1/114. Atypical and typical cranial dystonia following dental procedures.It is generally recognized that focal dystonia of the limbs or cervical region and blepharospasm sometimes follow, and in these cases may be caused or triggered by, peripheral injury. However, the association between peripheral injury and lower cranial dystonia is rare. We report eight cases who developed cranial dystonia within hours to months following a dental procedure. One group of five cases, all women, developed atypical dystonia associated with painful paresthesias at the site of dystonia. Two of these five cases had fixed jaw-deviating dystonia, whereas the remaining three had additional tremor and spread of their dystonia to involve the tongue in all three, and the lips and neck in two cases. These five patients are reminiscent of cases of limb causalgia-dystonia syndrome, which occurs after minor peripheral trauma and can spread. The remaining three cases developed more typical cranial dystonia following the dental procedure. There was no family history of dystonia or prior use of neuroleptics in any of the patients. The close association in time and location of the procedure and onset of symptoms suggests that the onset of the dystonia may have been caused by the dental intervention, but whether there is a causal relationship between the dental intervention and the development of the dyskinesias requires further epidemiologic studies.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/114. Painful pectoralis major myospasm as a result of sternal wound reconstruction: complete resolution with bilateral pectoral neurectomies.We report a patient with a highly unusual and previously unreported complication with the use of the pectoralis major muscle to treat the infected median sternotomy. The diagnosis of painful myospasm was made by a combination of physical findings and exclusion of other conditions such as recurrent infection. Treatment by pectoral denervation was relatively simple and highly successful. patients with chest-wall pain after sternal wound reconstruction should have myospasm entertained as a possible cause.- - - - - - - - - - ranking = 2.4683810492761keywords = pain, chest (Clic here for more details about this article) |
3/114. Painful tonic/dystonic spasms in sjogren's syndrome.Three patients with sjogren's syndrome are presented in whom frequent tonic/dystonic spasms of the limbs developed during the course of the illness. These patients' clinical findings suggested spinal cord involvement, a localization that was confirmed by magnetic resonance imaging in two patients. In one patient the painful movements responded to treatment with phenytoin and in one other to baclofen. sjogren's syndrome should be considered in the differential diagnosis of conditions that produce tonic/dystonic limb spasms.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
4/114. Colonic spasm and pseudo-obstruction in an elongated colon secondary to physical exertion: diagnosis by stress barium enema.Anatomic and functional abnormalities of the colon are known to cause a variety of abdominal complaints, including constipation, diarrhea, and pain. We describe a patient with dolichocolon (elongated colon) with transient spasm (pseudo-obstruction) associated with exertion. The diagnosis in this case rested with a novel approach and less invasive evaluation of the colon.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
5/114. Unilateral painful vasospasm in the lower limbs of young women.The cases of five young women who presented with severe pain and associated vascular changes in one foot are described. The pain was spontaneous in onset and lasted for days, and its severity was such that none of the patients were able to walk without disability. Arteriography in three patients revealed arterial spasm. All had a good response from lumbar sympathectomy on the affected side.- - - - - - - - - - ranking = 6keywords = pain (Clic here for more details about this article) |
6/114. Previous cholecystectomy and choledochal sphincter spasm after morphine sedation.PURPOSE: To describe a patient with probable choledochal sphincter spasm after preoperative morphine, and to suggest a history of cholecystectomy as a predisposing factor. CLINICAL FEATURES: A 60 yr old man for femoral-popliteal artery bypass grafting developed right upper quadrant abdominal pain after preoperative morphine and scopolamine. He had a previous cholecystectomy. His pain was relieved with naloxone. CONCLUSION: Choledochal sphincter spasm should be part of a differential diagnosis in right upper quadrant pain after sedative doses of morphine, especially if there is a previous cholecystectomy.- - - - - - - - - - ranking = 3keywords = pain (Clic here for more details about this article) |
7/114. Diaphragmatic cramp as a possible cause of noncardiac chest pain and referred mandibular pain.The initial assumption that sudden acute chest pain may be of cardiac origin is justifiable, but when this proves not to be the case the patient is left with little explanation of the cause. It is suggested here that diaphragmatic cramp may be a cause of some undiagnosed noncardiac chest pains associated with mandibular referred pain. The phrenic nerve provides both motor and sensory innervation to the diaphragm, while the trigeminal nerve carries sensation from the mandibular teeth. Both nerves originate in separate nuclei close together in the lower medulla. Interconnections between these nuclei and others higher up in the brain may provide one explanation for this problem.- - - - - - - - - - ranking = 237.30934797895keywords = chest pain, pain, chest (Clic here for more details about this article) |
8/114. Cervical disc herniation in a patient with congenital insensitivity to pain: a case report.STUDY DESIGN: A case report of a patient with a known diagnosis of congenital insensitivity to pain who developed a herniated cervical disc. OBJECTIVES: To study the clinical manifestations of cervical radiculopathy in a patient with congenital insensitivity to pain and the long-term outcome after surgical treatment. SUMMARY OF BACKGROUND DATA: There have been no reports in the English literature documenting such a patient. methods: Retrospective case report and long-term clinical and radiographic follow-up. RESULTS: This patient with a known diagnosis of congenital insensitivity to pain had neurologic motor weakness with "neck and shoulder pain." Clear radicular pattern could not be elicited. The patient underwent a successful anterior discectomy and fusion with long-term clinical and radiographic results. CONCLUSION: patients with congenital insensitivity to pain who develop a cervical disc herniation may present with atypical symptoms not manifesting in the classic radicular pattern. Higher index of suspicion by the clinician must be practiced to make the appropriate diagnosis. Successful surgical outcome may be achieved in these patients.- - - - - - - - - - ranking = 9keywords = pain (Clic here for more details about this article) |
9/114. tetanus-like syndrome secondary to metoclopramide administration.A case of metoclopramide-induced pseudotetanus in a 24-year-old woman is described. Symptoms included flexor spasms of the neck muscles, neck pain, left deviation of the lower jaw and tongue protrusion. tetanus was initially suspected. mydriasis, hyperhydrosis and clinical observation indicated that this syndrome could be caused by metoclopramide taken for gastrointestinal symptoms. orphenadrine hydrochloride, diazepam and ketoprofen completely resolved the symptoms. Pseudotetanus presents in many different ways, and it is sometimes very hard to distinguish it from infective tetanus, which is very difficult to diagnose. physicians using metoclopramide should be aware of its adverse effects and how to treat them.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
10/114. Recurrent myocardial infarction and angina in a woman with normal coronary angiograms.A case is reported of recurrent myocardial infarction and angina pectoris in a woman with normal coronary arteries documented by coronary angiogram. The recurrence of infarction in contiguous areas of the heart supplied by the left anterior descending coronary artery and the association of the anginal syndrome implicate coronary arterial spasm as the probable cause.- - - - - - - - - - ranking = 0.015506584360005keywords = area (Clic here for more details about this article) |
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