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At least 469 records · Page 26Linked to original sources
PubMed1999

Sensory sequelae of medullary infarction: differences between lateral and medial medullary syndrome.

BACKGROUND AND PURPOSE: A comparison between long-term sensory sequelae of lateral medullary infarction (LMI) and medial medullary infarction (MMI) has never been made. METHODS: We studied 55 patients with medullary infarction (41 with LMI and 14 with MMI) who were followed up for >6 months. We examined and interviewed the patients with the use of a structured format regarding the most important complaints, functional disabilities, and the presence of sensory symptoms. The nature and the intensity of sensory symptoms were assessed with the modified McGill-Melzack Pain Questionnaire and the visual analog scale, respectively. RESULTS: There were 43 men and 12 women, with an average age of 59 years. Mean follow-up period was 21 months. The sensory symptoms were the most important residual sequelae in LMI patients and the second most important in MMI patients. In LMI patients, the severity of residual sensory symptoms was significantly related to the initial severity of objective sensory deficits (P<0.05). Sensory symptoms were most often described by LMI patients as numbness (39%), burning (35%), and cold (22%) in the face, and cold (38%), numbness (29%), and burning (27%) in the body/limbs, whereas they were described as numbness (60%), squeezing (30%) and cold (10%), but never as burning, in their body/limbs by MMI patients. LMI patients significantly (P<0.05) more often cited a cold environment as an aggravating factor for the sensory symptoms than did the MMI patients without spinothalamic sensory impairment. The subjective sensory symptoms were frequently of a delayed onset (up to 6 months) in LMI patients, whereas they usually started immediately after the onset in MMI patients. CONCLUSIONS: Our study shows that sensory symptoms are major sequelae in both LMI and MMI patients. However, the nature, the mode of onset, and aggravating factors are different between the 2 groups, which probably is related to a selective involvement of the spinothalamic tract by the former and the medial lemniscus by the latter. We suggest that the mechanisms for the central poststroke pain or paresthesia may differ according to the site of damages on the sensory tracts (spinothalamic tract versus medial lemniscal tract).

Adult↗
PubMed1999

Plantar fascia release through a transverse plantar incision.

A transverse plantar incision for plantar fascial release was assessed for pain relief, numbness, and subsequent heel pad symptoms. Twenty-seven feet in 26 patients who underwent plantar fascia release were reviewed with a minimum follow-up of 2 years after surgery (average, 37.6 months). Comprehensive data were obtained on 25 feet (24 patients) (93% response rate). The plantar fascia origin was completely transected in all cases. This led to complete resolution of symptoms in 19 feet and residual minor symptoms in six feet. After 2 years, four patients had developed recurrent symptoms, two in the area of surgery and two on the dorsum of the foot, in association with a pes planus foot. Two patients had some continued persistence of heel pain after surgery, although significantly less pain than preoperatively.Thus, 76% of patients had complete relieve of there symptoms, 12% of patients had mild symptoms not affecting daily activities, and 12% of patients had moderate symptoms that limited some activities. No patient suffered heel pad symptoms or numbness after surgery. It is concluded that plantar fascia release through a transverse plantar incision is a successful procedure for long-term relief of symptoms which avoids unnecessary heel pad numbness and scar morbidity. The benefits of a transverse incision include greater intraoperative vision, to ensure adequate release and spur excision, and an incision parallel to the medial calcaneal branches of the tibial nerve.

Adult↗
PubMed2006

Tarsal tunnel syndrome caused by a talocalcaneal joint amyloidoma in a long-term haemodialysis patient: a case report.

We present a case of tarsal tunnel syndrome caused by an amyloidoma arising from the talocalcaneal joint in a 64-year-old man with a long history of haemodialysis. He presented with numbness in the medial plantar area of the right foot without any antecedent trauma. The numbness was minimal at rest but gradually worsened, causing difficulty, when walking. Paraesthesia was present on the medial sole of the right foot. A positive Tinel-like sign was noted 2.5 cm below the medial malleolus. Magnetic resonance imaging demonstrated a round lesion, 1 cm in diameter, in the calcaneus, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. In addition, a mass, 1 cm in diameter with a signal isointense to that of muscle was found adjacent to the talocalcaneal joint. The medial plantar nerve was decompressed after removing a solid, 1-cm diameter mass from the talocalcaneal joint. At 6 months post surgery, the numbness had completely resolved. No recurrence was observed at the 24-month follow-up.

Amyloidosis↗
PubMed2005

Role of glial cell line-derived neurotrophic factor in germ-line stem cell fate.

The overall goal of this study is to unravel the role(s) played by glial cell line-derived neurotrophic factor (GDNF) in the fate of spermatogonial stem cells. There is great interest in the biology of spermatogonial stem cells, or A(single) spermatogonia, because of their importance in the treatment of infertility, the development of contraceptives, and the understanding of the etiology of testicular cancer, particularly seminoma. In the mouse, spermatogonial stem cells express GFRalpha-1, the receptor for GDNF, and respond to this growth factor in vivo and in vitro. GDNF is produced by the adjacent Sertoli cells, which are part of the germ-line stem cell niche in vertebrates. We specifically isolated GFRalpha-1-positive spermatogonia using an immunomagnetic bead technique. We then stimulated the cells with 100 ng/mL of rGDNF for 10 hours; unstimulated cells served as negative controls. Microarray analysis, immunocytochemistry, and Western blotting revealed that Numb, a regulator of the Notch pathway, is upregulated by GDNF in spermatogonial stem cells. There are indications that in rats, mice, and humans, the Notch pathway promotes spermatogonial differentiation. We observed that an increase in Numb expression is concomitant with Notch degradation in these cells. Thus, through Numb, GDNF might inhibit differentiation and allows the maintenance of the stem cell pool in the mouse seminiferous epithelium.

Animals↗
PubMed2006

Temporomandibular joint cyst presenting as trigeminal neuropathy and middle fossa mass: case report.

OBJECTIVE: We describe the case of a temporomandibular joint cyst eroding into the middle fossa, initially causing compression of the trigeminal nerve and trigeminal neuropathy, and ultimately causing destruction of the second division of the nerve with facial numbness. CLINICAL PRESENTATION: A 50-year-old woman with rheumatoid arthritis on prednisone developed right-sided, initially lancinating facial pain that ultimately became dull in nature in the maxillary division of the trigeminal nerve. This change in pain was associated with the development of numbness in the same distribution. The facial pain gradually resolved, but the facial numbness persisted. Imaging revealed a heterogeneously enhancing mass in the middle fossa lateral to Meckel's cave. INTERVENTION: During surgery, the dura was elevated, and a smooth, firm lesion with several thinly encapsulated, cystic areas containing viscous, white fluid was identified. The mass had eroded through the floor of the middle cranial fossa. The thick, fibrous capsule was freed from the bone edges and was sectioned sharply extracranially. Pathological evaluation was consistent with a cyst originating from the temporomandibular joint. CONCLUSION: Extracranial mass lesions involving the middle fossa structures are uncommon and typically arise from the parotid gland. This case represents the first example of a middle fossa mass originating from an abnormal temporomandibular joint and a unique cause of trigeminal neuropathy. After excision, there has been no recurrence after 2 years of follow-up.

Cranial Fossa, Middle↗
PubMed1999

A functional analysis of inscuteable and its roles during Drosophila asymmetric cell divisions.

Cellular diversity in the Drosophila central nervous system is generated through a series of asymmetric cell divisions in which one progenitor produces two daughter cells with distinct fates. Asymmetric basal cortical localisation and segregation of the determinant Prospero during neuroblast cell divisions play a crucial role in effecting distinct cell fates for the progeny sibling neuroblast and ganglion mother cell. Similarly asymmetric localisation and segregation of the determinant Numb during ganglion mother cell divisions ensure that the progeny sibling neurons attain distinct fates. The most upstream component identified so far which acts to organise both neuroblast and ganglion mother cell asymmetric divisions is encoded by inscuteable. The Inscuteable protein is itself asymmetrically localised to the apical cell cortex and is required both for the basal localisation of the cell fate determinants during mitosis and for the orientation of the mitotic spindle along the apical/basal axis. Here we define the functional domains of Inscuteable. We show that aa252-578 appear sufficient to effect all aspects of its function, however, the precise requirements for its various functions differ. The region, aa288-497, is necessary and sufficient for apical cortical localisation and for mitotic spindle (re)orientation along the apical/basal axis. A larger region aa288-540 is necessary and sufficient for asymmetric Numb localisation and segregation; however, correct localisation of Miranda and Prospero requires additional sequences from aa540-578. The requirement for the resolution of distinct sibling neuronal fates appears to coincide with the region necessary and sufficient for Numb localisation (aa288-540). Our data suggest that apical localisation of the Inscuteable protein is a necessary prerequisite for all other aspects of its function. Finally, we show that although inscuteable RNA is normally apically localised, RNA localisation is not required for protein localisation or any aspects of inscuteable function.

Animals↗
PubMed2002

Post radial artery harvest hand perception: postoperative 12-month follow-up results.

The 12-months' follow-up results for radial artery harvest in relation to complications are reported and compared with the postoperative 3-months' results. The postoperative wound problems of 155 patients who underwent coronary artery bypass grafting with radial artery harvesting were assessed using a questionnaire at 3 and 12 months after surgery. The questionnaire contained 9 statements concerning hand and forearm problems in daily life. The answers were graded in 7 levels. An answer of higher than grade 3 (mild symptoms) was regarded as a significant symptom. No hand ischemic complications was observed. In the 12 month-study, 152 patients (98.1%) were normal. Hand pain and numbness occurred in 25 patients (16.1 %) and 33 patients (21.3%), respectively, at 3 months and were markedly improved at 12 months (pain: 13 (8.4%), p = 0.045, numbness: 20 (12.9%), p = 0.069). Total scores for all questions also significantly decreased at 12 months (10.2 +/- 3.5) compared with 3 months (11.1 +/- 3.9) postoperatively (mean +/- SD, p = 0.0003). Radial artery harvest was quite acceptable from the patient's perception, although a few patients had numbness and pain in the 3 months after surgery. Those complications significantly improve in the later postoperative phase.

Coronary Artery Bypass↗
PubMed2006

Two cases of subacute combined degeneration: magnetic resonance findings.

We report two cases of subacute combined degeneration. Both patients had undergone total gastrectomy. The chief complaints were numbness in both upper extremities in case 1 and numbness in both the upper and lower extremities and gait disturbance in case 2. The pain, temperature, and vibration senses of both patients were decreased. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 level in both cases. In both cases T2-weighted magnetic resonance images showed an area of hyperintensity in the dorsal columns of the cervical spinal cord. The patients were treated with vitamin B12. The abnormal signals had disappeared on follow-up magnetic resonance examination 1 year later in case 1 and 3 months later in case 2. These patients showed neurological improvement, but the numbness in the upper extremities persisted even after the area of abnormal signal intensity had disappeared in case 1.

Aged↗
PubMed1991

[Analysis of subjective symptoms of upper extremities in dental technicians].

Our review of the literature showed no report on the subjective symptoms of the upper extremities in dental technicians. This study was therefore undertaken on 164 dental technicians in Gifu Prefecture to investigate the relationship between the subjective symptoms of the hands, arms and shoulders and work of dental technicians. The following results were obtained. 1) The prevalence of Raynaud's phenomenon and numbness of the fingers was 5.5 and 18.5 %, respectively. A significant positive correlation was observed between the prevalence and frequency of numbness and cold sensation in the fingers and the daily usage time (h) of high-speed type machines. In addition, pain in the fingers and around the wrists, and pain and numbness in the arms were significantly related to the daily usage time (h) of low-speed type machines. These results suggest that the usage of high- and low-speed type machines may be a cause of vibration syndrome among dental technicians. 2) A high prevalence of pain in the shoulders (30.8%), neck (30.1%), and back (36.3%) was observed in dental technicians. It is considered that these symptoms are related to the working posture and usage of machines.

Adult↗
PubMed2003

Backpacking-induced paresthesias.

OBJECTIVE: To evaluate the presence of numbness and paresthesias among long-distance backpackers on the Appalachian Trail. METHODS: Backpackers who hiked a minimum of 7 days were interviewed while hiking. Following their hike, a written questionnaire was mailed to the participants that explored the incidence of injuries and illnesses among hikers. Paresthesias were defined as either numbness or "phantom, burning, or shooting pains." A case-control analysis of risk factors for paresthesias was performed. RESULTS: Paresthesias were reported by 34% (96 of 280) of the backpackers completing the study. They included ulnar paresthesias (n = 4), meralgia paresthetica (n = 10), tarsal tunnel syndrome (n = 6), digitalgia paresthetica (n = 21), and nonspecific paresthesias (n = 61). The most common symptom was numbness: 81% (78 of 96). Significant risk factors included a distance of >2000 miles (relative risk [RR] = 1.3; 95% CI, 1.1-1.6; P = .01) and the duration of hiking (RR = 2.0; 95% CI, 1.2-3.2; P = .004) for the longest quartile. Nonsignificant factors included backpack weight, initial body weight, percentage of weight loss, running shoe usage, and multivitamin usage. Ninety-eight percent of the paresthesias (94 of 96) had resolved by the time of follow-up (median = 30 days). CONCLUSIONS: Paresthesias were a surprisingly common complaint among long-distance backpackers. Although they were distressing during backpacking, these neuropathies were self-limited and resolved after completion of hiking.

Adult↗
PubMed1997

Procurement of bone graft from the iliac crest. An operative approach with decreased morbidity.

We compared the donor site morbidity in fifty-seven consecutive patients in whom a bone graft had been procured from the iliac crest through an incision parallel to the superior cluneal nerves and perpendicular to the posterior iliac crest (the study group) with that in fifty-three consecutive patients in whom the graft had been procured through an oblique incision parallel to the posterior iliac crest (the control group). Numbness, tenderness, and pain at the donor site one and six months postoperatively were assessed by means of an interview with the patient and a review of the records. The prevalence of symptoms in the control group was greater than that in the study group. At one month, thirty-nine patients (74 per cent) in the control group had numbness, compared with twenty-five (44 per cent) in the study group (p = 0.001). At six months, thirty-one patients (58 per cent) in the control group had numbness, compared with fourteen (25 per cent) in the study group (p = 0.0002). Thirty-six patients (68 per cent) in the control group and twenty-four (42 per cent) in the study group had tenderness over the incision at one month (p = 0.005), and twenty-seven (51 per cent) and eleven (19 per cent), respectively, had tenderness at six months (p = 0.0003). Forty patients (75 per cent) in the control group and forty-six patients (81 per cent) in the study group had deep pain in the region of the iliac crest at one month, compared with thirty-two (60 per cent) and thirty-one (54 per cent), respectively, at six months. The mean analog score for pain at the donor site was 7 of 10 points in the control group and 6 points in the study group (p = 0.001) at one month and 3 and 2 points, respectively, at six months (p = 0.001).

Activities of Daily Living↗
PubMed2006

Stereotactic radiosurgery using CT cisternography and non-isocentric planning for the treatment of trigeminal neuralgia.

OBJECTIVE: Frame-based radiosurgical rhizotomy has been shown in clinical studies to be effective for managing trigeminal neuralgia (TN). To date, however, only a small pilot study has been published for the frameless, image-guided CyberKnife system. We present our preliminary experience with 29 trigeminal neuralgia patients treated with the frameless CyberKnife using X-ray image-guided targeting, a novel CT method for target definition, and non-isocentric planning. MATERIALS AND METHODS: All 29 patients failed previous medical therapy and 14 had undergone prior surgical procedures. CT iohexal cisternography was used to identify the 6- to 8-mm segment of nerve to be lesioned. The marginal dose ranged from 60 to 70 Gy (median 66.4 Gy) as defined at an average 79th percentile. The corresponding Dmax varied from 71.4 to 86.4 Gy (median 77.91 Gy). RESULTS: After a median 10-month follow-up, 26 of 29 (90%) patients rated their pain control as excellent and 3 (10%) reported no improvement. Median time to improvement was 6 days. No or only minor progression in numbness was reported by 22 of 29 (76%) patients, 4 of 29 (14%) patients reported worsening, and 3 of 29 (10%) reported the onset of severe ipsilateral facial numbness. Two patients whose target volume inadvertently included the semi-lunar ganglion developed painful dysethesias in the distribution of their numbness. CONCLUSION: Although the optimal dose and length of nerve to be lesioned are still being refined, this preliminary experience suggests that image-guided robotic radiosurgery can effectively lesion the trigeminal nerve. Further follow-up is needed to determine whether our method has advantages over the more commonly used procedure for radiosurgical trigeminal rhizotomy.

Adult↗
PubMed2005

Comparison of posterior fossa exploration and stereotactic radiosurgery in patients with previously nonsurgically treated idiopathic trigeminal neuralgia.

OBJECT: Stereotactic radiosurgery (SRS) is commonly performed in patients with trigeminal neuralgia, and numerous investigators have found that facial pain outcomes after this procedure are better for patients in whom prior surgery did not fail. Researchers in some centers claim that the results of SRS are equivalent to posterior fossa exploration (PFE). The goal in this study was to verify that claim. METHODS: Information was retrieved from a prospectively maintained database of patients less than 70 years old with idiopathic trigeminal neuralgia who underwent PFE (55 patients) or SRS (28 patients) as their initial surgery between 1999 and 2004. Of the two groups, patients who underwent radiosurgery were older (60.5 compared with 50.7 years, p<0.001). Microvascular decompression was performed in 49 patients (89%) and partial nerve section was performed in six (11%) in the PFE group. The mean maximum dose for SRS was 89.1 Gy. At a mean follow-up duration of 25.5 months, patients who had undergone PFE were more commonly pain free without medications (75% at 1 year, 72% at 3 years) compared with the patients treated with SRS (59% at 1 and 3 years; p = 0.01). Additional surgery was performed in 10 patients (18%) after PFE, compared with eight patients (29%) after SRS (p = 0.4). Eight patients (15%) had either new facial numbness (six cases) or dysesthesias (two cases) after PFE, whereas 12 (43%) had either new facial numbness (eight cases) or dysesthesias (four cases) after SRS. No correlation was noted between the development of facial numbness and facial pain outcome after PFE (p = 0.37), whereas patients in whom trigeminal dysfunction developed after radiosurgery were more frequently free of pain (p = 0.02). CONCLUSIONS: The results support PFE as a more effective primary surgery than SRS in patients with idiopathic trigeminal neuralgia. Moreover, injury to the trigeminal nerve during PFE is not required to achieve excellent facial pain outcomes.

Cranial Fossa, Posterior↗
PubMed1983

Quantitative analysis of lesion parameters in radiofrequency trigeminal rhizotomy.

A series of 144 lesions made during 32 radiofrequency rhizotomies was reviewed. The parameters of each lesion were compared with the sensory change resulting from the lesion. One-half of the lesions resulted in no sensory change, but 16.7% produced numbness in a division not predicted by stimulation. This was a barely detectable sensory change in 6% of lesions and more dense in 10%. The first lesion in a series was particularly likely to result in sensory deficit, and accounted for half of the more dense lesions not predicted by stimulation. When the threshold at which stimulation was perceived was 0.2 volts or less, a lesion was likely to produce numbness, and when it was 0.5 volts or greater, marked sensory loss did not occur. There was no apparent relationship between the likelihood of sensory change and lesion temperature or duration. Analysis of lesion temperature was made more difficult by the use of low temperatures when numbness should be easy to obtain. With careful technique, radiofrequency rhizotomy can be performed with acceptable risk of unpredicted sensory loss. Particular care should be taken during the first lesion in each procedure and when stimulation thresholds are 0.2 volts or less.

Aged↗
PubMed2000

Gamma knife radiosurgery as a primary treatment for prolactinomas.

OBJECT: The purpose of this study was to estimate the efficacy of gamma knife radiosurgery (GKS) in controlling tumor growth and endocrinopathy associated with prolactinomas. METHODS: Between 1993 and 1997, 164 of 469 patients with pituitary adenomas treated by GKS harbored prolactinomas. The dose to the tumor margin ranged from 9 to 35 Gy (mean 31.2 Gy), and the visual pathways were exposed to a dose of less than 10 Gy. The mean tumor diameter was 13.4 mm. The mean follow-up time for 128 cases was 33.2 months (range 6-72 months). Tumor control was observed in all but two patients who underwent surgery 18 and 36 months, respectively, after GKS. Clinical cure was achieved in 67 cases. Clinical improvement was noted with a decrease in the hyperprolactinemia after GKS. Nonetheless, in 31 (29%) of 108 patients who were followed for more than 2 years no improvement in serum prolactin levels was demonstrated, although this could be normalized by bromocriptine administration after treatment. Nine infertile women became pregnant 2 to 13 months after GKS and all gave birth to normal children. There was no visual deterioration related to GKS. Five women experienced premature menopause. In these patients there was subtotal disappearance of the tumor and an empty sella developed. CONCLUSIONS: Gamma knife radiosurgery as a primary treatment for prolactinomas can be safe and effective both for controlling tumor growth and for normalization of prolactin hypersecretion. A higher margin dose (> or = 30 Gy) seemed to be associated with a better clinical outcome. Gamma knife radiosurgery may make prolactinomas more sensitive to the bromocriptine.

Humans↗
PubMed2005

Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response.

OBJECT: The purpose of this study was to assess the durability and completeness of pain relief in patients treated using stereotactic gamma knife surgery (GKS) for trigeminal neuralgia (TN). METHODS: Thirty-eight patients with refractory TN were treated with stereotactic GKS. All patients received a prescription radiation dose of 35, 40, or 45 Gy to the 50% isodose surface through a 4-mm collimator helmet. The group was assessed regularly based on physician-directed interviews for a median follow up of 24 months (range 6-27 months). Pain relief was classified as excellent (no pain without medication), good (well-controlled pain with continued medication), fair (decreased but residual pain with continued medication), or poor (unimproved or increased pain with the same or increased medication). Three months after treatment, pain relief was good or excellent in 71% of patients. By 24 months post-GKS, 50% of the original cohort had poor pain relief, 21% continued to have either excellent or good relief, 3% had fair relief, and 26% had not reached the 24-month follow up. Based on their status at the last follow up, 29% of patients had excellent and 16% had good pain relief. Thirty-seven percent experienced facial numbness, which was dose related. In addition, there was a significantly higher rate of complete pain relief in patients who had facial numbness following treatment (p = 0.003). CONCLUSIONS: Stereotactic GKS is an effective treatment in patients with TN; however, the durability of pain relief and the time to treatment response are limiting factors. As with other types of ablative treatment, facial numbness is strongly associated with better treatment response.

Adult↗
PubMed1998

Measurement of palatal surface sensation by neuro-sensory tests in the postoperative cleft palate patients.

To clarify the effects of abnormal sensation on the palatal surface on speech sounds in postoperative cleft palate patients, we measured palatal surface sensation in these patients. Tactile and vibratory sensation were measured quantitatively using a SW sensemeter and a vibrometer. The obtained values were compared with those in controls. The following results were obtained. In both the postoperative cleft palate patients and controls, the sensation in the anterior region of the hard palate was more numb than that in the anterior region of the soft palate or the premolar alveolar region. The tactile sensation in the postoperative cleft palate patients was more numb than that in the controls. In particular, a marked difference was observed in the premolar alveolar mucosa. The vibratory sensation in the postoperative cleft palate patients, however, did not clearly differ from that in the controls. There was a positive correlation between the tactile sensory threshold and the vibratory sensory threshold in the controls. No association between the two thresholds was observed in the postoperative cleft palate patients. The authors concluded that the tactile sensation at premolar alveolar region in the postoperative cleft palate patients was more numb than in the controls. This abnormality may affect speech development.

Adolescent↗
PubMed2000

Assessment of trigeminal somatosensory evoked potentials in burning mouth syndrome.

OBJECTIVE: The measurement of pain threshold (PT) and the assessment of trigeminal somatosensory evoked potentials (TSEPs) were performed. These experiments indicated the pathological conditions of nerve afferent and efferent pathways in patients with burning mouth syndrome (BMS). This study also explored the probable pathophysiological mechanisms in BMS. MATERIALS AND METHODS: The dorsum linguae of 38 samples in 19 subjects (22 BMS with pain, 10 BMS with numbness, and 6 controls) were stimulated by electroneuromyography. PT was measured as the lowest stimulation intensity the subjects could detect. N3, P4 latency, and spike potential latency of TSEP were recorded by stimulating the lingual nerve. RESULTS: Pain thresholds were significantly lower, N3, P4 latencies were significantly shorter, and the spike potential appeared earlier in the BMS with pain group (P < 0.01). The opposite tendency of these values presented in the BMS with numbness group (P > 0.05). CONCLUSIONS: The results indicated that the nerve sensitivity was elevated in the BMS with pain group, and that these patients were easily affected by etiological factors. In the BMS with numbness group, partial or complete nerve blockage may have been indicated. This study suggested that selfreports of BMS pain appeared to be of value, and that there were pathological conditions in nerve transmission. It supported the theory that peripheral or central nervous system involvement might play an important role in BMS. It was possible to show the pathogenesis of BMS. All of these objectively explain the clinical understanding of BMS, and may be of assistance in the treatment of BMS.

Afferent Pathways↗