1/19. Neurological deficit following spinal anaesthesia: MRI and CT evidence of spinal cord gas embolism.A 62-year-old diabetic woman developed permanent neurological deficits in the legs following spinal anaesthesia. MRI showed oedema in the spinal cord and a small intramedullary focus of signal void at the T10 level, with negative density at CT. Intramedullary gas bubbles have not been reported previously among the possible neurological complications of spinal anaesthesia; a combined ischaemic/embolic mechanism is hypothesised.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/19. Anaesthesia of the right lower hemilip as a first manifestation of multiple myeloma. Presentation of a clinical case.multiple myeloma is a malignant proliferation of plasma cells. It may affect any of various bones, causing osteolytic lesions with a characteristic "punched out" radiographic appearance. The commonest symptom is bone pain. One of the most frequent locations is the mandible. Symptoms of multiple myeloma of the mandible include tumefaction, non-specific pain, tooth mobility and sometimes loss, and paraesthesia of the dental nerve. Here we report a case of multiple myeloma of the mandible which was unusual in that the presenting complaint was anaesthesia of the right lower hemilip.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
3/19. Recurrent neurological symptoms in a patient following repeat combined spinal and epidural anaesthesia.A healthy woman developed neurological symptoms after two consecutive Caesarean sections under combined spinal and epidural anaesthesia. Amethocaine was used for spinal anaesthesia and mepivacaine for epidural anaesthesia on both occasions, and a combination of fentanyl and bupivacaine was continuously infused for pain relief after the second. Her symptoms on both occasions were similar, including pain in the buttocks of 7-11 days duration and numbness in the sacral area of 5-6 months.- - - - - - - - - - ranking = 1.1666666666667keywords = anaesthesia (Clic here for more details about this article) |
4/19. Necrotizing sialometaplasia: an unusual bilateral presentation associated with antecedent anaesthesia and lack of response to intralesional steroids. Case report and review of the literature.Necrotizing sialometaplasia is a self-limiting, variably ulcerated benign process affecting minor salivary glands. Accurate histological diagnosis is paramount, as it has been mistaken for malignancy, which has resulted in excessively aggressive and unnecessary radical surgery. A unique case of bilateral necrotizing sialometaplasia, presenting with anaesthesia of the greater palatine nerves, is described. An attempt at active therapy with intralesional steroids had no effect on the course of the condition.- - - - - - - - - - ranking = 0.83333333333333keywords = anaesthesia (Clic here for more details about this article) |
5/19. Mental nerve anaesthesia; a complication of sickle cell crisis during childbirth.This report describes the case of an Afro-Caribbean lady diagnosed with sickle cell anaemia, who presented with permanent mental nerve anaesthesia as a result of a sickle cell crisis during childbirth.- - - - - - - - - - ranking = 0.83333333333333keywords = anaesthesia (Clic here for more details about this article) |
6/19. radial nerve injury after general anaesthesia in the lateral decubitus position.A 43-year-old female patient underwent pyelolithotomy in the left lateral decubitus position. Her upper right arm was placed on a padded armboard. Surgery lasted for 240 min. Postoperatively, she complained of numbness of the dorsal part of her right hand and wrist drop. Neurological examination revealed hypoaesthesia of the dermatome of the right forearm and hand innervated by the radial nerve. electromyography revealed advanced axonal degeneration of the radial nerve below the level of the elbow. Treatment with diclofenac, vitamin B and physiotherapy was started. Her symptoms improved gradually and at the 60th postoperative day, motor weakness had completely resolved. In order to prevent peri-operative nerve injury, careful positioning of every patient on the operating table with proper padding is essential, with attention paid to time-dependent risks. If an injury occurs, diagnosis and treatment should be started as rapidly as possible.- - - - - - - - - - ranking = 0.66666666666667keywords = anaesthesia (Clic here for more details about this article) |
7/19. Unilateral hypoplasia of the trigeminal ganglion.CASE REPORT: We report a case of unilateral anaesthesia of the V1 (ophthalmic) division of the trigeminal cranial nerve presenting with persistent corneal erosions and ulceration secondary to trigeminal ganglion hypoplasia. The patient had a lifelong history of unexplained left-sided ophthalmic symptoms for which numerous diagnoses were provided. Cranial nerve testing demonstrated partial trigeminal dysfunction on the left side. Further investigation eliminated viral etiologies, and subsequent magnetic resonance imaging determined that the patient had a hypo-plastic left trigeminal ganglion. COMMENTS: We present the case to alert clinicians to the possibility of this rare condition.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
8/19. Genital anaesthesia persisting six years after sertraline discontinuation.Sexual side-effects, in general, are common with selective serotonin-reuptake inhibitors (SSRIs). Genital anaesthesia is a rare side-effect previously described with sertraline and fluoxetine use. With SSRI discontinuation, the sexual side-effects are expected to resolve. We report a case of a 26-year-old male who experienced genital anaesthesia during sertraline treatment and continued to be symptomatic despite medication discontinuation 6 years previously. To date, there have been no published reports of SSRI-induced sexual side-effects persisting beyond SSRI discontinuation. This case highlights the complex interplay of psychopharmacologic and psychodynamic factors that can occur in patients with sexual dysfunction.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
9/19. Proposal for a standardized protocol for the systematic orofacial examination of patients with Hereditary Sensory Radicular Neuropathy.AIM: To apply a standardized protocol for the orofacial evaluation of two adult siblings (one male and one female) with Hereditary Sensory Radicular Neuropathy (HSRN) that presented with dental problems. SUMMARY: The systematic evaluation consisted of (a) clinical questionnaire; (b) radiographs [orthopantomography and computarized tomography (CT)]; (c) orofacial psychophysical tests (pain, thermal, mechanical and electrical sensation); and (d) histology of gingiva and pulp (optical and transmission electronic microscopy). The female patient had complete insensitivity to orofacial pain and partial facial heat sensitivity, and received dental treatment without anaesthesia or pain. She had a severe and painless jaw infection due to pulp necrosis in tooth 37. The male patient had partial insensitivity to orofacial pain and required anaesthesia for dental treatment. Histological examination of gingivae and pulpal tissue revealed an altered proportion of unmyelinated and myelinated sensory nerve fibres. KEY learning POINTS: * patients with HSRN may present with significant, silent dental disease. * A standard protocol is helpful when evaluating such patients. * If the opportunity arises, evaluation of pulp tissue may reveal an altered proportion of myelinated and unmyelinated nerve fibres. This may avoid the more estabilished sural nerve biopsy.- - - - - - - - - - ranking = 0.33333333333333keywords = anaesthesia (Clic here for more details about this article) |
10/19. Thalamic glioma. An unusual presentation.Thalamic gliomas, because of their anatomical location, usually present with early and extensive neurologic signs. A case, which at initial presentation had subjective hemianaesthesia, but no objective neurologic deficit, is being reported, to emphasize the importance of proper investigations even in absence of clinical signs.- - - - - - - - - - ranking = 0.16666666666667keywords = anaesthesia (Clic here for more details about this article) |
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