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At least 433 records · Page 24Linked to original sources
PubMed2000

Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study.

The objective of this study was to compare the efficacy and tolerability of gabapentin and amitriptyline monotherapy in painful diabetic neuropathy. This was a 12-week, open-label, prospective, randomized trial. Twenty-five type-II diabetic patients with pain attributed to diabetic neuropathy and a minimum score of 2 on a pain intensity scale ranging from 0 (no pain) to 4 (excruciating pain) were randomized to receive either gabapentin, titrated from 1,200 mg/day to a maximum of 2,400 mg/day, or amitriptyline, titrated from 30 mg/day to a maximum of 90 mg/day. Both drugs were titrated over a 4-week period and maintained at the maximum tolerated dose for 8 weeks. The main outcome measures were weekly pain intensity and paresthesia intensity, measured on two categorical scales. Thirteen patients received gabapentin and 12 received amitriptyline. All 25 patients completed the trial. Gabapentin produced greater pain reductions than amitriptyline (mean final scores were 1.9 vs. 1.3 points below baseline scores; P = 0.026). Decreases in paresthesia scores also were in favor of gabapentin (1.8 vs. 0.9 points; P = 0. 004). Adverse events were more frequent in the amitriptyline group than in the gabapentin group: they were reported by 11/12 (92%) and 4/13 (31%) of patients, respectively (P = 0.003). Side effects were the main limiting factor preventing dose escalation. Gabapentin produced greater improvements than amitriptyline in pain and paresthesia associated with diabetic neuropathy. Additionally, gabapentin was better tolerated than amitriptyline. Further controlled trials are needed to confirm these preliminary results.

Acetates↗
PubMed2004

Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy.

Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN) resulting in disabling sensory disturbances such as pain, dysesthesia, paresthesia, hypoesthesia, or anesthesia. Two fundamental mechanisms are responsible for the injury: the chemical neurotoxicity and the mechanical compression caused by the extruded material. Although spontaneous resorption has been described for some materials, early surgical exploration with removal of the material and decompression of the IAN should be performed, irrespective of the material used, given that the importance of nerve damage increases with the duration of the injury. We report 4 cases of disabling dysesthesia and paresthesia following endodontic treatment of lower molars in which sagittal osteotomy was used to remove the endodontic paste and to perform nerve decompression. All the patients experienced immediate relief of dysesthesia and paresthesia.

Adult↗
PubMed2006

[Headache after a stay in the Dominican Republic].

CASE HISTORY: In a 27-year-old female German patient severe headache and wandering paresthesias appeared one week after returning from a holiday in the Dominican Republic. After 3 weeks of ongoing symptoms she was admitted to our hospital with the suspicion of an inflammatory or infectious disease of the central nervous system. Upon admission slight stiffness of the neck, fever (38.2 C) and paresthesias of the right elbow and the right thigh were noticed. LABORATORY FINDINGS: Cerebrospinal fluid (CSF) revealed an eosinophilic pleocytosis. In the acute phase of the disease, antibodies against nematodes were found in CSF, without corresponding antibody-reactivity in serum. In the course levels of nematode antibodies in CSF increased and antibody-reactivity in serum was observed. Thorough investigation for other infectious or inflammatory causes of eosinophilic meningitis revealed no abnormalities. DIAGNOSIS, TREATMENT AND COURSE: Symptoms, onset within the typical incubation period and the eosinophilic meningitis lead to the diagnosis of a suspected Angiostrongyliasis. Successful treatment was achieved with a combination of oral albendazole and corticosteroids given for 4 weeks. CONCLUSION: Infection with larvae of Angiostrongylus cantonensis is one of the main causes of eosinophilic meningitis worldwide. Human infection can occur after ingestion of intermediate hosts or contaminated vegetables. Angiostrongyliasis has been endemic to Southeast Asia and the Pacific Basin and only recently cases from the Caribbean have been described. Headache, paresthesias and the finding of an eosinophilic meningitis in patients returning from tropical or subtropical regions should lead to the suspicion and eventually the treatment of an Angiostrongyliasis.

Adult↗
PubMed2003

Neurofibromatosis type I: clinical and imaging features of Von Recklinghausen's disease.

OBJECTIVE: To discuss the case of a 45-year-old woman, with a prior diagnosis of neurofibromatosis type 1 (NF-1), complaining of low back and cervical spine pain with bilateral upper extremity paresthesias. CLINICAL FEATURES: The patient had a dull, achy, constant low-back pain of 4 months' duration, with mild headaches and upper extremity paresthesias. Multiple skin lesions and spinopelvic postural imbalances were present. Diagnostic radiography, along with advanced imaging, demonstrated multilevel dysplastic osseous changes, with dural ectasia, scoliosis, and tumor extension. In addition to the previous diagnosis of NF-1, our clinical diagnosis included segmental dysfunction with resultant cervicalgia, lumbalgia, and myospasm. INTERVENTION AND OUTCOME: Treatment consisted of a course of spinal manipulation of the lumbopelvic region, with adjunctive therapy consisting of interferential therapy, heat, and rehabilitative exercise. Marked reduction in pain and paresthesia with improved function were achieved. CONCLUSIONS: NF-1 is a multisystem disease with neoplasia of the skin and nervous system. Patients experience a lifetime of morbidity and increased risk of mortality, depending on the extent of the disease. A multitude of therapeutic regimens may be engaged to improve NF-1-associated symptomatology and morbidity. Chiropractic spinal manipulation may have a positive effect in pain reduction and improved function in patients who have NF-1 without spinal instability.

Female↗
PubMed2003

Complications after radial artery harvesting for coronary artery bypass grafting: our experience.

BACKGROUND: The aim of this study was to evaluate the incidence of complications in the upper limbs as a new event after radial artery (RA) harvesting for coronary artery bypass grafting (CABG). METHODS: From June 1997 to August 2001, the RA graft was used in 271 patients who underwent cardiac surgery at our department. These patients were prospectively reviewed. All patients were preoperatively examined to determine the presence of normal sensation and circulation in the upper limbs; then we evaluated the incidence of complications at discharge, 8 weeks, and 6 months. RESULTS: No donor arms developed symptoms of ischemia or motor dysfunction. At 8 weeks 2 patients (0.7%) reported donor arm weakness, and cutaneous paresthesia was noted postoperatively in 10 upper limbs (3.7%). The univariate statistical analysis showed that significant risk factors for persistent cutaneous paresthesia were diabetes and smoking. CONCLUSIONS: This study demonstrates that complications after harvesting the RA for CABG are a rare consequence. The main symptom is a persistent cutaneous paresthesia present in 10 patients at 6-month follow-up.

Arm↗
PubMed2001

Adverse events in peripheral progenitor cell collection: a 7-year experience.

Collection of peripheral progenitor cells (PPC) by apheresis machines is generally regarded as a safe procedure. However, data about adverse events in PPC harvesting are scarce. In a monocentric retrospective study, the data of 540 PPC collections in a period of 7 years were reviewed. Adverse events were subdivided in collection-associated technical problems and patient/donor-related side effects. Patient/donor-related side effects occurred most often (19.8%); most of them were paresthesias due to citrate toxicity. Paresthesias were treated by oral (20.4%) or intravenous (1.1%) calcium supplementation. Problems with venous access were also seen frequently, resulting in blood flow alarms (11.3%) and blockades in the return line (4.3%). A total of 6.9% of these problems were catheter associated, requiring revision of the central venous line in 2.6%. Technical problems with the blood cell separators were observed in 11.7%. Ten PPC collections were discontinued due to adverse events. The data of this retrospective, monocentric analysis show that patient/donor-associated problems were observed in every fifth PPC harvest. Most of them were paresthesias, which could be easily treated by calcium supplementation. Problems with venous access and technical problems with the cell separators occurred in every tenth PPC collection.

Adolescent↗
PubMed1996

The efficacy of axillary block for surgical procedures about the elbow.

Surgical procedures to the distal humerus, elbow, and proximal ulna and radius are ideally suited to regional techniques. However, axillary block is usually not recommended for surgery about the elbow because blockade at this level may result in inadequate block of the terminal nerves that arise from the medial, posterior, and lateral cords, and provide sensory innervation to the upper arm. This study reports the success rates for interscalene, supraclavicular, and axillary blocks for surgery about the elbow. Three hundred thirty surgical procedures in 260 patients were reviewed retrospectively. Approach to the brachial plexus (interscalene, supraclavicular, axillary), anesthetic technique (paresthesia, nerve stimulator, transarterial), and local anesthetic solution were recorded. Success rate, defined as the percent of cases in which the block provided adequate surgical anesthesia, and the frequency of perioperative respiratory compromise were also determined. In 156 cases, the surgical procedure involved a bony structure. The surgery involved only soft tissue in the remaining 174 cases. Adequate surgical anesthesia was present in 283 cases, for an overall success rate of 86%. Adequate surgical anesthesia was present in 219 of 247 axillary (89%), 46 of 59 supraclavicular (78%), and 18 of 24 interscalene (75%) blocks (P < 0.025). Successful axillary block was achieved in 95% of blocks using paresthesia technique, 88% of blocks using a nerve stimulator/motor response, 94% of combination blocks (paresthesia or nerve stimulator combined with transarterial injection), and 81% of blocks performed exclusively with transarterial injection (P < 0.05). In addition, axillary blocks performed with mepivacaine had a higher success rate (93%) than those performed with bupivacaine (81%) (P < 0.01). There were no patients with perioperative respiratory compromise. These results demonstrate that the axillary approach to the brachial plexus may be successfully used for surgical procedures about the elbow.

Anesthesia Recovery Period↗
PubMed1996

Axillary brachial plexus anesthesia: electrical versus cold saline stimulation.

The aim of this study was to investigate which of two methods of nerve stimulation, cold saline-induced paresthesia or use of a nerve stimulator, was more effective in increasing the successful brachial plexus block rate by the axillary approach. Twenty patients were randomly assigned to Group A (saline below 11 degrees C), and 20 patients to Group B (nerve stimulator). All blocks were performed by the same anesthesiologist using 40 mL of 1.5% mepivacaine and 4 mL of 8.4% sodium bicarbonate. Successful block was defined using Vester-Andersen et al.'s criteria. Cold saline-induced paresthesiae in the hand or forearm were obtained in 19 patients (95%) during one of four attempts allowed, and in 15 patients (75%) on the first attempt. A motor response was evoked by a nerve stimulator in 17 patients (85%). Two patients (10%) had a paresthesia in the hand without a motor response with the current at less than 1 mA. A successful block was achieved in 19 patients in each group.

Anesthetics, Local↗
PubMed1999

The effects of needle bevel orientation during epidural catheter insertion in laboring parturients.

UNLABELLED: Lateral needle bevel orientation during identification of the epidural space has been recommended to reduce the risk of postdural puncture headache (PDPH). Rotation to cephalad or caudad orientation before catheter insertion is assumed necessary for analgesic success. We prospectively compared the effects of catheter insertion through lateral- and cephalad-oriented Tuohy needle bevels in laboring parturients. Anesthesiology residents were randomized to identify the epidural space with bevels oriented cephalad or lateral. Catheters were inserted without needle rotation. Outcomes compared included ease of insertion, analgesic effectiveness, and complications. We evaluated 534 catheter insertions in 500 parturients. Initial catheter insertion produced satisfactory analgesia in 80.2% of the lateral group versus 91.1% of the cephalad group (P < 0.001). Resistance preventing catheter insertion accounted for the difference. There were no differences in i.v. cannulation (5.8% vs 5.1%), dural puncture (3.8% vs 2.0%), PDPH (0.4% vs 0.7%), or asymmetric block (31% vs 27%). There was a slightly higher rate of paresthesias in the lateral group (31% vs 23%; P = 0.048). In 78% of parturients experiencing both paresthesias and asymmetric block, the side of the paresthesia and greater extent of block were the same. Analgesic effectiveness, as measured by using a visual analog scale, was not different between the groups. IMPLICATIONS: Two methods of epidural catheter insertion were compared in laboring parturients. Catheter insertion with the needle orifice oriented cephalad was associated with the greatest initial success and the fewest complications.

Adult↗
PubMed2001

Regional anesthesia does not increase the risk of postoperative neuropathy in patients undergoing ulnar nerve transposition.

UNLABELLED: The use of regional anesthetic techniques in patients with preexisting neuropathies has been widely debated. The possibility of needle- or catheter-induced trauma, local anesthetic toxicity, or neural ischemia during regional blockade may place patients with underlying mechanical, ischemic, or metabolic neurologic derangements at increased risk of progressive neural injury. We evaluated the safety of regional versus general anesthesia in patients with a preexisting ulnar neuropathy undergoing ulnar nerve transposition. All patients (n = 360) who underwent ulnar nerve transposition at the Mayo Clinic from 1985 to 1999 were retrospectively studied. A general anesthetic was performed in 260 (72%) patients. The remaining 100 (28%) patients received an axillary block, including 64 patients in whom an ulnar paresthesia or nerve stimulator motor response was elicited at the time of block placement. Patient characteristics, the severity of preoperative ulnar nerve dysfunction, and surgical variables were similar between groups. Anesthetic technique did not affect neurologic outcome (new or worsening pain, paresthesias, numbness, or motor weakness) immediately after surgery or at 2 or 6 wk after surgery. All six patients in the Axillary Block group who reported new or worsening neurologic symptoms after surgery had received bupivacaine in combination with either an ulnar paresthesia or motor response. By using logistic regression, bupivacaine was identified as an independent risk factor for worsening of ulnar nerve function compared with other local anesthetics. We conclude that axillary blockade is a suitable anesthetic technique for this procedure. IMPLICATIONS: The use of regional anesthetic techniques in patients with preexisting neuropathies has been widely debated. Theoretical concerns include the risk of progressive nerve damage from direct needle trauma or local anesthetic toxicity. This investigation, however, supports the safety of axillary blockade in patients with preexisting ulnar neuropathy undergoing ulnar nerve transposition.

Anesthesia, General↗
PubMed2001

Acute and nonacute complications associated with interscalene block and shoulder surgery: a prospective study.

BACKGROUND: The incidence, etiology, and evolution of complications after interscalene brachial plexus block (ISB) are not well-known. The authors prospectively monitored 521 patients for complications during the first 9 months after ISB. METHODS: A total of 521 adults scheduled for elective shoulder surgery performed with an ISB were included in this prospective study. The ISB procedure was standardized for all patients Acute complications were recorded. Patients were observed daily (for 10 days) for paresthesias, dysesthesias, pain not related to surgery, and muscular weakness and were evaluated at 1, 3, 6, and 9 months after surgery. Persistence of paresthesias dysesthesias, pain not related to surgery, or muscular weakness was investigated at 1 or 3 months by means of electroneuromyography. Final evaluation was performed at 9 months. RESULTS: A total of 520 patients completed the study; one was excluded after surgical axillary nerve damage. Two hundred thirty-four patients had an interscalene catheter. Acute complications consisted of one pneumothorax (0.2%) and one episode of central nervous system toxicity (incoherent speech; 0.2%). A 10 days, 74 patients (14%) were symptomatic, and none had muscular weakness. At 1 month, 41 patients (7.9%) had symptoms, and none had muscular weakness. Thirty patients under went electroneuromyography; sulcus ulnaris syndrome (n = 8) carpal tunnel syndrome (n = 2), and complex regional pain syndrome (n = 1) were diagnosed. At 3 months 20 patient (3.9%) were symptomatic, and none had muscular weakness All underwent electroneuromyography; carpal tunnel syndrome (n = 2), complex regional pain syndrome (n = 4), plexus neuropathy (n = 1), and plexus damage (n = 1) were diagnosed. At 6 months, 5 patients (0.9%) were symptomatic. At 9 months 1 patient (0.2%) had persistence of dysesthesia. CONCLUSIONS: Interscalene brachial plexus block performed with a standardized technical approach, material, and drugs is associated with an incidence of short- and severe long-term complications of 0.4%. In case of persistent paresthesia, dysesthesia, or pain not related to surgery after ISB, sulcus ulnaris syndrome, carpal tunnel syndrome, or complex regional pain syndrome should be excluded since specific treatment may be required.

Adolescent↗
PubMed2000

Enucleation of blind, painful eyes.

PURPOSE: To determine the demographics and results of treatment in patients undergoing enucleation of blind, painful eyes. METHODS: Medical records were reviewed to determine the precipitating cause, preoperative symptoms, prior therapy, and results of treatment in 58 patients in whom enucleation was performed to relieve ocular discomfort. Patient perception of symptoms and treatment was assessed by a follow-up mail survey. RESULTS: Forty-five percent of patients had sustained prior trauma. Ocular discomfort was attributed to phthisis (43%), elevated intraocular pressure (40%), or corneal decompensation (10%). Preoperative symptoms included ocular pain (91%), periocular headache (17%), tearing (26%), and ipsilateral photophobia (26%). Eight patients experienced contralateral photophobia. Enucleation provided complete symptomatic relief in 54 patients (93%). Two of the four patients with persistent discomfort experienced painful facial paresthesias, attributed to prior retrobulbar alcohol injections. Ninety-one percent of the 32 patients who completed the follow-up survey reported pain relief after surgery, whereas 94% would recommend enucleation to others with blind, painful eyes. CONCLUSIONS: Trauma is the most common precipitating condition in patients undergoing enucleation of blind, painful eyes. These patients experience a variety of symptoms, including ocular pain, facial pain or paresthesias, tearing, and photophobia. Contralateral photophobia is not uncommon. Enucleation is highly effective in relieving these symptoms and should be considered in patients unresponsive to topical therapy. Facial paresthesias in patients who have received prior retrobulbar alcohol injections are not relieved by enucleation.

Adolescent↗
PubMed2002

New trends in neuromodulation for the management of neuropathic pain.

Since its first application in 1967, the methodology and technology of spinal cord stimulation for the management of chronic, intractable pain have evolved continuously. Despite these developments and improved knowledge of the effects of spinal anatomy and epidural contact configuration on paresthesia coverage, the clinical results of spinal cord stimulation-particularly the long-term effects-are still unsatisfactory in many patients. This dissatisfaction has come primarily from the failure of single-electrode configurations to provide consistent paresthesia coverage of the entire painful area. Therefore, new approaches were developed during the late 1990s that attempted to selectively cover one or more dermatomes with paresthesia as well as to provide sequential stimulation of different anatomic sites. These approaches have been applied both intraspinally and extraspinally by stimulating either the spinal nerves or the dorsal columns. To target parts of the latter, different methods have been developed and tested using either two-dimensional contact configurations or electronic field steering. These developments hold promise for improving long-term outcomes as well as increasing the number of pain conditions that can be treated with neuromodulation therapy. In this review, the history, theoretical basis, and evolution of these methodologies, as well as the ways in which they represent new trends in neuromodulation, are discussed.

Electric Stimulation Therapy↗
PubMed2005

Intentional lateral epidural catheter placement for anterior cruciate ligament reconstruction.

BACKGROUND: Unilateral epidural block might constitute a clinical option in lower limb orthopedic surgery. METHODS: Seventy-five patients undergoing anterior cruciate ligament reconstruction (ACLR) were randomized to either a laterally directed epidural catheter (IUEC, n = 40) or a classic midline catheter (CMEC, n = 35). Paresthesia encountered during catheter insertion was registered. The start dose of the anesthetic mixture clonidine 60 microg (0.4 ml), sufentanil 15 microg (0.3 ml) and ropivacaine 10 mg ml(-1)(10.3 ml) in 11 ml of total volume) was set at 5 ml and was increased by 2 ml if anesthesia was inadequate after assessment for sensory blockade to cold and pin-prick. Data were registered intra- and postoperatively regarding pain scores as well as motor block, hemodynamic parameters, adverse effects and need for supplemental analgesia other than a continuous postoperative epidural infusion. RESULTS: In the IUEC group 80% of patients reported a light paresthesia of the affected side during catheter insertion, whereas 71% of patients in the CMEC group reported no paresthesia at all. The amount of anesthetic used to establish surgical anesthesia was lower in the IUEC group (6.2 +/- 0.8 vs. 8 +/- 1.9 ml, P < 0.001). Motor block (Bromage score) of the unaffected side was significantly lower in the IUEC group (P < 0.001). Pain intensity scores, hemodynamic parameters, and supplemental analgesia given were similar between the two groups except for VAS scores at 12 h postoperatively, which were higher in the CMEC group (P < 0.01). Urinary retention was significantly more frequent in the CMEC group (19/35 vs. 5/40, P < 0.001). CONCLUSION: These results suggest that the IUEC technique is a feasible and efficient method for providing anesthesia and analgesia for ACLR and is associated with a lower consume of anesthetics, less motor block and a reduced incidence of urinary retention.

Adolescent↗
PubMed1992

Psychophysical correlates of phantom limb experience.

Phantom limb phenomena were correlated with psychophysiological measures of peripheral sympathetic nervous system activity measured at the amputation stump and contralateral limb. Amputees were assigned to one of three groups depending on whether they reported phantom limb pain, non-painful phantom limb sensations, or no phantom limb at all. Skin conductance and skin temperature were recorded continuously during two 30 minute sessions while subjects continuously monitored and rated the intensity of any phantom limb sensation or pain they experienced. The results from both sessions showed that mean skin temperature was significantly lower at the stump than the contralateral limb in the groups with phantom limb pain and non-painful phantom limb sensations, but not among subjects with no phantom limb at all. In addition, stump skin conductance responses correlated significantly with the intensity of non-painful phantom limb paresthesiae but not other qualities of sensation or pain. Between-limb measures of pressure sensitivity were not significantly different in any group. The results suggest that the presence of a phantom limb, whether painful or painless, is related to the sympathetic-efferent outflow of cutaneous vasoconstrictor fibres in the stump and stump neuromas. The hypothesis of a sympathetic-efferent somatic-afferent mechanism involving both sudomotor and vasoconstrictor fibres is proposed to explain the relationship between stump skin conductance responses and non-painful phantom limb paresthesiae. It is suggested that increases in the intensity of phantom limb paresthesiae follow bursts of sympathetic activity due to neurotransmitter release onto apposing sprouts of large diameter primary afferents located in stump neuromas, and decreases correspond to periods of relative sympathetic inactivity. The results of the study agree with recent suggestions that phantom limb pain is not a unitary syndrome, but a symptom class with each class subserved by different aetiological mechanisms.

Adult↗
PubMed1990

Postoperative effects and value of sural nerve biopsies: a retrospective study.

In order to compare the adverse effects with the benefits for the characterization of neuropathies after complete sural nerve biopsy, 56 out of 80 patients were examined postoperatively. Preoperatively, sensory deficits were reported by 30 patients (53%), paresthesia and dysesthesia by 18 (32%), and pain by 16 (28%). Twenty-one months after biopsy on the average, persistent loss of sensation was found in 52 patients (93%), persistent paresthesia and dysesthesia in 17 (30%) patients each, and persistent pain in 14 (25%) patients. Pain and paresthesia showed better postoperative improvement than the other sensory symptoms. 15 cases (27%) were diagnosed by histology alone. In 21 cases (37%), nonspecific histological findings contributed valuable diagnostic information. The remaining 20 cases (36%) continued to be unclear despite histology. Demyelinating or mixed-type neuropathies did not yield better results than purely axonal forms. We conclude that sural nerve biopsy is a valuable diagnostic tool, but its side-effects require careful selection of fully informed patients.

Adolescent↗
PubMedDate not supplied

Late-life migraine accompaniments--further experience.

In 1980, 120 cases with late-life migrainous accompaniments resembling transient ischemic attacks were presented. In the present paper, 85 further cases examined in the past five years are analyzed. The findings support the concept advanced previously. In general, the cases are divided into the same categories: visual--21 cases, visual and paresthesias--6, visual and speech disturbance--2, visual, paresthesias and speech disturbance--3, visual, paresthesias, speech disturbance, and weakness--20, visual and brainstem symptoms--3, and cases without visual symptoms--32. The ages ranged from 40 to 73 years. Headache occurred in association with the episodes in only 40% of cases. There was a history of recurrent headache in 65%. The condition can justifiably be regarded as benign. Migrainous accompaniments account for some of the cases of transient ischemia with normal angiograms. Knowledge of the condition helps in the planning of rational management.

Adolescent↗
PubMed2003

Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study.

OBJECTIVE: To evaluate the effect of reflexology on symptoms of multiple sclerosis (MS) in a randomized, sham-controlled clinical trial. METHODS: Seventy-one MS patients were randomized to either study or control group, to receive an 11-week treatment. Reflexology treatment included manual pressure on specific points in the feet and massage of the calf area. The control group received nonspecific massage of the calf area. The intensity of paresthesias, urinary symptoms, muscle strength and spasticity was assessed in a masked fashion at the beginning of the study, after 1.5 months of treatment, end of study and at three months of follow-up. RESULTS: Fifty-three patients completed this study. Significant improvement in the differences in mean scores of paresthesias (P = 0.01), urinary symptoms (P = 0.03) and spasticity (P = 0.03) was detected in the reflexology group. Improvement with borderline significance was observed in the differences in mean scores of muscle strength between the reflexology group and the controls (P = 0.06). The improvement in the intensity of paresthesias remained significant at three months of follow-up (P = 0.04). CONCLUSIONS: Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in MS patients.

Adult↗