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At least 217 records · Page 12Linked to original sources
PubMed2006

[Mental neuropathy and pathologic fracture of the mandible as initial symptoms of metastatic prostate carcinoma].

BACKGROUND: Distant metastases of solid tumors account for about 1% of all malign neoplasms. In about 30% of all patients who present with an oral metastasis, the distant primary tumour has not been diagnosed yet. CASE REPORT: We report the case of a 71-year-old man who clinically demonstrated unilateral mental neuropathy as well as pathologic fracture of the mandible. Prostate carcinoma was identified as a primary tumor. Clinically, there was significant hypesthesia of the skin area innervated by the left inferior alveolar nerve. X-ray examination revealed an osteolytic lesion of the ascending ramus of the mandible as well as a pathologic fracture of the mandible. Further imaging showed an extensive neoplasm of the mandible and adjacent soft tissues and significant supraclavicular lymph node enlargement. The diagnosis of metastatic carcinoma of the prostate was histopathologically confirmed. CONCLUSION: Mental neuropathy without a dental focus indicates screening for an osseous metastasis. In cases of left-sided supraclavicular lymph node enlargement in men over 45 years, metastatic prostate carcinoma must be excluded.

Aged↗
PubMed1999

[Regeneration of mouth mucosa in the buccal plane following graft procurement for reconstruction of bulbar urethral stenoses].

The use of free buccal mucosal grafts in the treatment of urethral strictures has become very popular. In 1996 and 1997 we harvested free buccal mucosal grafts up to 7 cm long and 4 cm wide from 12 patients who underwent urologic surgery for urethral strictures. In 2 patients the donor site was closed primarily by sutures. Four patients received Lyodura and another 4 patients received Syspurderm as temporary wound coverage. In 2 patients Ethisorp patches were used. Donor site pain was judged by the patients on a visual analogue scale during the first postoperative week. The 2 patients who received the Ethisorp patches complained of more intense pain, probably caused by the rigidity of the material. In all patients regeneration of the donor site mucosa was good. During the follow-up period of 4-18 months scar formation at the lower vestibulum was noticed as the only complication. Permanent limitation of mouth opening, stenosis of the parotid duct or hypesthesia did not occur.

Adolescent↗
PubMed1995

Anti-dorsal root ganglion neuron antibody in a case of dorsal root ganglionitis associated with Sjögren's syndrome.

We report the case of a 59-year-old woman with primary Sjögren's syndrome who developed hypesthesia, hypalgesia, and neurogenic arthropathy in her lower limbs. Neurological examination and electrophysiological studies indicated involvement of the dorsal root ganglia. The immunohistochemistry of sections of rat dorsal root ganglion (DRG) showed that the IgG in the serum and cerebrospinal fluid (CSF) from the patient bound to the neuronal perikarya of small DRG neurons but not to the cerebellum or peripheral nerves. These results, consistent with particular impairment of pain and touch senses, suggest that dorsal root ganglionitis in primary Sjögren's syndrome is mediated by humoral autoimmunity.

Blotting, Western↗
PubMed1983

Trigeminal neurinoma revealed by intratumoral hemorrhage following a minor head injury.

A trigeminal neurinoma which produced the signs and symptoms of a localized intratumoral hemorrhage without showing any extratumoral hemorrhage successive to a minor head injury is reported here. A 33-year-old man noticed pain and hypesthesia on the right side of the forehead and double vision on the day following an occipital trauma. A computed tomographic scan demonstrated a large high-density mass in the anterior part of the right cerebellopontine angle. A diagnosis of trigeminal neurinoma was made and the tumor was successfully removed. The largest part of the tumor consisted of a blood clot and necrotic tissue. In this case of minor head injury, the intratumoral hemorrhage was thought to have occurred as a result of obliteration of the lumen followed by recanalization of the meningeal vessels enclosed in the tumor by the growing neurinoma and distal vessel necrosis. Such a case of trigeminal neurinoma which revealed itself through intratumoral hemorrhage following a minor head injury has not been previously reported.

Adult↗
PubMed1993

Bilateral synovial cysts of the thoracic spine: a case report.

We report a case of bilateral synovial cysts of the thoracic spine. The patient presented with progressive, lower-extremity weakness and hypesthesia, culminating in complete paraplegia. This rare lesion should be considered when confronted with a patient with thoracic cord compression.

Aged↗
PubMed1995

Treatment of type II perimedullary arteriovenous fistulas by intraoperative transvenous embolization: case report.

BACKGROUND Perimedullary arteriovenous fistulas (AVFs) are abnormal vascular connections between medullary arteries and veins without an intervening nidus. It is thought to be difficult to treat Type II AVFs which have multiple feeding branches. We performed intraoperative transvenous embolization to treat Type II AVFs. CASE REPORT A 30-year-old man with Type II perimedullary arteriovenous fistulas (AVFs), present at the level of the L-1 vertebral body, underwent surgical and endovascular treatment. The patient displayed slight motor weakness (4/5) and slight hypesthesia in the right lower extremity. Angiograms demonstrated that an anterior spinal artery and posterior spinal arteries were feeding arteries for the perimedullary AVFs. The patient underwent surgical occlusion of the fistulas three times. Fistulas present on the dorsal surface of the spinal cord were occluded with hemoclips, while those located on the ventral and ventolateral aspect of the spinal cord were occluded transvenously with isobuthyl-2-cyanoacrylate (IBCA) during surgery. Total occlusion of the perimedullary AVFs was achieved with these procedures, and no change was noted postsurgically in the patient's symptoms. CONCLUSIONS In summary, Type II perimedullary AVFs are sometimes difficult to treat using either embolization or open surgery. In such cases, both open surgery and intraoperative transvenous embolization should be performed in order to obtain occlusion of multiple fistulas.

Adult↗
PubMed1996

Primary cavernous sinus malignant lymphoma treated by gamma knife radiosurgery: case report and review of the literature.

BACKGROUND: Malignant lymphomas originating primarily in the cavernous sinus have not been histologically verified by any authors. The first reported case to our knowledge of primary cavernous sinus malignant lymphoma, initially diagnosed as benign meningioma and treated by gamma knife radiosurgery, is presented. CASE DESCRIPTION: The patient was a 77-year-old man whose initial symptoms were left facial hypesthesia and diplopia on left gaze. During the 21-month follow-up period after gamma knife radiosurgery, no evidence of tumor regrowth was seen in the irradiated area, but an unirradiated mass expanded with invasion of the brain stem. Subsequent surgery provided histologic verification of the diagnosis. Despite successful local tumor control, the patient died due to sepsis 31 months after the onset of symptoms. Autopsy failed to disclose any remaining lymphoma cells either in the primary lesion or anywhere throughout the entire body. CONCLUSION: Primary cavernous sinus malignant lymphoma is an extremely rare brain tumor, but it must be considered in the differential diagnosis of an enhanced mass in the cavernous sinus. Stereotactic radiosurgery using the gamma knife technique for intracranial brain tumors, especially in the cavernous sinus, is associated with risk, as was seen in our patient. Our experience points out the pitfalls of gamma knife radiosurgery; it should be performed only after histologic confirmation has been obtained.

Aged↗
PubMed1987

Transposition of the mental nerve in orthognathic surgery.

Transposition of the mental nerve in association with orthognathic surgery was performed 25 times in 16 patients. Indications for transposition generally were use of the premolar region for surgical correction of anterior open bite or dentoalveolar prognathism. In one case, reduction of the mandibular base was the surgical indication. Postoperative hypesthesia occurred in 16 mental nerves but sensibility gradually returned to normal in almost all the patients at between six and 18 months. Partial nerve damage occurred accidentally in three cases with reduced sensibility at follow-up.

Adult↗
PubMed1989

The transmandibular implant: a 12-year follow-up study.

A clinical study of the use of the transmandibular implant for reconstructing severely atrophic mandibles in preparation for an implant-borne dental prosthesis was performed. This study included 368 patients with a mean height of the mandible of 10 mm. They were examined clinically, radiographically, and by means of a questionnaire. The follow-up period for 185 patients was 5 years or more, and 55 were followed 10 years or more. Removable dentures were made for 350 patients, and fixed bridges for 18 patients. Forty-three patients had reversible complications, one patient had unilateral hypesthesia, and six patients had their implant removed. Reversible complications of infection, gingival hyperplasia, loading of individual posts, and fenestration of threads were controlled without deleterious effects on the gingival, mucosal, or osseous tissues. The transmandibular implant system was shown to successfully restore function of the severely atrophic mandible in a more predictable manner than augmentation procedures.

Adult↗
PubMed1991

The transmandibular implant: a 13-year survey of its use.

During the period from August 1976 until July 1989 the transmandibular implant was introduced in a total of 31 oral and maxillofacial surgery departments in the Netherlands and 1,466 patients were treated. This study includes 1,356 treated patients from 28 departments. The treatment course of 1,201 patients (89.6%) was uneventful. Of the 157 complications, 58 related to the anatomic contour of the mandible, 49 to the surgery, 25 to the prosthetic reconstruction, 8 to the psychosocial attitude of the patient, 8 to the use of medication, 5 to trauma, and 4 to the presence of a skin graft. Treatment of the complications included removal of the implant in 44 patients; in 106 patients the complication was treated satisfactorily. In the remaining 7 patients, hypesthesia was present. The reasons for the removal of the 44 implants were infection (11), operative error (5), premature loading of the implant (3), insufficient width of the mandible after a visor osteotomy (1), loss of osseointegration caused by the prosthesis (14), psychological problems (4), trauma (3), drug-related gingival hyperplasia (2), and inexplicable pain (1). The present survey shows a consistent success rate of 96.8%.

Adult↗
PubMed1978

Local anesthetic effect of intrathecal normal saline.

The effects of intrathecally administered normal saline have been studied in patients undergoing graduated spinal anesthesia. The injection of 5 or 10 ml volumes resulted in segmental hypesthesia to pin-scratch and cold stimuli extending from the lower thoracic to the sacral dermatomes. There was also partial sympathetic block evidenced by a diminished psychogalvanic skin reflex. The sites and possible mechanisms of action of saline are discussed; its use as placebo in graduated spinal anesthesia is questioned. It is concluded that normal saline acts as a weak local anesthetic when injected intrathecally.

Adult↗
PubMed1979

The needle effect in the relief of myofascial pain.

In reviewing techniques for therapeutic local anaesthesia of pain spots, it appeared that the common denominator was puncture by the needle and not the anaesthetic employed. The present study examines short- and long-term effects of dry needling in the treatment of chronic myofascial pain. 241 patients and 312 pain sites were treated by needling. When the most painful spot was touched by the needle, immediate analgesia without hypesthesia was observed in 86.8% of cases. Permanent relief of tenderness in the needled structure was obtained for 92 structures; relief for several months in 58; for several weeks in 63; and for several days in 32 out of 288 pain sites followed up. The effectiveness of treatment was related to the intensity of pain produced at the trigger zone, and to the precision with which the site of maximal tenderness was located by the needle. The immediate analgesia produced by needling the pain spot has been called the "needle effect".

Acupuncture Therapy↗
PubMed1994

Median nerve compression in the proximal forearm.

Thirty-nine limbs in 36 patients underwent surgical decompression of the median nerve in the proximal forearm. Seventeen patients with 19 limbs had prior ipsilateral carpal tunnel releases, and 24 had workers' compensation claims related to heavy labor or repetitive tasks. The most common presenting complaints were paresthesias/numbness in the distribution of the median nerve and pain in the forearm or hand. The most common physical finding was a positive pronator compression test, followed by median nerve hypesthesia. Elbow to wrist nerve conduction tests were obtained in 37 of 39 limbs and were abnormal in 12. Intraoperatively, the nerve was compressed at the flexor digitorum superficialis tendon in 22 limbs, pronator teres in 13 limbs, and both in 4 limbs. Postoperatively, 30 limbs had complete or partial relief of symptoms; in a sub-group of 19 limbs that had a prior failed carpal tunnel release, 14 had complete or partial relief. Although there was a trend toward better results in patients with normal preoperative nerve conduction tests and intraoperative compression at the flexor digitorum superficialis, the difference was not significant.

Adult↗
PubMed1989

Endoscopic management of carpal tunnel syndrome.

This article describes a subcutaneous endoscopic operative procedure for carpal tunnel syndrome and analyzes its effectiveness using electrophysiological data. Subcutaneous transverse carpal ligament release under universal subcutaneous endoscope (USE) was performed using local anesthesia without pneumotourniquet in 54 hands of 45 patients since June 1986. The mean follow-up period was 13.8 months. Sensory disturbances began to subside immediately after the operation and disappeared within 2 months in all cases. After the disappearance of sensory disturbances, we performed postoperative electrophysiological studies in 27 patients (33 hands). Postoperative electrophysiological data were significantly improved in all cases. Patients did not suffer from any serious complications such as motor branch injuries of the median nerve, hypesthesia of the palm, or injuries of the superficial palmar arch. From these results, we conclude that the transverse carpal ligament can be safely incised by this procedure.

Adult↗
PubMed2004

Occipital stroke shortly after cannabis consumption.

There are several indications that imply cannabis consumption triggers cerebrovascular events. A right occipital ischemic stroke occurred in a 37-year-old Albanese man with a previously uneventful medical history, 15 min after having smoked a cigarette with approximately 250 mg of marijuana. Clinical manifestations of the stroke were left-sided hemiparesis, hemi-hypesthesia and blurred vision, which vanished spontaneously and almost completely after 3 days. He has been smoking joints regularly from the age of 27, with a frequency of 2-3 joints per week during the 6 months that preceded his stroke. Except for cigarette smoking and slight dyslipidaemia, classical risk factors for stroke/embolism were absent. Therefore, as the family history for cerebrovascular events, blood pressure, clotting tests, examinations for thrombophilia, vasculitis, extracranial and intracranial arteries and cardiac investigations were normal or respectively negative, the stroke was attributed to the chronic cannabis consumption.

Adult↗
PubMed2005

Mitochondrial neuropathy.

Polyneuropathy is a frequent feature of mitochondriopathy (MCP). If and how often polyneuropathy in MCP is primarily due to the underlying disorder (mitochondrial neuropathy, MN) or due to other well-known causes is unknown. Retrospectively investigated were 108 MCP-patients with polyneuropathy. According to established diagnostic criteria 37 patients were classified as definite MCP, 56 as probable MCP and 15 as possible MCP. In 38 of the 108 MCP-patients with polyneuropathy (35%), no plausible cause for polyneuropathy other than MCP could be found. MN was characterized by weakness, muscle cramps, wasting, reduced tendon reflexes, muscle pain, ataxia, restless legs, hypesthesia, paresthesia, dysesthesia, and vegetative impairment. In 21 cases predominantly motor fibers, in 14 cases both motor and sensory fibers and in 3 cases predominantly sensory fibers were affected. Axonal degeneration was found in 19 cases, demyelination in 4 and mixed-type polyneuropathy in 15. On sural nerve biopsy axonal loss was the predominant finding. In a single case tomaculae and abnormally shaped and structured mitochondria were found. MN exists, occurs in one third of the MCP-patients with polyneuropathy, and is characterized by predominant affection of the motor and sensory fibers with diffuse, symmetric and equal distribution between upper and lower limbs and by axonal degeneration.

Adult↗
PubMed2006

Embolic internal auditory artery infarction from vertebral artery dissection.

A 51-year-old man developed sudden vertigo, right hearing loss and dysphagia. Examination revealed right Horner syndrome, spontaneous torsional-horizontal nystagmus, right central type facial palsy, dysarthria, reduced soft palate elevation without gag reflex, left hypesthesia, right dysmetria and imbalance. Audiometry and bithermal caloric tests documented right sensorineural hearing loss and canal paresis. Brain MRI and cerebral angiography documented right lateral medullary infarction from vertebral artery dissection, without involvement of other parts of the brainstem supplied by the anterior inferior cerebellar artery (AICA). This case suggests artery-to-artery embolism as a possible mechanism of isolated vertigo or hearing loss from labyrinthine infarction.

Adult↗
PubMed2005

Cervical clear cell meningioma mimicking a vertebral metastasis.

Cervical vertebral involvement of clear cell meningioma is very rare. We report a case of clear cell meningioma in the cervical vertebral body in a 72-year old male. Seven years prior to this presentation, the patient underwent palliative surgery and posterior instrumentation for a cervical vertebral tumor at C5, which had been diagnosed as a metastatic renal cell carcinoma. On this admission, the patient presented with severe neck pain. Examination revealed hypesthesia on the left in a C6 nerve root distribution. Plain X-rays and MRI revealed an enlarging tumor in the C5 and C6 vertebral bodies. The tumor was resected via an anterior approach followed by fusion using a strut bone graft. Histological examination of the surgical specimen diagnosed a clear cell meningioma. Postoperatively, the patient achieved pain relief and resolution of the neurological deficit. At follow-up two years postoperatively, he remains asymptomatic. We emphasize that cervical clear cell meningioma with involvement of the vertebral bodies may mimic metastatic renal cell carcinoma.

Aged↗