1/31. Treatment with AC pulsed electromagnetic fields improves olfactory function in Parkinson's disease.Olfactory dysfunction is a common symptom of Parkinson's disease (PD). It may manifest in the early stages of the disease and infrequently may even antedate the onset of motor symptoms. The cause of olfactory dysfunction in PD remains unknown. Pathological changes characteristic of PD (i.e., lewy bodies) have been demonstrated in the olfactory bulb which contains a large population of dopaminergic neurons involved in olfactory information processing. Since dopaminergic drugs do not affect olfactory threshold in PD patients, it has been suggested that olfactory dysfunction in these patients is not dependent on dopamine deficiency. I present two fully medicated Parkinsonian patients with long standing history of olfactory dysfunction in whom recovery of smell occurred during therapeutic transcranial application of AC pulsed electromagnetic fields (EMFs) in the picotesla flux density. In both patients improvement of smell during administration of EMFs occurred in conjunction with recurrent episodes of yawning. The temporal association between recovery of smell and yawning behavior is remarkable since yawning is mediated by activation of a subpopulation of striatal and limbic postsynaptic dopamine D2 receptors induced by increased synaptic dopamine release. A high density of dopamine D2 receptors is present in the olfactory bulb and tract. Degeneration of olfactory dopaminergic neurons may lead to upregulation (i.e., supersensitivity) of postsynaptic dopamine D2 receptors. Presumably, small amounts of dopamine released into the synapses of the olfactory bulb during magnetic stimulation may cause activation of these supersensitive receptors resulting in enhanced sense of smell. Interestingly, in both patients enhancement of smell perception occurred only during administration of EMFs of 7 Hz frequency implying that the release of dopamine and activation of dopamine D2 receptors in the olfactory bulb was partly frequency dependent. In fact, weak magnetic fields have been found to cause interaction with biological systems only within narrow frequency ranges (i.e., frequency windows) and the existence of such frequency ranges has been explained on the basis of the cyclotron resonance model.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
2/31. Acute axonal polyneuropathy in chronic alcoholism and malnutrition.In contrast to the classic, slowly progressive polyneuropathy in alcoholic patients, acute forms, clinically mimicking guillain-barre syndrome, are rare. We present a patient who developed motor weakness and sensory loss in all four limbs within four days. Laboratory data were consistent with long-term alcohol abuse and documented thiamine deficiency. Repeated cerebrospinal fluid examinations were normal. Electrophysiological studies showed an acute sensorimotor polyneuropathy with predominantly axonal involvement. We conclude that acute alcoholic neuropathy has to be distinguished from guillain-barre syndrome and other forms of acute polyneuropathy by using clinical, laboratory, and electrophysiological data. Both ethanol toxicity and vitamin deficiency could play a role in the pathogenesis.- - - - - - - - - - ranking = 0.047142370861709keywords = contrast (Clic here for more details about this article) |
3/31. Desensitization of the gag reflex in an adult with cerebral palsy: a case report.Severe oral hypersensitivity and aversive oral behaviors present a significant barrier to dental treatment and compromise oral health status. Although several authors have addressed the reduction of oral hypersensitivity and aversive behaviors (such as gagging, retching, and vomiting) in the otherwise well dental patient, treatment for patients with severe disability has not been explored. The successful management of oral hypersensitivity and aversive behavior can have significant health benefits. These can be described via an outcomes paradigm as physical and social benefits for the patient, psychological benefits for the patient, carer, and practitioner, and organizational benefits for the institutions providing dental care and medical management. This paper summarizes the management of a severely disabled patient whose aversive behaviors were eliminated with non-invasive therapy techniques. oral hygiene was facilitated and health benefits were identified across a number of domains following successful multi-disciplinary management.- - - - - - - - - - ranking = 3keywords = sensitivity (Clic here for more details about this article) |
4/31. Congenital corneal anesthesia: a series of four case reports.PURPOSE: Discussion of four cases of congenital corneal anesthesia with varied systemic associations and modes of presentation. classification and systemic associations of congenital corneal anesthesia along with the importance of multi-specialty evaluation of such patients. methods: Clinical examination of all four cases and corneal sensation assessment with Cochet-Bonnet esthesiometer. Thorough systemic examination and investigations including serum bio-chemical analysis, roentgenography, ultrasonography, nerve conduction studies, and CT scan of the patients to identify systemic associations. RESULTS: All four patients proved to have bilateral congenital corneal anesthesia with Cochet-Bonnet esthesiometry confirming corneal anesthesia. Systemic examination revealed associated congenital mesenchymal anomalies in the first case. The second case had generalized reduction in pain sensitivity confirmed by nerve conduction studies. The third case was an isolated bilateral congenital corneal anesthesia, while the fourth was a case of congenital trigeminal nerve anesthesia involving all three divisions of both trigeminal nerves. Other causes of corneal anesthesia and self-inflicted corneal injuries were ruled out by clinical multi-specialty evaluation and appropriate investigations. Correct diagnosis and symptomatic treatment aided speedy relief of symptoms of all the patients. CONCLUSION: Congenital corneal anesthesia is a rare condition and is often a diagnostic dilemma. Although more common conditions that cause corneal anesthesia can mislead the clinician, the congenital variant should be kept in mind in any case of intractable corneal ulceration in children. early diagnosis, symptomatic treatment and measures to prevent further corneal damage will immensely help in retaining useful vision for the affected children.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
5/31. Alteration of the ocular surface with recurrence of granular/avellino corneal dystrophy after phototherapeutic keratectomy: report of five cases and literature review.PURPOSE: To study the changes in ocular surface findings with recurrence after phototherapeutic keratectomy (PTK) in patients with Avellino and granular dystrophy. DESIGN: Observational case series. PARTICIPANTS: Five eyes of five patients with recurrent granular/Avellino corneal dystrophy after PTK seen at Kobe Kaisei Hospital were studied. INTERVENTION: The patients underwent routine ophthalmic examinations, corneal sensitivity measurements, tear film breakup time (BUT), Schirmer test, tear film lipid layer interferometry, and conjunctival impression cytology. MAIN OUTCOME MEASURES: The alterations of clinical features, tear function, and conjunctival impression cytology parameters with a recurrence after PTK were investigated. RESULTS: The average pre-PTK corneal sensitivity and tear film breakup time were low in all five patients. Tear film lipid layer interferometry grade and conjunctival squamous metaplasia displayed higher grades before PTK. All of these parameters improved gradually after PTK and were maintained until a recurrence, which was associated with further worsening of the corneal sensitivity, tear function, and impression cytology parameters. CONCLUSIONS: Although PTK improves the ocular surface health in granular/Avellino corneal dystrophies, recurrence of the initial dystrophy is associated with decline of the ocular surface health parameters. Our findings also suggest that corneal epithelium is most probably involved in the recurrence of the disease process in Avellino/granular corneal dystrophy.- - - - - - - - - - ranking = 3keywords = sensitivity (Clic here for more details about this article) |
6/31. Transient vestibular balance dysfunction after primary blast injury.Explosive munitions are used routinely in support of military operations. Moreover, service personnel are increasingly being deployed to regions where active conflict, terrorism, and land mines pose significant threats. Despite aggressive protective measures and safety practices, blast injury is an inherent risk. In contrast to secondary and tertiary blast injuries, primary blast injuries are generally limited to the air-filled organs of the respiratory, gastrointestinal, and auditory systems. We report the case of a Marine who entered the back-blast arc of a shoulder-launched multipurpose assault weapon at close range. Despite the magnitude of the blast, he sustained none of the classic findings suggestive of severe primary blast injury. However, he manifested unique vestibular balance abnormalities that precluded his return to full duty for several months. This suggests that personnel who sustain even a mild traumatic brain injury with vestibular manifestations may need prolonged observation and modified duty in certain military occupational specialties.- - - - - - - - - - ranking = 0.047142370861709keywords = contrast (Clic here for more details about this article) |
7/31. Indolent corneal ulcers in a patient with congenital insensitivity to pain with anhidrosis: a case report and literature review.PURPOSE: To report a case of bilateral corneal neurotrophic ulcer in patient with congenital insensitivity to pain with anhidrosis (CIPA) and review the literature. CASE REPORT: A 6 year-old boy presented with bilateral central corneal sterile ulcer, decreased corneal sensitivity, moderately altered corneal reflex and normal tearing response. history taken, systemic evaluation and medical chart review were undertaken. DISCUSSION: Fifty-two cases of CIPA have been reported worldwide. Fourteen cases had corneal involvement. The clinical picture of our patient is characteristic of CIPA. CONCLUSIONS: Congenital insensitivity to pain with anhidrosis may present as neurotrophic corneal ulcer. We report herewith, this vision threatening corneal congenital abnormality. early diagnosis and prompt treatment are mandatory to prevent corneal complications such as scarring and perforation.- - - - - - - - - - ranking = 7keywords = sensitivity (Clic here for more details about this article) |
8/31. Misinterpretation of regional sensory loss in an injured worker: a case report.Regional patterns of motor or sensory loss are considered indicators of a behavioral component to the complaints of an injured worker. This assumption may lead to a discounting of signs and symptoms with premature return to work and discharge from care. We present the case of a 25-year-old airline baggage handler with an 8-month history of unresolved neck and shoulder complaints who had been returned to work after a lack of objective findings on physical examination. On physiatric evaluation, his unusual pattern of insensitivity to pinprick led to prompt magnetic resonance imaging that revealed a focus of increased intramedullary signal at C6 consistent with a syrinx. This case report shows the importance of a detailed neuromuscular examination coupled with appropriate diagnostic imaging in the assessment of individuals with regional sensory or motor loss so as not to miss more serious spinal cord pathology.- - - - - - - - - - ranking = 1keywords = sensitivity (Clic here for more details about this article) |
9/31. multiple sclerosis and oral care.multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.- - - - - - - - - - ranking = 0.12373065510853keywords = visual (Clic here for more details about this article) |
10/31. Physiotherapy for pusher behaviour in a patient with post-stroke hemiplegia.OBJECTIVE: This case report describes a specific, literature-based physiotherapy treatment and the outcome for a stroke patient with pusher behaviour. Pusher behaviour is characterized by pushing strongly towards the hemiplegic side in all positions and resisting any attempt at passive correction of posture to bring the weight towards or over the midline of the body. methods: The patient was a 71-year-old man with clear pusher behaviour due to a stroke. Therapy for the pushing behaviour was performed over a 3-week period. Motor function, mobility, disability, tone anomalies and pusher behaviour were assessed before and after the study period. Immediate effects of a single training session were assessed by clinical observation. RESULTS AND CONCLUSION: Immediate effects on the pusher behaviour were observed when using visual and auditory feedback, but not when somatosensory input was used. These results were not maintained to the end of the treatment period. Treatment makes the patient able to use compensatory strategies for functional activities. The long-term effects should be investigated in more depth in the future.- - - - - - - - - - ranking = 0.12373065510853keywords = visual (Clic here for more details about this article) |
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