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At least 685 records · Page 38Linked to original sources
PubMed2001

Impact of axillary level I and II lymphnode dissection on the therapy of stage I and II breast cancer.

BACKGROUND: Routine performance of axillary node dissection (AND) in the treatment of stage I and II breast cancer has become controversial because of pretended morbidity of this procedure and progressing consent for sentinel lymphadenectomy. METHODS: Ninety-four consecutive patients who underwent AND for clinical stage I and II breast cancer were evaluated for a range of 48.3 months after surgery for movement and sensory alterations and arm swelling. Arm circumference was measured in all patients at the same four sites on both the operated and non operated sides preoperatively and in the immediate and late postoperative course. Capacity for movement was assessed pre- and postoperatively as active ranging at the shoulder joint. Postoperative numbness and paresthesias were assessed by standard questions. RESULTS: No patient had axillary recurrence. None of the detected differences between the preoperative and postoperative arm circumferences reached statistical significance. No persistent motion limitation was observed. Pain, numbness, paresthesia were detected in almost all patients in the immediate postoperative period but resolved spontaneously in all cases within 6 months. The obese body habit was detected on multivariate analysis as the only significant predictor of edema. CONCLUSIONS: No significant morbidity and no axillary recurrence were observed in current experience to follow AND. These findings suggest that axillary level I and II dissection remains an effective and safe tool for diagnostic, as well therapeutic, purposes in the treatment of stage I and II breast cancer. Further studies are necessary before it can safely be reported that axillary node dissection is an optional part of the treatment of stage I and II breast cancer.

Adult↗
PubMedDate not supplied

[Isolated posterior cord syndrome in Lyme s disease: a clinico neurophysiological study].

INTRODUCTION: Lyme disease, caused by spirochete Borrelia burgdorferi, is a multisystemic infectious disorder with prominent neurologic involvement, affecting both the peripheral and the central nervous system. Meningitis, cranial neuritis and radiculoneuritis are the usual manifestations in the acute phase, and peripheral neuropathy in the chronic phase. Other less common manifestations have been also described. Here we report one case of Lyme disease confirmed by PCR, with a previously undescribed neurological manifestation, and the neurophysiological studies performed before and after treatment. CLINICAL CASE: Our patient showed a chronic and progressive clinical picture consisting of instability on walking and distal paresthesia of lower limbs, suggestive of posterior column disfunction. The neurophysiological exam performed prior to treatment with ceftriaxone revealed bilateral absence of lower limbs somatosensory evoked potentials (SEPs), without alterations in the distal nervous conduction or in upper limbs SEPs. The exam performed after treatment revealed a partial recovery of lower limb SEP with presence of an evoked response in SEP of left lower limb, coincident with a transitory clinical improvement of paresthesia in the same extremity. CONCLUSIONS: Our findings reveal that posterior column disfunction can be a neurological manifestation of Lyme disease. Furthermore the neurophysiological study shows that this manifestation is partially reversible following treatment. Our study emphasize the importance of the neurophysiological tests for the diagnosis and follow up of neurological manifestations of Lyme disease.

Borrelia burgdorferi↗
PubMed2001

[A case of chronic methyl bromide intoxication showing symmetrical lesions in the basal ganglia and brain stem on magnetic resonance imaging].

A 30-year-old man developed paresthesia in the feet, unstable gait and blepharoptosis subsequent to pharyngeal pain while working in a warehouse of imported fruit and vegetable fumigated with methyl bromide and cyanate. Neurological examination showed bilateral blepharoptosis, diplopia, ataxic gait and paresthesia below the inguinal region. The serum concentration of thiociane, a metabolite of cyanide, was within normal limits, but that of bromide was elevated (43.7 mg/l, normal: 3.7-8.6). Thus we diagnosed the patient as intoxication of methyl bromide. Magnetic resonance imaging of the brain (MRI) revealed bilateral symmetrical lesions of high signal intensity in the posterior region of the putamen, the subthalamic nuclei, the dorsal medulla oblongata corresponding to inferior cerebellar peduncles and vestibular nuclei, the inferior colliculi and the periaqueductal gray matter surrounding the oculomotor nucleus of the midbrain. As far as we know, this is the first report of MRI detected cerebral lesions in a case with intoxication of methyl bromide.

Adult↗
PubMed2002

[Combined block of femoral, sciatic, obturator nerves and lateral cutaneous nerve block with ropivacaine for leg amputation above the knee].

A 76-yr-old male presented for leg amputation above the knee. The patient complained of dyspnea due to pulmonary embolism occurring 3 weeks before operation. In addition, the patient could not report paresthesias because he had suffered from a cerebral infarction. Anesthesia was performed with combined block of femoral, sciatic, obturator nerves and the lateral cutaneous nerve of the thigh. The nerves were anesthetized with 0.75% ropivacaine solution 31 ml by use of an electrical nerve stimulator and an insulated needle. Nerve stimulation technique is the best choice for patients who are unable to report paresthesias reliably.

Aged↗
PubMedDate not supplied

[Electrophysiological evaluation of a case of sensory-motor multifocal acquired demyelinating neuropathy. The effects of immunoglobulin therapy].

INTRODUCTION: Sensory motor multifocal acquired demyelinating neuropathy (SMMADN) is a variant of the chronic multifocal neuropathies. Several reports have been published about the clinical and electrophysiological progression in motor multifocal neuropathy (MMN) prior to and following immunoglobulin (Ig) therapy, but we have found no reports that deal with SMMADN. AIMS: We describe a case of SMMADN in which we conducted a clinical and electrophysiological evaluation before and after therapy with Ig UNC Hemoderivados. CASE REPORT: Female, 40 years of age, who presented asymmetrical weakness in all four limbs which she had been suffering for 12 years. We observed distal muscular atrophies, notable weakness and paresthesias in the four limbs. Electrophysiological studies revealed demyelinating neuropathy with secondary axonal involvement. Intravenous Ig was indicated. We observed a clear improvement in muscular strength, and changes in motor and sensory conduction speeds, but not in the amplitudes of the respective potentials. CONCLUSION: SMMADN is a chronic sensory motor multiple mononeuropathy that begins in the upper limbs and progresses asymmetrically down towards the lower members. The most usual sensory disorders are distal paresthesias. Electrophysiology presents conduction blockages, temporal dispersion, prolongation of the distal latencies, diminished conduction speeds, absence or prolongation of the F wave in one or more motor nerves, and abnormal sensory conduction speed. Accepted treatment is with Ig and, in some cases, with corticoids. In our case, the variations that were obtained could be explained by myelin reconstitution following the immunomodulatory effect of Ig and the axonal involvement that existed due to the secondary sequelae of the inflammatory process.

Adult↗
PubMed2003

[A case of Crow-Fukase syndrome with extramedullary plasmacytoma: marked clinical deterioration following a biopsy to plasmacytoma].

A 66-year-old man developed paresthesia of the distal parts of the bilateral lower limbs a week after his upper respiratory infection, followed by the weakness with the legs and paresthesia with the lip area, tongue and finger tips. Those symptoms gradually became worse to the point that he was unable to walk 10 days later. Although skin pigmentation, edema, and lymph node swelling were not found, we made a diagnosis of Crow-Fukase syndrome (CFS) because of clinical features of polyneuropathy, IgG-lambda type M proteinemia, endocrinological abnormality, elevated plasma level of vascular endothelial growth factor (VEGF) and extramedullary plasmacytoma in his abdomen. Following intravenous immunoglobulin therapy (IVIg), he showed marked improvement. However, his neurologic symptoms deteriorated acutely just after open biopsy together with the elevation of VEGF level, and a few days later he was in the state of flaccid quadriparesis. We tried IVIg therapy again and his neurologic symptoms were markedly improved. We speculated that an elevated VEGF, released from plasma cells induced by the bioprocedure, might have caused an increase in microvascular permeability and affected the blood-nerve-barrier, thereby his neurologic symptoms deteriorated. It is thought that this case may support the hypothesis that a significant role is played by VEGF in the pathomechanism of the development of CFS. Additionally we experienced that IVIg was very effective to the neurologic symptoms, and we think that IVIg will be able to be one of the future therapy of the CFS. To our knowledge, there has been no report of CFS which manifested acute deterioration of his neurologic symptoms just after open biopsy with acute onset with Guillain-Barré syndrome like symptoms.

Aged↗
PubMed1992

[Schwannoma located in the tongue. A clinical case report].

Schwannoma or neurilemmoma and neurofibroma are two tumors of the peripheral nerves originating in the nerve sheaths. Schwannoma account for just over 1% of benign tumors reported in the oral cavity. The tongue is unanimously considered the most frequent site at this level; however, the tip is the least affected part of the organ. The case of schwannoma reported here is the third observed with a lingual localization in 18 years by the Division of Maxillo-Facial Surgery of The Odontostomatological Clinic of the University of Turin. The case is of interest due the rarity of this pathology and the presence of non-significant symptoms for a presumed initial diagnosis. CASE REPORT. A 21-year-old woman was referred to our attention following the appearance two years earlier of a slowly growing swelling on the tip of the tongue. The patient complained of the fastidious presence, disturbance to mastication and phonation and occasional paresthesia of the tip of the tongue. The small mass, which was clearly evident on examination, was covered with normal mucosa. On palpation it had a hard-elastic consistency; it was slightly painful, smooth and partial mobile on surrounding levels. The patient underwent the surgical removal of the neoplasia under anesthesia. The mass was well capsulated and a good cleavage plane was easily found. The neoformation was yellowy grey, oval bean-shaped, measuring 1.9 x 1.3 x 1.1 cm. The histological diagnosis, confirmed by immunohistochemical tests, was benign Antoni's, type A schwannoma. The postoperative period was good an there was no recidivation during the course of a one-year follow-up. DISCUSSION AND CONCLUSIONS. Benign schwannoma, which are relatively rare in the oral cavity, represent a pathology which are often not taken into account during clinical practice. Symptoms which take the form of slight hypoesthesia and vague paresthesia may lead to the suspected diagnosis of this type of neoplasia. The final diagnosis is always made after a definitive histological examination. Differential diagnosis must be made in relation to malignant tumors (on the basis of anamnestic data relating to the speed of growth and clinical appearance of the neoplasia) and, above all, in relation to numerous benign neoformations based on epithelial and connective tissues (lipoma, fibroma, leiomyoma and adenoma). Treatment is always surgical: in the case reported here, the exeresis of the lesion also allowed its histological characterization (excisional biopsy). Surgery was conservative and did not require local or locoregional prophylactic measures. After the final histological diagnosis of schwannoma, the patient underwent a thorough general objective examination to check the presence of other characteristic signs of Von Recklinghausen's syndrome, have a probability of malignant degeneration ranging between 5 and 16%. Isolated schwannoma hardly ever become malignant and in general, if exeresis is complete, no recidivation occurs after surgery.

Adult↗
PubMed1992

Some observations on whiplash injuries.

Motor vehicle accidents with a whiplash mechanism of injury are one of the most common causes of neck injuries, with an incidence of perhaps 1 million per year in the United States. Proper adjustment of head restraints can reduce the incidence of neck pain in rear-end collisions by 24%. Persistent neck pain is more common in women by a ratio of 70:30. Whiplash injuries usually result in neck pain owing to myofascial trauma, which has been documented in both animal and human studies. Headaches, reported in 82% of patients acutely, are usually of the muscle contraction type, often associated with greater occipital neuralgia and less often temporomandibular joint syndrome. Occasionally migraine headaches can be precipitated. Dizziness often occurs and can result from vestibular, central, and cervical injury. More than one third of patients acutely complain of paresthesias, which frequently are caused by trigger points and thoracic outlet syndrome and less commonly by cervical radiculopathy. Some studies have indicated that a postconcussion syndrome can develop from a whiplash injury. Interscapular and low back pain are other frequent complaints. Although most patients recover within 3 months after the accident, persistent neck pain and headaches after 2 years are reported by more than 30% and 10% of patients. Risk factors for a less favorable recovery include older age, the presence of interscapular or upper back pain, occipital headache, multiple symptoms or paresthesias at presentation, reduced range of movement of the cervical spine, the presence of an objective neurologic deficit, preexisting degenerative osteoarthritic changes; and the upper middle occupational category. There is only a minimal association of a poor prognosis with the speed or severity of the collision and the extent of vehicle damage. Whiplash injuries result in long-term disability with upward of 6% of patients not returning to work after 1 year. Although litigation is very common and always raises questions of secondary gain in patients with persistent symptoms, most patients are not cured by a verdict. Acute treatment of neck pain consists of ice for 24 hours followed by heat applications, pain pills, NSAIDs, and muscle relaxants. Trigger point injections can be beneficial in both the acute and the persistent phases. Use of cervical collars should probably be kept to a minimum during the first 2 to 3 weeks after the injury and then avoided. Early passive mobilization and range of motion exercises may accelerate recovery. Physical therapy and transcutaneous nerve stimulators may be helpful in reducing pain and improving movement.(ABSTRACT TRUNCATED AT 400 WORDS)

Diagnosis, Differential↗
PubMed2003

[A case of multiple sclerosis with incongruous homonymous hemianopia due to lateral geniculate body lesion].

We report a rare case of a 31-year-old woman who was diagnosed as multiple sclerosis with homonymous hemianopia due to a demyelinative lesion in the lateral geniculate body. Paresthesia appeared in the distal parts of both legs from September, 2002. She complained of loss of visual field in both eyes 2 months later. Since a left asymmetric wedge-shaped homonymous hemianopia was detected by Octopus automatic perimetry, she was referred to our hospital on December 2, 2002. Neurological examination showed subjective paresthesia in the distal parts of both legs in addition to Lhermitte's sign. Brain MRI showed demyelinated lesions in the lateral geniculate body on the right and periventricular areas of the lateral ventricles. Spinal MRI revealed a demyelinated lesion in the upper cervical cord. She was diagnosed as multiple sclerosis and underwent a steroid pulse therapy. Homonymous hemianopia resolved a few days later.

Adult↗
PubMed1992

[A case of myasthenia gravis occurring in the period of remission of chronic inflammatory demyelinating polyradiculoneuropathy].

A 31-year-old woman noticed progressive muscular weakness in the limbs and paresthesia in the fingers in February 1989. Paresthesia worsened and improved 4 times during 2 months. Intravenous edrophonium chloride failed to improve her muscular weakness. She had high antiacetylcholine receptor antibody titer in serum. We made a diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) because of slow nerve conduction velocity (NCV), increased CSF protein, and the clinical course. Treatment with prednisolone improved muscular weakness and the slow NCV. Two years later she acutely had dyspnea, dysphagia, and muscular weakness after upper respiratory infection. Intravenous edrophonium chloride dramatically improved her symptoms. The diagnosis was made as myasthenia gravis (MG). After thymectomy her weakness was getting better without any medications. There may exist an autoimmune mechanism common, at least in part, to both CIDP and MG in our patient.

Adult↗
PubMed2004

[Tolerability of riluzole: a review of the literature].

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with the fatal evolution. Recent studies in knowledge of the pathogenic mechanisms underlying ALS showed that the excitotoxicity has an important role in the neurodegeneration. The riluzole, an antagonist of glutamate, is the first drug approved by FDA for the treatment of patients with ALS. The efficacy of riluzole (dose recommended 50 mg twice a day) in prolonging the survival of patients with ALS has been demostrated in two principal controlled clinical trials. The most frequent adverse events related to riluzole treatment were: nausea, vomiting, anorexia, diarrhea, asthenia, somnolence, vertigo, circumoral paresthesia, abdominal pain and dizziness. Some events tend to be related to the dose: vertigo, diarrhea, nausea, circumoral paresthesia and anorexia appear more frequently with 200 mg/die that with lower dose. Generally with tree months from the beginning of the treatment with riluzole, an increase serum transaminase levels has been noted; mostly transient and regressing after two-sex months of treatment. A monitoring of serum transaminase levels is suggested during the first year of treatment with riluzole The clinical studies shows that the adverse events produced by riluzole are mostly reversible and dose-dependent, this demostrates a satifying profile of tolerability of the drug. Anyway, a deeper knowledge of its tolerability may lead us to a better use of riluzole, avoiding in this way the interruption of treatment.

Excitatory Amino Acid Antagonists↗
PubMed2004

Variability in the extent of sensory deficit after sural nerve biopsy.

BACKGROUND: Sural nerve biopsy (SNBx) is associated with multiple complications such as paresthesia, pain, or numbness in the sural nerve distribution at the site of biopsy and wound infection. An accurate idea of these adverse events would be useful while taking informed consent from patients. AIMS: We conducted a prospective study to determine the extent of sensory deficits after SNBx. SETTINGS AND DESIGN: It is a prospective, hospital-based (tertiary teaching hospital) study. MATERIALS AND METHODS: All the patients who had SNBx between May 2003 and March 2004 were eligible for inclusion. However, patients with sensory impairment in sural nerve territory or abnormal sural nerve conduction studies prior to the procedure were excluded. SNBx was performed in the ankle region under local anesthesia, and a 3 cm nerve segment was excised. Touch, pain, temperature, vibration and joint position were tested after the nerve biopsy. The extent of sensory deficit was determined. Any other complications, when present were also noted. Follow-up assessment was performed at three months or later. RESULTS: Fifty patients (26 women) fulfilled the inclusion and exclusion criteria. The mean age was 37.4 (16-63) years. One-two weeks after the SNBx, 46 (92%) patients had sensory deficit along the lateral aspect of the foot at the site of the biopsy, and 48 (96%) patients had sensory impairment extending beyond the outer aspect of the fifth toe. At follow-up, sensory deficit was present in 89% patients and paresthesia in 39%. CONCLUSIONS: The majority of the patients undergoing SNBx develop persistent sensory deficits, which often extend beyond the typical sural nerve territory.

Adolescent↗
PubMed2004

Acute Pain Service and multimodal therapy for postsurgical pain control: evaluation of protocol efficacy.

AIM: The institution of a postoperative Acute Pain Control Service is mandatory to improve the control of pain induced by surgical injury. Treatment of postoperative pain may be achieved using a combination of analgesic agents and techniques, reducing the incidence of side effects owing to the lower doses of the individual drugs. In 1997 we established an Acute Pain Service (APS) at the San Raffaele Hospital in Milan. The aim of this study was to assess the efficacy and safety of our APS both in terms of treatment protocols and organisational issues. METHODS: In this prospective observational study we included 592 patients undergoing abdominal, gynecological, or orthopedic surgery with severe expected pain. According to general guidelines on pain treatment, the patients were assigned to different treatment protocols based on the kind of operation. All protocols were based on the multimodal therapy, with the association of nonsteroidal anti-inflammatory drugs (NSAIDS), opioids and regional anesthesia techniques. During the first 48 h of the postoperative period we recorded vital signs, level of pain and occurrence of any side effect. RESULTS: Our analgesic protocols proved to be effective and safe (low incidence of side effects) for every surgery. The incidence of postoperative nausea and vomiting was higher in patients receiving patient-controlled morphine than that with continuous epidural or nerve block. After lower abdominal surgery, pain at movement at 24 h was significantly lower in the epidural group than in the Patient Control Analgesia group. Nausea and vomiting, numbness and paresthesias at the lower limbs were higher in gynecological patients. A larger percentage of orthopedic patients in the epidural group reported numbness and paresthesias at the lower limbs in comparison with patients receiving continuous peripheral nerve block. CONCLUSION: In agreement with previous literature, this study confirmed that a multimodal approach to pain treatment provides an adequate control of postoperative pain, minimizing side effects.

Abdomen↗
PubMed2004

Adverse effects of GH self administration on peripheral nerve. A case report.

To our knowledge there is no evidence of multientrapment neuropathy related to growth hormone (GH) administration. We observed the case of a 45-year-old bodybuilder complaining of paresthesias and dysesthesias of the hands and feet after self-administration of high-dose of recombinant GH therapy. The patient complained of transitory symptoms after each cycle of GH therapy. The electrodiagnosis showed: 1) moderate right carpal tunnel syndrome (CTS) and minimal left CTS; 2) mild right ulnar entrapment at elbow; 3) a reduction of motor nerve conduction velocity of the left ulnar nerve across elbow; 4) a reduction of the amplitude of the sensory nerve action potential of the left ulnar nerve in digit-wrist segment; 5) the absence of the ulnar F wave bilaterally registering from abductor digiti minimus. Our data suggest a multiple entrapment condition of the upper limbs; furthermore, based on the history (paresthesia at feet), we can hypothesize a mild involvement of distal sensory fibres in the legs (neurophysiologically negative). The anecdotal history and neurophysiological findings of this case suggest an increased awareness to the adverse effects of GH on peripheral nerve.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[Diagnostic and therapeutic management of essential thrombocythemia in children].

BACKGROUND: Essential thrombocythemia is a myeloproliferative disease resulting from the clonal proliferation of a multipotent myeloid stem cell with an increased platelet count in peripheral blood. In 2% of cases the cause remains unknown. It is then called idiopathic essential thrombocythemia. THE AIM: The objective of this study was to present the diagnostic and therapeutic management of essential thrombocythemia in children. MATERIAL AND METHODS: The authors analysed complete medical records of 5 patients treated for essential thrombocythemia in the Department of Children Haematology and Oncology, Medical University Lublin during a 6 years (1996-2002) period. The investigated group consisted of 5 children: 3 boys and 2 girls with mean age of 7 years and 8 months (varying from 5 years and 3 months to 11 years and 8 months). RESULTS: The peripheral platelet count was above 1200 x 10(9)/L. Three patients developed functional symptoms of microvascular blood flow alteration (headaches, sensory disorders. paresthesiae). In 2 patients thrombocythemia was asymptomatic and the diagnosis was made incidentally. Diagnosis of essential thrombocythemia was made according to the criteria of the Polycythemia Vera Study Group and treatment with anagrelide hydrochloride was started. One patient due to bad drug tolerance was treated with hydroxyurea. Treatment of essential thrombocythemia in all patients resulted in: (1) decreased (500-600 x 10(9)/L) platelet count in peripheral blood; (2) resolving the symptoms of small vessels obturation (headaches, sensory disorders, paresthesiae); (3) low platelet separating megakaryocytes count in control myelograms (4) no transformation into acute neoplastic disease. CONCLUSIONS: In the treatment of children with essential thrombocythemia anagrelid was effective in four of five patients.

Blood Platelets↗
PubMed2005

[A case of intracranial neurinoma arising from the maxillary branch of the trigeminal nerve].

The intracranial portion of the trigeminal branches is rarely involved in neurinomas. The clinical characteristics including symptoms, neuroradiological findings and results of surgical excision of the previously reported 11 neurinomas and the present case arising from the intracranial trigeminal branches are reviewed. A 59-year-old female patient complained of paresthesia and hypesthesia in the infraorbital region with no other neurological abnormalities. Neuroradiological examinations revealed a round cyst-like tumor located at the middle fossa with enlargement of the foramen rotundum and pterygopalatine fossa. No vascular abnormalities were found by angiography. At surgery, the solid tumor with no cystic component arising from the intracranial maxillary nerve was removed totally via a frontotemporal extradural and interdural approach with zygomatic osteotomy. Histopathology revealed a typical neurinoma. The paresthesia disappeared following surgery. Clinical features of neurinomas arising from the trigeminal branches are varied but distinct depending upon the site of origin of the tumors. These tumors can be removed totally in most cases through the extradural and interdural approach without critical morbidity. Special care should be taken not to cause injuries to the surrounding neurovascular structures such as cranial nerves and internal carotid artery. A small amount of residue is acceptable in cases of tumors with tenacious adhesion to these critical structures.

Cranial Nerve Neoplasms↗
PubMed2005

[Clinical analysis of six cases with juvenile primary fibromyalgia syndrome].

OBJECTIVE: To study the clinical features of juvenile primary fibromyalgia syndrome (FMS) and to evaluate outcome after treatment. METHODS: Six patients with juvenile primary FMS were registered in department of rheumatology and their clinical data were assessed, including degree of pain (visual analog scale, VAS), fatigue, depression, anxiety, sleep disturbances, arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms, urinary urgency, dysmenorrhea, morning stiffness, paresthesias, illness changes with weather, feeling worse with exercise, laboratory examination and outcome of treatment. RESULTS: Abdominal pain was the first symptom in 5 of the cases with juvenile primary FMS, diffuse aching and left knee pain were the first symptoms in one patient. All the 6 patients were misdiagnosed prior to their rheumatological evaluation. Diffuse aching, fatigue, sleep disturbances, illness changes with weather and feeling worse with exercise existed in all the 6 patients (100%), the mean pain score was 8.8 and the mean initial tender points (TP) count was 13.7. Arthrodynia, subjective joint swelling, abdominal pain, irritable bowel symptoms and urinary urgency existed in 5 of the 6 patients (83%). Dysmenorrhea existed in 4 (67%), depression in 3 (50%), morning stiffness in 2 (33%), paresthesias in 2 (33%) and anxiety in 2 (33%), respectively. The results of laboratory examination were normal and the outcomes of treatment were good. CONCLUSION: Juvenile primary FMS may not be a rare disease and the clinicians should pay more attention to it for avoiding misdiagnosis.

Adolescent↗
PubMed1991

[Little known forms of compression neuropathies of the lower extremities].

Neuropathies of the sural nerve, deep peroneal nerve and tibial nerve at the level of the tendinous arch of the musculus soleus pertain to the little-known forms of compression neuropathies. Examinations of 36 patients with 57 cases of such compression neuropathies have demonstrated that the main etiological moments of the disease are orthopedic diseases, illnesses of the joints and veins of the lower limbs and loading factor. The major clinical symptoms of the disease are spontaneous pains at the site of nerve compression, paresthesias, disorders of sensitivity in the area of innervation of the damaged nerve as well as pains on palpation at the level of nerve compression. Diagnosis is verified by the positive tests inducing pains and paresthesias and by stimulation electromyography. The principal treatment method lies in paraneural injection of glucocorticoids.

Adult↗