minimal leg and face weakness, and frontal headache. Parietal hemorrhage (3 cases) began with anterior temporal ("temple") headache and hemisensory deficit, sometimes involving the trunk to the midline. One patient had a right temporal hemorrhage. Spontaneous lobar hemorrhage and branch artery embolism in the same region produce similar clinical syndromes. Headache is a first and prominent symptom. A rapid but not instantaneous onset over several minutes, when combined with one of the typical syndromes, suggests lobar hemorrhage rather than other types of stroke. Ancillary investigations (including CT scanning, angiography in 11 patients, and autopsy in 4) disclosed 2 patients with bleeding diatheses due to warfarin, 2 with arteriovenous malformations, and 1 with metastatic tumor. Only 8 of the 26 patients had chronic hypertension (blood pressure greater than 130/85 mm Hg), suggesting that hypertension is not an etiological factor in most lobar hemorrhages.
 ...
PMID:Lobar cerebral hemorrhages: acute clinical syndromes in 26 cases. 742 68

Patients with acute brachial plexus neuritis are often misdiagnosed as having cervical radiculopathy. Acute brachial plexus neuritis is an uncommon disorder characterized by severe shoulder and upper arm pain followed by marked upper arm weakness. The temporal profile of pain preceding weakness is important in establishing a prompt diagnosis and differentiating acute brachial plexus neuritis from cervical radiculopathy. Magnetic resonance imaging of the shoulder and upper arm musculature may reveal denervation within days, allowing prompt diagnosis. Electromyography, conducted three to four weeks after the onset of symptoms, can localize the lesion and help confirm the diagnosis. Treatment includes analgesics and physical therapy, with resolution of symptoms usually occurring in three to four months. Patients with cervical radiculopathy present with simultaneous pain and neurologic deficits that fit a nerve root pattern. This differentiation is important to avoid unnecessary surgery for cervical spondylotic changes in a patient with a plexitis.
 ...
PMID:Acute brachial plexus neuritis: an uncommon cause of shoulder pain. 1108 88

Currently in many centers, magnetic resonance (MR) imaging is the technique of choice for the assessment of brachial plexopathies. The anatomy of the brachial plexus is complex, and is surrounded by other anatomic structures, making artifact-free imaging quite challenging. With the faster breathing-independent and breath-hold MR imaging sequences, brachial plexopathies can be assessed with more confidence. Over a 2-year period, 20 patients underwent MR imaging of the brachial plexus at our department. MR imaging was based on a comprehensive protocol, including T(1)-weighted gradient echo, T(2)-weighted single-shot fast spin-echo, and gadolinium-enhanced T(1)-weighted gradient echo with fat suppression. Nine of the 20 patients had proved diagnoses at pathology, and included schwannoma (n = 2), ganglioneuroblastoma (n = 1), hemangioma (n = 1), metastatic breast cancer (n = 2), Pancoast tumor (n = 1), and metastatic lung cancer (n = 2). Most of the lesions had presenting symptoms, such as pain, swelling, paresthesia, and arm weakness. At MR imaging, the location and characteristics of the lesions on different types of T(1)-weighted and T(2)-weighted sequences were described with pathologic correlation.
 ...
PMID:MR imaging of the brachial plexus: current imaging sequences, normal findings, and findings in a spectrum of focal lesions with MR-pathologic correlation. 1265 65

A 36 year old woman ruptured her right Achilles tendon in a skiing accident. Previous medical history is unremarkable except for a history of migraine for many years. She is married with three children with no history of spontaneous miscarriage. She smokes 15 cigarettes a day and takes the oral contraceptive pill. She is admitted to a local hospital where surgery to repair the Achilles tendon is performed followed by fitting of a plaster cast. Due to pain from the plaster cast she is slow to mobilise. On day 7 postoperatively she develops increasing pain in the right leg. When the plaster is removed the right calf is found to be painful, warm, and swollen. The next day while straining on the toilet she collapsed with left arm weakness. Clinical examination revealed dysarthria with pyramidal weakness of the left arm. The significance of these symptoms, the diagnosis, and the short and long term treatment of these postoperative problems are discussed in an interactive case presentation.
 ...
PMID:Learning on the Web. Case 2: patent foramen ovale (PFO) and paradoxical embolism. 1806 45

A 38-year-old man presented with an abrupt onset of occipital and neck pain, radiating to both shoulders. The pain was accompanied by inability to lift his arms against gravity (the "man-in-the-barrel" syndrome). These symptoms were associated with bilateral hand paresthesias, right-sided throbbing headache, vertigo, nausea, and vomiting. All symptoms resolved within 30 minutes, but arm weakness recurred. The differential diagnosis and historical origins of the "man-in-the-barrel" syndrome are reviewed.
 ...
PMID:A man in the barrel with neck pain. 1989 75

A child with joint or extremity pain is a common presentation to the emergency department. Often, there is some element to the patient's history, whether it is trauma or some other significant history, which leads to a likely diagnosis. When there is a history of fever and progressive arm weakness, an astute emergency physician would have heightened awareness of a possible systemic process. We describe a case of unilateral shoulder pain with associated fever in a 7-year-old boy who presented to the emergency department with progressive arm weakness to the same side.
 ...
PMID:Progressive unilateral arm weakness in a 7-year-old boy. 2083 91

The authors present the case of a 56-year-old right hand-dominant woman who was referred for chronic neck pain and a second opinion regarding a cervical lesion. The patient's pain was localized to the subaxial spine in the midline. She reported a subjective sense of intermittent left arm weakness manifesting as difficulty manipulating small objects with her hands and fingers. She also reported paresthesias and numbness in the left hand. Physical and neurological examinations demonstrated no abnormal findings except for a positive Tinel sign over the left median nerve at the wrist. Electromyography demonstrated bilateral carpal tunnel syndrome with no cervical radiculopathy. Cervical spine imaging demonstrated multilevel degenerative disc disease and a pneumatocyst of the C-5 vertebral body. The alignment of the cervical spine was normal. A review of the patient's cervical imaging studies obtained in 1995, 2007, 2008, and 2010 demonstrated that the pneumatocyst was not present in 1995 but was present in 2007. The lesion had not changed in appearance since 2007. At an outside institution, multilevel fusion of the cervical spine was recommended to treat the pneumatocyst prior to evaluation at the authors' institution. The authors, however, did not think that the pneumatocyst was the cause of the patient's neck pain, and cervical pneumatocysts typically have a benign course. As such, the authors recommended conservative management and repeated MR imaging in 6 months. Splinting was used to treat the patient's carpal tunnel syndrome.
 ...
PMID:Cervical pneumatocyst. 2161 2

Suprascapular nerve block (SSNB) is a popular treatment for shoulder pain. To date, studies undertaken mainly describe the methods of performing the technique or are trials examining its efficacy. As a result, the numbers of blocks reported are small and therefore confidence in the safety of the procedure must be limited. Furthermore, although most studies report pain reduction using visual analogue scales, there are no reports of patient satisfaction with the subsequent pain relief. This study aimed (1) to determine the safety of SSNB in a population of patients presenting in rheumatology practice and (2) to determine the patient satisfaction with the pain relief. From 2003 to 2009, 1,005 SSNBs were undertaken by rheumatologists in several centres in South Australia. All patients who had at least one SSNB performed were identified. Case notes were examined and patients were contacted to identify any side effects from the procedure. Patients were also asked to report their satisfaction with the pain relief. Of the 1,005 nerve blocks performed, there were a total of six side effects. They were three episodes of transient dizziness, two episodes of transient arm weakness and one episode of facial flushing. There were no serious side effects reported. Patient satisfaction with the pain relief was high, with over 80% of respondents being satisfied or very satisfied with the result. SSNB is a very safe procedure in the outpatient setting, even among frail, elderly patients. Patients rate the satisfaction with the pain relief highly.
 ...
PMID:Safety and acceptability of suprascapular nerve block in rheumatology patients. 2177 12

A 57-year-old woman with a history of hypertension and hypothyroidism presented with painless left arm weakness and numbness 2 weeks before evaluation. Nerve conduction studies of the left arm revealed normal motor and sensory responses. Needle examination revealed acute denervation changes in all myotomes of the affected extremity, including cervical paraspinals on the left, and several myotomes on the contralateral side. The laboratory evaluation revealed normal anti-GM1 antibodies and 3 IgM/5 IgG bands on Lyme Western Blot. The patient began treatment with 28 days of intravenous ceftriaxone. On follow-up, patient had regained full strength of her extremities with no sensory deficits. Inflammatory borrelia radiculitis usually presents with pain in the distribution of the affected nerves and nerve roots. The novelty of this case report rests on (1) the absence of primary borreliosis symptomatology preceding the radiculitis and (2) the painless and bilateral clinical presentation in a patient with suspected Lyme radiculitis.
 ...
PMID:Acute bilateral painless radiculitis with abnormal Borrelia burgdorferi immunoblot. 2317 87


1 2 Next >>