Cases reported "Pain, Intractable"

Filter by keywords:



Filtering documents. Please wait...

1/70. Effectiveness of lymphocytapheresis in a patient with ankylosing spondylitis.

    immunomodulation by lymphocytapheresis (LCA) was carried out in a patient with ankylosing spondylitis (AS) who suffered severe pain in joints and back. LCA was performed once a week and 3 x 10 9 lymphocytes were extracted each time. Fifteen courses of LCA were completed. The joint score was gradually decreased and the improvement was maintained 11 months after treatment. The population of NK cells detected by Leu-7 and Leu-11 monoclonal antibodies decreased and HLA-DR positive CD3 cells increased during and after the treatment. The effectiveness of LCA in AS may confirm the participation of immunological mechanisms in the pathogenesis of AS.
- - - - - - - - - -
ranking = 1
keywords = back
(Clic here for more details about this article)

2/70. renal artery embolization controls intractable pain in a patient with polycystic kidney disease.

    A 65-year-old man with adult polycystic kidney disease (APKD) and chronic renal failure suffered from intractable abdominal pain and distension for 2 weeks. meperidine infusion did not alleviate his pain. However, pain and abdominal distension were successfully controlled by embolization of both renal arteries.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

3/70. Histological findings after long-term infusion of intrathecal ketamine for chronic pain: a case report.

    ketamine, a selective, noncompetitive N-methyl-D-aspartate (NMDA)-receptor antagonist, is able to alter pain perception at the spinal level. Little clinical data exist on the intrathecal and epidural use of ketamine in chronic pain. Histopathologic findings after intrathecal injection of ketamine with and without preservatives are rarely reported. This outcome was evaluated in a 72-year-old woman with abdominal pain due to cancer who was treated with the intrathecal application of bupivacaine, clonidine, and morphine. We reached satisfactory pain relief with the addition of ketamine to the mixture for 7 days. On postmortem, focal lymphocytic vasculitis close to the catheter injection site was found. This finding has not been described previously after long-term application of ketamine intrathecally. The intrathecal infusion of ketamine with preservative, or the mixture of ketamine, clonidine, morphine, and bupivacaine resulted in isolated lymphocytic vasculitis of the spinal cord and leptomeninges without any clinical signs of neurological deficit.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

4/70. Ventral transdural herniation of the thoracic spinal cord: surgical treatment in four cases and review of literature.

    BACKGROUND: A specific cause of progressive brown-sequard syndrome has been identified: a ventral herniation of the thoracic spinal cord through the dural sleeve on one side. METHOD: Four female patients who were affected by a progressive Brown Sequard syndrome related to a transdural spinal cord herniation have been investigated and were submitted to surgery and postoperative evaluation. FINDINGS: The MRI scan showed atrophy and forward displacement of the spinal cord on one side and adhesion of the spinal cord to the dura mater. CT myelography demonstrated the disappearance of the premedullar rim at the level of the herniation and the shadow of the extradural herniation. Surgical treatment consisted in the excision of the arachnoid cyst when there was one, section of the dentate ligament, release of the adhesions, detachment of the spinal cord from the hernial orifice, and lastly suture of the dural tear or placement by a patch. Follow-up examination showed motor improvement with persistent sensory deficit in two cases and stabilisation in two cases. INTERPRETATION: The cause of the dural tear, either traumatic or congenital could not be confirmed in the four cases. Symptoms probably occur when herniation fills the orifice and strangulation happens which explains the late appearance and progressive evolution of this myelopathy. Mobilisation of the herniated spinal cord back into the intradural space can be achieved by surgery and may stop the evolution of the symptoms and signs.
- - - - - - - - - -
ranking = 1
keywords = back
(Clic here for more details about this article)

5/70. Punctate midline myelotomy for the relief of visceral cancer pain.

    OBJECT: This study offers clinical support for the concept that neurosurgical interruption of a midline posterior column pathway by performing a punctate midline myelotomy (PMM) provides significant pain relief without causing adverse neurological sequelae in cancer patients with visceral pain refractory to other therapies. methods: A PMM of the posterior columns was performed in six cancer patients in whom visceral pain had been refractory to other therapies. The cause of the visceral pain was related to residual, progressive, or recurrent local cancer or postirradiation effects. Clinical efficacy of the procedure was examined by comparing patient pain ratings and narcotic usage pre- and post-PMM. Follow-up periods ranged from 3 to 31 months. Examination of the results indicates a significant reduction in pain ratings as well as a significant reduction in daily narcotic use. No adverse neurological effects were observed. One spinal cord has been recovered for postmortem examination. CONCLUSIONS: These findings provide corroborating clinical evidence for the existence of a newly recognized midline posterior column pathway that mediates the perception of visceral pelvic and abdominal pain. Preliminary data indicate that significant pain relief can be obtained following PMM with minimal neurological morbidity and suggest that the procedure may provide an alternative treatment modality for cancer-related pain in patients in whom adequate pain control with narcotics cannot be achieved or narcotic side effects cannot be tolerated.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

6/70. Endometrioma of the liver.

    Hepatic endometriosis is extremely rare. The diagnosis is often missed and treatment is delayed. A 37-year-old woman was referred to the gynaecology department with vague abdominal pains. She had a past history of pelvic endometriosis and hysterectomy with bilateral salpingo-oophorectomy. Further investigations in due course confirmed it to be endometriosis of the liver. She was eventually referred to the hepatobiliary unit, almost three years after her first presentation, where she was operated on with good results.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

7/70. Atlanto-axial subluxation syndrome and management of intractable headache, neck pain and shoulder pain with auricular stimulation: a clinical case report.

    Atlanto-axial subluxation syndrome is a condition that is easily overlooked, misdiagnosed and mismanaged. anatomy, neurovascular involvement and description of clinical manifestations are reviewed. Bi-Digital O-Ring Test is employed to establish an accurate diagnosis and its value and accuracy described briefly. Bi-Digital O-Ring Test has been an important diagnosis confirmation method (reconfirmed by CT or MRI in over 95% of more than 850 clinical cases) in this author's practice of spinal disorder and intractable pain management. A newly described device, the KIM-STIM, offers auricular stimulation of multiple points, using electrical microcurrent. Each unit is individually custom-molded to the patient's ear, and fitted with multiple electrodes. It was found to be very effective in managing the majority of intractable pain, especially pain requiring multiple daily treatments in order for the patient to live and function normally. The KIM-STIM device allows the patient to self-manage the pain, by day or night, thus allowing for a reduction or elimination of medication intake and diminishing the necessity for frequent doctor visits.
- - - - - - - - - -
ranking = 4.009128943399
keywords = headache
(Clic here for more details about this article)

8/70. endosonography-guided celiac plexus neurolysis in the treatment of pain secondary to acute intermittent porphyria.

    Acute intermittent porphyria is a metabolic error transmitted as an autosomal dominant disorder with incomplete penetrance. Its clinical picture includes intermittent abdominal pain, nausea, vomiting, and diarrhea, with or without neurological changes. We report the case of a young woman whose pain attacks were controlled with high-dose opiates, in whom we decided to perform endosonography-guided celiac plexus neurolysis (EUS-CPN). This is the first reported attempt with this new treatment option. There was significant clinical and nutritional improvement after treatment.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

9/70. Videothoracoscopic splanchnicectomy for intractable pain from adrenal metastasis.

    Splanchnicectomy has been known for years as a treatment for refractory pain in patients with pancreatic cancer or chronic pancreatitis. We report herein the performance of a videothoracoscopic left splanchnicectomy in a patient with a previous right pneumonectomy who suffered intractable pain from an irresectable left adrenal metastasis associated with metastatic retroperitoneal lymph nodes. Immediate pain relief was obtained, but abdominal pain of middle intensity recurred 6 weeks later. Although infrequently required, this procedure might be of value in some patients with refractory pain.
- - - - - - - - - -
ranking = 5.275757555941
keywords = abdominal pain
(Clic here for more details about this article)

10/70. Intractable cluster headaches in a migraineur.

    Some migraineurs have the additional misfortune of suffering from cluster headaches; this situation can be challenging.
- - - - - - - - - -
ranking = 5.0114111792488
keywords = headache
(Clic here for more details about this article)
| Next ->


Leave a message about 'Pain, Intractable'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.