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PubMed1978

Treatment of demyelinating and degenerative diseases by electro stimulation of the spinal cord.

Electrical stimulation was applied to the spinal cord of 75 patients who had demyelinating and degenerative diseases of the central nervous system, and 3 patients who had sustained spinal cord injuries. The electrical energy was delivered to the central nervous system by the percutaneous technique. The amount of electrical energy required to produce the perception of paresthesias was measured in 11 patients. The minimum power necessary was 76.89 muW, the maximum was 868 muW, and the average was 448.8 muW. The patients were evaluated by 4 examiners by means of routine neurologic examination, videotape movies, and measurement of urinary bladder function. Continued improvement in neurological status, which allowed the patient to live a better lifestyle, occurred in 30 of the 61 patients with multiple sclerosis, and 6 of the 10 patients with ataxia. The patient with transverse Myelitis, the patient with primary lateral sclerosis, and 1 patient with olivopontocerebellar atrophy; also noted similar enhancement of neurological function. The patients with amyotrophic lateral sclerosis and spinal cord injuries had no changes of significance. Thirty-two out of 44 patients who were ambulatory had significant improvement, whereas 10 of the 19 patients who were not ambulatory had improvement. There was no evidence that electrical stimulation of the spinal cord, when applied via dorsally placed percutaneous electrodes and when carried only to the perception of a paresthesias, has any adverse effect on neurological function. It is hypothecated that the electrical current alters neurotransmitters to enhance the transmission along nervous and neurochemical pathways. The exact mechanisms are unknown at the present time.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

[Health survey on morbility and accidents in various productive agricultural sectors].

A health survey on morbidity and accidents was carried out on a population of 970 farmers in the district of Bari working in 6 different agricultural sectors. Data were gathered through a CNR-based (National Research Council) questionnaire administered by two occupation specialists. Results showed, first of all, that fertilizers are used in all agricultural sectors, while antiparasitic agents and herbicides are used in different ways according to the kind of culture. Horticulture is the sector where pesticides are more widely used as it is an intensive culture and has many cultivation cycles during the agricultural year. Interviewed subjects referred different pathologies, in particular arthrosis of spinal cord and limbs paresthesia. No significant direct association was observed between these pathologies and the sectors considered. Arthrosis of spinal cord seems to be related to exposure duration as it is well known that agricultural work implies unfavourable postures and exposure to adverse climatic conditions which favour the degeneration processes causing arthrosis. 19.5% of cases showed eczema. As far as accidents are concerned the situation is worrisome both for the frequency of accidents and the seriousness of lesions. This survey showed the need to investigate thoroughly the etiology of limbs paresthesia, eczema and accidents of farmers.

Accidents, Occupational↗
PubMedDate not supplied

The effectiveness of ketanserin in patients with primary Raynaud's phenomenon. A randomized, double blind, placebo controlled study.

In 41 patients with Primary Raynaud's Phenomenon (PRP) the effectiveness of the serotonin receptor blocker ketanserin has been studied in a double blind cross-over study. Subjective assessments included: frequency and duration of the attacks (both per se and combined to a severity score), cold sensation, numbness, paresthesia, pain, cold water and cold weather provocation and the appearance of spontaneous attacks. The objective measurements comprised Digital Skin Temperature (DST), Digital systolic Blood Pressure (DBP) and Doppler Spectral Analysis (DOSA) of the radial and ulnar arteries. All measurements were performed both at room temperature and after instant cold provocation. The severity score, the occurrence of numbness and paresthesia and cold weather provocation improved significantly on ketanserin treatment. All objective measurements with the exception of the end-diastolic blood flow velocity of DOSA did not show significant improvements. Neither blood chemistry nor systemic blood pressure showed any significant change during ketanserin treatment. However, in the 6 (15%) patients with hypertension both systolic and diastolic blood pressure normalized. Although in objective measurements hardly any significant effects of ketanserin could be demonstrated, the results of the study suggest that orally administered ketanserin is effective for minimizing subjective complaints in patients with PRP. Ketanserin did not show any side effects.

Adolescent↗
PubMed1988

[Axillary blockade of the brachial plexus. A prospective evaluation of 1133 cases of plexus catheter anesthesia].

UNLABELLED: The results of 1133 axillary catheter brachial blocks are reported. Effectiveness and side-effects were monitored in a prospective manner over a period of 1 year. METHOD: The puncture was performed with an 18-gauge plastic cannula fitted with a solid steel stylet. The stylet has a 45 degrees, short bevel with rounded edges. When puncturing the axillary neurovascular sheath, no attempt was made to elicit paresthesias with the needle. A distinct "click" and very easy advancement of the plastic cannula were signs of being well inside the neurovascular sheath. To confirm the correct positioning, 0.5-3 ml refrigerated saline solution were injected. If no paresthesias could be produced, a new puncture was performed using a nerve stimulator. The plastic cannula was fixed to the skin. For long-lasting operations or if postoperative analgesia or sympatholysis was required, a more flexible catheter was introduced through the plastic cannula. As an initial dose 40 ml 1% mepivacaine was injected via the cannula. If there was an insufficient block after 20 min, another 20 ml 1% mepivacaine was given. For long-lasting operations, 40 ml 1% mepivacaine was injected every 2 h. RESULTS: Surgery was completed in 72% of patients; 24% required some form of supplementation including 17.2% of patients who received a "top-up" after 20 min (Table 1). In 3.8% of cases the technique was considered to be a complete failure, meaning that patients needed some type of general anesthesia including the use of i.v. ketamine.(ABSTRACT TRUNCATED AT 250 WORDS)

Axilla↗
PubMed1988

[Tunnel lesion of the median nerve in the ulnar area].

Difficulties in the diagnosis of tunnel impairment of the median nerve in the ulnar area are explained by the presence of marked pain and other mild symptoms of its damage. Examination of 30 patients showed that the main symptoms include paresthesia and spontaneous pain, as well as other types of pain provoked by palpation of the nerve at the tunnel level with pain irradiation into the zone of the median nerve innervation. The diagnosis is confirmed by positive pain- or paresthesia-inducing tests and a slower rate of impulse conduction along the median nerve at the tunnel level. The main methods of the treatment are paraneural administration of steroid drugs and surgical decompression of the median nerve in the ulnar area.

Adult↗
PubMed1987

[Electroclinical correlations in the carpal tunnel syndrome. Apropos of 100 cases].

This study involved 100 cases of carpal tunnel syndrome defined according to current electromyographic criteria. This investigation compared electromyographic data, in particular the speed of sensory conduction in the median nerve in the wrist with 8 clinical criteria, age, the duration of the disorder, the incidence and painful nature of nocturnal paresthesia observed, the incidence of diurnal paresthesia, Tinel's sign, Phalen's test, and the test of hyperextension of the wrist. After comparing these findings, two conclusions may be drawn: the identification of high-risk patients, who are persons over 70 years of age and the existence of a statistically significant correlation between the speed of sensory nervous conduction and Phalen's test. All other criteria examined have no bearing in predicting the severity of median nerve compression.

Adult↗
PubMed1987

Occult carbon monoxide poisoning.

A syndrome of headache, fatigue, dizziness, paresthesias, chest pain, palpitations and visual disturbances was associated with chronic occult carbon monoxide exposure in 26 patients in a primary care setting. A causal association was supported by finding a source of carbon monoxide in a patient's home, workplace or vehicle; results of screening tests that ruled out other illnesses; an abnormally high carboxyhemoglobin level in 11 of 14 patients tested, and abatement or resolution of symptoms when the source of carbon monoxide was removed. Exposed household pets provided an important clue to the diagnosis in some cases. Recurrent occult carbon monoxide poisoning may be a frequently overlooked cause of persistent or recurrent headache, fatigue, dizziness, paresthesias, abdominal pain, diarrhea and unusual spells.

Adult↗
PubMed1985

[Percutaneous epidural electrical stimulation of the spinal cord for intractable pain--with special reference to deafferentation pain].

In a study of 44 patients with different types of chronic pain, mostly associated with deafferentation, chronic percutaneous epidural spinal stimulation has proved useful treatment achieving an initial 52% incidence of pain amelioration overall. Long-term result showed at six months in 86%, at 1 year in 90%, although technical problems, which included electrode displacement and required minor operative readjustment, affected 48% of those permanently implanted. No other complications were seen. Success bore no relationship to quality of pain reported by the patients or to duration of pain. The patients with denervation caused by nerve or root lesions responded better than those with cord lesions even though electrical paresthesia were delivered to the area of pain in each case. A decline in effectiveness with time was noted in small numbers of our cases despite persistence of paresthesia in the area of pain. It is suggested that late failure reflects plasticity of the nervous system in adapting to new inputs. Morphine study was carried out in some of these patients. Morphine did not help to ameliorate the pain in many cases with deafferentation pain. And also Naloxone was administered during successful pain-relieving stimulation. This did not result in recurrence of pain. The Somato Sensory Responses were recorded in 25 patients before and during neurostimulation. When stimulation was applied the late component was suppressed in most of those who enjoyed a good result. The early component was not changed in those patients even during stimulation. These results suggest that spinal cord stimulation would suppress the denervative hypersensitivity of dorsal horn in the patients with deafferentation pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Symptomatic intraspinal synovial cyst in a 66-year-old marathon runner.

A 66-year-old marathon runner developed an intraspinal synovial cyst arising from the L5-S1 zygapophyseal joint, clinically characterized by episodic pain, paresthesia and sense of coldness. Symptoms were predictably and completely relieved by running; Valsalva maneuver elicited the pain, paresthesia and cold sensation. A precisely similar episode occurred 3 years previously on the right side and disappeared spontaneously without recurrence. Routine films and myelogram were not diagnostic; a CAT scan showed the lesion. The cyst was successfully resected; the patient has been asymptomatic for 2 year postoperatively.

Aged↗
PubMed1971

Complications of rubella immunization in children.

A rubella vaccine, prepared in dog kidney cell culture, was given to 4,734 primary school children in one California county in May, 1970. Adverse reactions of arthritis, arthralgia and paresthesia were reported two to eight weeks later. Paresthesia was a very prominent complaint and showed a peculiar diurnal pattern. Objective findings in a group of symptomatic children who came to medical attention were limited to tender, swollen, small joints. Rubella virus was isolated from throat swabs from two children with symptoms 38 and 43 days after immunization.A sample telephone survey of immunized and non-immunized children was conducted two to three months after the vaccination program to estimate the frequency, type, and distribution of reactions. Approximately 7 percent of inoculated children had symptoms subsequent to vaccination. Almost no reactions were found in the control group. There was a preponderance of girls affected, but symptoms appeared to be more severe in boys. The highest complication rate was found in the youngest age group. These reactions should be brought to the attention of medical groups and the public, but since these reactions are usually mild and self-limited, ongoing immunization programs need not be altered.

Arthritis↗
PubMed1981

Combination chemoimmunotherapy for advanced renal carcinoma with Adriamycin, bleomycin, vincristine, cyclophosphamide, plus BCG.

Fourteen patients with advanced renal carcinoma were treated with Adriamycin 40 mg/m2 I.V., bleomycin 15 U/m2 I.V., vincristine 2 mg I.V., cyclophosphamide 200 mg/m2 p.o. x 4 days, and BCG by scarification every 4 weeks. Of 13 evaluable patients, three (23%) achieved partial remissions on therapy, five (39%) were improved, and three were stable. Responding disease sites included lung and pleural metastases, and an abdominal mass. Median duration of response was 4 months. Median survival was 8.5 months, but the partial responders survived for 13, 17, and 19 months. Toxicity included nausea and vomiting (31%), leukopenia (8%), thrombocytopenia (8%), diarrhea (15%), alopecia (8%), stomatitis (8%), and paresthesias (8%). This well-tolerated stomatitis (8%), and paresthesias (8%). This well-tolerated chemoimmunotherapy regimen has moderate activity in renal carcinoma and deserves further evaluation.

Adult↗
PubMed1983

[Clinico-pharmacological study of prospidin].

Different schemes of prospidin administration to 54 patients were evaluated. Stage IV paresthesia or renal derangements are limitations of prospidin treatment due to its toxicity. Rheovasographic studies established that disorders in vascular tension are responsible for paresthesia development. The best results were obtained with the administration of 300-400 mg every other day for 2-3 weeks. Schemes of combined administration of prospidin and cyclophosphamide and bleomycin were worked out (58 cases). Therapeutic effect was recorded in the treatment of melanoma, carcinoma of the lip, tongue, nasopharynx, salivary gland and skin. Prospidin, cyclophosphamide and radiation therapy were successfully used in the management of small cell carcinoma of the lung.

Adult↗
PubMed1981

Central osteoma of the mandible: report of case.

A case of central osteoma of the mandible in a 22-year-old woman is presented. Pain, paresthesia, and abnormal lip spasms were symptoms. Pain and paresthesia were the result of direct nerve compression, and were relieved by removal of the lesion.

Adult↗
PubMed1995

High prevalence of undetected carpal tunnel syndrome in patients with fibromyalgia syndrome.

OBJECTIVE: To assess the prevalence of carpal tunnel syndrome (CTS) in patients with fibromyalgia syndrome (FM). METHODS: A series of 206 consecutive patients with FM was evaluated for CTS in an unblinded, uncontrolled study. Sixty patients with dermatomal paresthesia in the fingers enervated by the median nerve were evaluated with electromyogram and nerve conduction velocity studies (EMG/NCV). RESULTS: Thirty-three patients showed EMG/NCV findings diagnostic for CTS (16% of the 206 cases, 55% of the 60 EMG studies). Only 2 of the 33 patients with CTS had been diagnosed before rheumatologic evaluation. We compared our results with those reported for women in the general population. The overall prevalence of CTS in women was higher (16 vs 10.2%), but not statistically different. However, in our series, there was a clear difference in the higher rate of undetected CTS in women with FM compared to that of the general population (14.1 vs 6.7%) (p < 0.01). CONCLUSION: (1) CTS is at least as common in patients with FM as in the general population, contrary to that reported in retrospective studies; (2) the rate of underdiagnosed CTS in women with FM is much higher than the rate reported in the general population; (3) NCV studies may be necessary to evaluate underdiagnosed CTS in patients with FM and dermatomal paresthesia in their hands.

Adolescent↗
PubMed1994

[A case of dumbbell-shaped hypoglossal neurinoma].

The authors report a case of dumbbell-shaped hypoglossal neurinoma. A 46-year-old female was admitted to our clinic with a history of right hemiatrophy of the tongue for more than 10 years and bilateral paresthesia on the face and legs for half a year. Neurological findings on admission were right hypoglossal palsy, attenuation of right gag and palatal reflex, mild truncal ataxia, right Bruns nystagmus, bilateral paresthesia on the face and legs (left > right), bilateral hyper-reflexia on the extremities. No sign of increased intracranial pressure was noted. Conventional computed tomography demonstrated the bone destruction around the right hypoglossal canal, and three-demensional computed tomography clearly revealed the extent of the bone destruction. Magnetic resonance imaging showed a large dumbbell-shaped mass extending both intra-and extra-cranially through the right hypoglossal canal, which severely compressed the brainstem postero-medially. Right suboccipital craniotomy with C1 laminectomy was performed in the prone position, and the occipital bone was drilled far-laterally around the Foramen Magnum with right occipital condyle rongeured to expose the intracanallicular mass. The mass was totally removed except around the IX Xth cranial nerves near the jugular foramen. Hypoglossal neurinoma is rare, and our case is the 62nd case, and the 15th dumbbell-shaped case in the literature. Hypoglossal nerve palsy is characteristic in dumbbell-shaped hypoglossal neurinoma. Enlargement of the hypoglossal canal can be detected by conventional and three-dimensional CT. MRI is more effective than CT in revealing the mass. Total removal of the dumbbell-shaped tumor requires that the hypoglossal canal can be exposed sufficiently.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Angiography↗
PubMed1994

[Late phase II clinical study of KW-2307 in previously untreated patients with non-small cell lung cancer. KW-2307 Study Group (Lung Cancer Group)].

A late Phase II clinical study of KW-2307, a new vinca alkaloid derivative, in previously untreated patients with non-small cell lung cancer was jointly carried out in 26 medical institutions. Of 80 enrolled cases, 75 cases were eligible, and PR was attained in 23 cases (30.7%). The main adverse effect of this drug, leukopenia (neutropenia), was observed in 62.7% (83.3%) of Grade 3 and 4 cases, but they recovered rapidly. In addition to decreased hemoglobin in 67% (Grade 3 in 5.7%) of the cases, adverse effects included slight disorder of hepatic function, anorexia, nausea and vomiting, fever, general fatigue, phlebitis, paresthesia and interstitial pneumonia. Peripheral neuropathy such as paresthesia occurred rarely and was slight, if any.

Adult↗
PubMed1975

A comparison between anterior and posterior spinal implant systems.

In four patients with intractable pain from metastatic cancer, application of current through electrodes placed on the anterior surface of the cord produced analgesia and pain relief below the level of implant without the development of paresthesias. Application of current through electrodes placed on the dorsal columns in these patients also relieved pain, but to a lesser degree and with the development of associated paresthesias. In one patient, application of current from anterior electrodes to posterior electrodes produced a zone of dissociated sensory loss. While it is simpler to implant electrodes over the dorsal columns, the anterior location may be superior when currents are to be applied for the pain relief in the lower lumbar and sacral dermatomes.

Animals↗
PubMed1993

[Neurogenic intermittent claudication of the femoral nerve caused by occlusion of the common iliac artery].

A 52 year old heavy smoker complained of paresthesiae and pain at the ventral side of the right thigh and the antero-medial side of the right lower leg as well as weakness of the right quadriceps femoris during exercise. Clinical examination revealed a paresis of the right quadriceps, hypesthesia and hypalgesia in the area of the femoral nerve and a reduced right patellar reflex after 10 min walking. An occlusion of the right common iliac artery was diagnosed by angiography. Following transluminal angioplasty and implantation of an intravascular stent, the patient was free of symptoms. On the basis of the clinical observations following recanalisation of the common iliac artery, the symptoms can best be explained by a reduced perfusion of the iliolumbar artery supplying the upper part of the femoral nerve, causing ischemia of the femoral nerve during exercise. In conclusion, stenosis/occlusion of the common iliac artery should be considered as a differential diagnosis of quadriceps weakness and paresthesia in the area of the femoral nerve associated with exercise.

Angiography, Digital Subtraction↗