1/225. Cervical foraminotomy: an effective treatment for cervical spondylotic radiculopathy.Between 1983 and 1994, posterior cervical foraminotomy as described by Frykholm was performed on 89 patients with exclusively radicular symptoms caused by cervical osteophytes. The main presenting feature was arm pain. Objective neurological signs were present in 50% of the patients. At mean postoperative follow-up of 8.6 months, 95.5% of patients reported excellent or good results, while 4.5% were not improved. No patient was rendered worse following the procedure. There were no deaths and the complication rate was 2.2%. Further surgery for recurrent root symptoms was required by 6.7% of patients. Our findings are in keeping with the good results and low complication rate of this procedure as described in other studies. Informal inquiries suggest that this procedure is not widely used, at any rate in the United Kingdom, and we present this series in order to emphasize the efficacy and safety of this procedure.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/225. Meralgia paresthetica secondary to limb length discrepancy: case report.Meralgia paresthetica consists of pain and dysthesia in the lateral thigh caused by entrapment of the lateral femoral cutaneous nerve (L2-L3) underneath the inguinal ligament. Abdominal distension, tight clothing, and hip hyperextension are all described causes of this condition. To our knowledge this has never been attributed to a limb length discrepancy. We present a 51-year-old man with a long-standing history of right sided meralgia paresthetica. history and physical and radiological examination were unrewarding except that his left leg was shorter than the right by 2 cm. Nerve conduction studies of the lateral femoral cutaneous nerve on the left had a normal latency and amplitude but were absent on the right. To prove the hpothesis that the limb length discrepancy was responsible for the condition, a single subject study was performed. The presence or absence of pain and dysesthesia in the right thigh was the observed behavior. Intervention consisted of wearing a 1.5-cm lift in the left or right shoe for 2 weeks each with an intervening 2-week lift-free period. Pain was recorded on a numeric scale and numbness as being present or absent. There was continuing pain without and with the lift in the right shoe but no pain or numbness with the lift in left shoe. It was concluded that the limb length discrepancy was responsible for the meralgia paresthetica. Pertinent literature and possible pathomechanics are discussed.- - - - - - - - - - ranking = 4keywords = pain (Clic here for more details about this article) |
3/225. Surgical treatment of vascular lesions of the spinal cord.Paravertebral block and resection of upper thoracic sympathetic ganglions were performed on cases in which vascular disturbance of the spinal cord was considered partly responsible. Block was performed in 14 cases and clinical improvement was seen in 10 cases out of them while resection was considered effective in 2 out of 3 cases. The evoked EMG of patients was assumed recovery of a part of synaptic function in the ischemic cord after the block. On the other hand, the skin temperature of the lower extremity did not show considerable change and this supports the view that the restoration of clinical picture was not due to the improvement of the periphral circulation of extremities. From these observations, it would be well presumed that favorable effect of sympathectomy consists partly in the improvement of vascular disturbance of the spinal cord.- - - - - - - - - - ranking = 0.027975768948819keywords = upper (Clic here for more details about this article) |
4/225. L4-5 disk lesion resulting in back pain with bowel, bladder and sexual dysfunction without paraparesis.This is a case report of a patient with bowel, bladder and sexual dysfunction associated with low back pain. This patient had an essentially normal neurological examination. There was radiological evidence of a disk lesion, and urodynamic findings consistent with lower motor neuron bladder dysfunction. His symptoms are attributed to a L4-5 disk herniation resulting in a partial cauda equina syndrome. The relevant anatomy is reviewed, and the differential diagnosis is discussed.- - - - - - - - - - ranking = 7.7393401938386keywords = pain, back pain, back (Clic here for more details about this article) |
5/225. A case of referred pain evoked by remote light touch after partial nerve injury.An unusual case of referred pain is presented in which a 63-year-old man, who suffered a severe injury to his right hand and arm during young adulthood, describes the later development of dysesthesia and shooting pain in his arm subsequent to stimulation of the ipsilateral scalp, the temporal and infrazygomatic region of the face, and the back. Referred sensations of this type are usually reported following amputation of an arm. Clinical examination of the sensory and motor function of the arm and hand revealed partial damage to the radial, ulnar and median nerves as well as possible brachial plexus involvement. Interestingly, pain could be evoked by repeated light touches applied to the remote trigger areas suggesting the involvement of a 'wind-up'-like process.- - - - - - - - - - ranking = 7.0578126981121keywords = pain, back (Clic here for more details about this article) |
6/225. occupational exposure to methyl methacrylate monomer induces generalised neuropathy in a dental technician.A 36-year-old dental technician for 14 years developed paraesthesia and numbness in her legs. Neurophysiological studies revealed absent sensory nerve action potentials (SNAPs) from her lower limbs and normal upper limb SNAPs on presentation. Motor nerve studies were normal. Repeat studies 2 months after leaving her job showed some improvement in the lower limb SNAPs. It is suggested that her symptoms were caused by occupational exposure to methyl methacrylate monomer.- - - - - - - - - - ranking = 0.027975768948819keywords = upper (Clic here for more details about this article) |
7/225. Lateral antebrachial cutaneous neuropathy in a windsurfer.Lateral antebrachial cutaneous neuropathy (LACN) was diagnosed in a young woman who developed pain and paresthesias in the right forearm after a long day of windsurfing (board sailing). The symptoms resolved with conservative treatment, including cessation of windsurfing and a brief course of oral corticosteroids. There was a permanent residual cutaneous sensory deficit in the distribution of the LACN. LACN is important to recognize because the symptomatology may mimic pathology of a cervical root, the brachial plexus, and the radial and median nerves at the level of the elbow.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
8/225. Quadrangular space syndrome associated with superficial radial sensory neuropathy.Compression of the axillary nerve in the quadrangular space is an unusual cause of pain and paresthesia of the upper extremity. In this report, the authors present a patient with a 1-year history of an undiagnosed axillary nerve compression associated with radial sensory neuropathy who improved after surgical decompression of the quadrangular space.- - - - - - - - - - ranking = 1.0279757689488keywords = pain, upper (Clic here for more details about this article) |
9/225. Gabapentin for the treatment of dysesthetic pain after reconstructive surgery.BACKGROUND: Debilitating, postoperative dysesthetic pain after reconstructive surgery is a rare but problematic complication. Conventional therapy is either marginally effective or fraught with side effects. Gabapentin is a new, novel antiepileptic drug helpful in the management of other pain states. OBJECTIVE: A case of disturbing, postoperative dysesthetic pain after reconstructive surgery is presented. methods: A trial of gabapentin in escalating dose was initiated and the results and side effects were recorded. RESULTS: Treatment with gabapentin was associated with a substantial decrease in pain, which relapsed after tapering the medication. Relief was obtained with dose escalation, and a successful taper was eventually accomplished. Side effects were minimal. CONCLUSION: This is the first reported use of gabapentin in the treatment of postoperative dysesthetic pain. Although this type of neuropathic pain is difficult to manage, gabapentin produced substantial relief with few side effects. Further investigation is warranted.- - - - - - - - - - ranking = 10keywords = pain (Clic here for more details about this article) |
10/225. Cranial arteritis: a medical emergency with orofacial manifestations.BACKGROUND: Cranial arteritis, or CA, a vascular disease affecting primarily elderly people, may result in permanent blindness if untreated. Since it frequently mimics temporomandibular joint, myofascial or odontogenic pain, dentists must be familiar with this condition. CASE DESCRIPTION: The authors present reports of two patients who had signs and symptoms of CA, some of which were suggestive of other head and neck pain disorders. In both cases, the diagnosis of CA was confirmed by temporal artery biopsy, and treatment with systemic steroids resulted in rapid resolution of symptoms. CLINICAL IMPLICATIONS: Prompt diagnosis and treatment of CA not only results in resolution of symptoms, but also may prevent blindness, the most serious sequela of the condition.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
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