1/29. Congenital insensitivity to pain with anhidrosis: a case report.Congenital insensitivity to pain with anhidrosis (CIPA) is a very rare genetic disorder of the peripheral nervous system characterized by recurrent episodes of unexplained fever, generalized anhidrosis, insensitivity to pain and temperature, and accompanied by self-mutilating behavior and mental retardation. We report on a 16 month-old boy with CIPA who exhibited these characteristic clinical features. A sural nerve biopsy revealed markedly reduced numbers of unmyelinated and small myelinated fibers, consistent with the characteristic features of CIPA.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/29. munchausen syndrome presenting in a patient who has undergone temporomandibular joint surgery.munchausen syndrome is a rare psychiatric disorder. patients with munchausen syndrome insist on and repeatedly undergo unnecessary investigations and operative treatments. No organic pathosis is demonstrated, and treatment consistently fails to alleviate the symptoms. This article presents a case report and a brief discussion to facilitate recognition and management techniques.- - - - - - - - - - ranking = 0.13819911264324keywords = organ (Clic here for more details about this article) |
3/29. Congenital insensitivity to pain with anhidrosis.Congenital insensitivity to pain with anhidrosis is an autosomal-recessive disorder resulting from defective neural crest differentiation with loss of the first-order afferent system, which is responsible for pain and temperature sensation. There is also a neuronal loss in the sympathetic ganglia. Lack of sweating, hyperthermia, and infections of bones are main features of the disorder; however, contradictory results have been published regarding eccrine sweat gland innervation. A 5-year-old male patient with typical clinical manifestations of congenital insensitivity to pain with anhidrosis is presented. immunohistochemistry with antibodies against S100 protein and neuron-specific enolase failed to reveal nerve fibers in the vicinity of the eccrine sweat glands. The roles of the nerve growth factor and tyrosine kinase receptor gene mutations in the pathogenesis of the disease are also discussed.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
4/29. Microsurgical replantation of sexual organs in three patients.OBJECTIVE: The present study deals with microsurgical replantation technique. MATERIAL AND methods: The technique was applied in 3 patients whose sexual organs had been accidentally cut off. RESULTS: necrosis of the sutured organs occurred in 2 cases. In 1 case, however, healing with proper miction and sexual function was achieved. Prolonged period (over 12 hours) from the accident to operation as well as the extensive injury of tissues with the vascular system crush were considered to be the main reason for failure. CONCLUSIONS: Microsurgical reconstruction of penis and testes with the use of vessel grafts prolonged the hypoxia which led to necrosis. Disturbances in vein blood outflow from the sutured organs contributed to this process as well. The third case resulted in success mostly due to quick intervention (5 h from injury) as well as to proper microsurgical reconstruction of vessels, nerves, and urethra. In addition suprapubic urine diversion was successfully applied and the urethra healed on the perforated catheter. Routine antibiotics as well as antithrombotic prophylactics were administered in all of the 3 cases.- - - - - - - - - - ranking = 1.9673937885027keywords = nerve, organ (Clic here for more details about this article) |
5/29. Self-inflicted vocal cord paralysis in patients with vagus nerve stimulators. Report of two cases.vagus nerve stimulation for treatment of epilepsy is considered safe; reports of severe complications are rare. The authors report on two developmentally disabled patients who experienced vocal cord paralysis weeks after placement of a vagus nerve stimulator. In both cases, traction injury to the vagus nerve resulting in vocal cord paralysis was caused by rotation of the pulse generator at the subclavicular pocket by the patient. Traumatic vagus nerve injury caused by patients tampering with their device has never been reported and may be analogous to a similar phenomenon reported for cardiac pacemakers in the literature. As the use of vagus nerve stimulation becomes widespread it is important to consider the potential for this adverse event.- - - - - - - - - - ranking = 9keywords = nerve (Clic here for more details about this article) |
6/29. Autosectio of the prolapsed uterus and vagina.The authors present a bizarre case of attempted autosection of prolapsed genital organ by a demented 81-year-old women with chronic alcocholism.- - - - - - - - - - ranking = 0.13819911264324keywords = organ (Clic here for more details about this article) |
7/29. The borderline syndrome in psychosomatic dermatology. Overview and case report.The borderline syndrome is one of the most severe disturbances of psychosomatic dermatology. patients with borderline syndrome are situated 'on the border' of psychosis, neurosis and personality disorders. The skin as a borderline organ carries a symbolic role. The clinical picture includes artefactual skin diseases due to self-mutilation by conscious or unconscious cutting, and rubbing, scratching or para-artefactual manipulations of pre-existing dermatoses. Leading symptoms of the borderline syndrome are poor impulse control, emotional instability and poor ego strength with low frustration tolerance and unstable personal relationships. We present the case of a 38-year-old female patient with borderline syndrome suffering from para-artefactual skin diseases of the face and a massive hyperhidrosis of the hands and feet. Within 9 months she was treated in four acute psychiatric hospitals and by 12 psychiatrists and psychotherapists. Early and accurate diagnosis and high-quality, sophisticated long-term therapy are necessary.- - - - - - - - - - ranking = 0.13819911264324keywords = organ (Clic here for more details about this article) |
8/29. Self-inserted intraorbital foreign bodies.We report an unusual case of self-mutilation by insertion of multiple foreign bodies in the orbit. A 26-year-old female psychiatric patient with a severe emotionally unstable personality disorder was reviewed in the ophthalmology clinic. She had allegedly inserted a metal staple into her right eye 2 days previously and was complaining of pain around the right eye. radiography showed multiple foreign bodies in the right orbit and one in the left orbit. Self-mutilation in psychiatric patients has been well documented. The management of nonorganic, nontoxic intraorbital foreign bodies is discussed. A low threshold for imaging in these cases is of vital importance.- - - - - - - - - - ranking = 0.13819911264324keywords = organ (Clic here for more details about this article) |
9/29. optic nerve massaging: an extremely rare cause of self-inflicted blindness.PURPOSE: To report a patient whose self-inflicted blindness was not clinically apparent by history or external signs of trauma. DESIGN: Observational case report. methods: A 12-year-old girl with a history of social and behavioral problems was noted to have visual loss in her right eye. Examination revealed no light perception, optic nerve atrophy, partial upper lid ptosis, exotropia, and hypoesthesia of the cheek, all on her right side. RESULTS: After undergoing extensive examinations which were unrevealing for a diagnosis, the patient admitted to a recurrent maneuver, which she secretly used to relieve anxiety and stress. This maneuver consisted of inserting her index finger under the right supraorbital rim and forcibly subluxating her globe out of the orbital space. CONCLUSIONS: Self-inflicted visual loss can occur in nonpsychotic and nonviolent patients. Accurate diagnosis is important, as there is a risk of similar involvement to the fellow eye, and referral for psychiatric counseling is mandatory.- - - - - - - - - - ranking = 5keywords = nerve (Clic here for more details about this article) |
10/29. Hereditary sensory autonomic neuropathy Type IV.Hereditary sensory autonomic neuropathy Type IV is an autosomal recessive disorder due to lack of maturation of small myelinated and unmyelinated fibers of peripheral nerves, which convey sensation of pain and temperature, therefore, resulting in self mutilation. There is anhidrosis due to lack of innervation of normal sweat glands resulting in recurrent episodes of hyperpyrexia. The clinical presentation of two children with this rare disease is described.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
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