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Apical periodontitis is a common development associated with teeth with necrotic pulp. Although rare, some cases may present further complications, such as neuropathies in areas adjacent to the affected tooth. A case is described in which mental nerve paresthesia was associated with a non-vital mandibular premolar. Endodontic therapy resolved the paresthesia completely without further clinical complications.
OBJECTIVES: This study was performed to assess the overall incidence and duration of alterations in tongue sensation and taste after operative microlaryngoscopy, and the relation of these symptoms to operative time. METHODS: We performed a retrospective review of information regarding tongue symptoms in patients who completed standard post-microlaryngoscopy follow-up at 1 week, 1 month, and 3 months. RESULTS: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusion criteria. Eighteen patients had positive findings at 1 week: 15 complained of paresthesia and 3 of dysgeusia. The symptoms decreased over time without treatment (4% of patients at 1 month and 1% of patients at 3 months). Only 1 case of dysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development of symptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p = .013). Patients whose operations lasted longer than 1 hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time less than 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval, 0.62 to 30.95; p = .182). CONCLUSIONS: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy, especially in female patients. They also tend to be associated with longer operative times. Although transient in nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient.
BACKGROUND: Thirty-nine percent of permanent altitude dwellers in the Andes experience acral paresthesias. METHODS: Clinical examinations, sural nerve biopsies, and electrodiagnostic studies on peripheral nerves were performed on 15 men. Ten Cerro de Pasco (CP) natives living at 4,338 meters were biopsied. Three of these subjects had no burning feet/burning hands (BF/BH); three had BF/BH; and four had chronic mountain sickness (CMS), a maladaptation syndrome resulting from living in the Andes, all with BF/BH. Three patients with CMS were biopsied in Lima within hours after leaving CP. Two normal Lima natives were biopsied in Lima. Symptom scores for BF/BH and CMS score ratings were used. The nerves were assayed for Na+, K+ adenosine triphosphatase (ATPase), cytochrome oxidase (CO), substance P (SP), and endothelin (ET). RESULTS: Low ATPase was inversely related to symptom scores and CMS scores (p < 0.001). Patients with CMS biopsied in normoxia (Lima) had ATPase levels similar to those of controls. Nerve motor conduction velocities and sensory action potentials were normal. CO was inversely related to age (p < 0.03) and no relation of SP to any variable was found. ET levels were lower in sea level natives (p = 0.04). CONCLUSIONS: Acral paresthesias are associated with low ATPase in peripheral nerves. Lower ET levels of sea level natives likely reflect lowered release from vasa nervorum.
Twenty patients were studied who developed central poststroke pain or paresthesia after lenticulocapsular hemorrhage. Pain or paresthesia occurred 0 to 24 months after the onset, more prominently in the leg than other body parts. The symptoms were described as numb, cold, burning, aching, swollen, and squeezing in various combinations. The mean score of the visual numerical scale was 5.6. The lesions involved the dorsal part of the posterior limb of the internal capsule, probably damaging the thalamocortical sensory pathway.
We report a case of a 75-yr-old female patient in whom motor deficits and paresthesias occurred after lumbar epidural analgesia. These symptoms were eventually found to be due to a tethered cord syndrome. An epidural catheter was inserted for analgesia after colon surgery. The postoperative course was characterized by fluctuating sensory and motor symptoms. A magnetic resonance imaging scan showed an intraspinal mass, which was removed by laminectomy. The presented complication is of major interest because the intraspinal tumor, which must have been present for years, became acutely symptomatic. Tethered cord syndrome is caused by a limited longitudinal mobility of the cord. It is often seen as a part of spinal closure defects and is also associated with intrathecal tumors. Typically, adult patients complain of weak legs, paresthesias of the legs, and urinary incontinence. However, our patient had denied any muscular or neurological problems or urinary incontinence during the preoperative interview. Postoperative electromyogram and electroneurography ascertained chronic neurogenic lesions of multiple lumbar and sacral nerve roots. Three months after the operation, the patient was able to walk 100 m with a crutch.
A case is reported in which paresthesia of the area supplied by the right mental nerve was associated with alveolar ridge resorption and a failing overdenture abutment. After surgical removal of the overdenture abutment, all signs and symptoms of the paresthesia resolved.
To study the reasons for referral to electrodiagnostic evaluation, 490 patients referred for electrodiagnostic evaluation to two laboratories (UNIFESP and UNEF) answered the following question: "What was the reason that brought you to look for a physician and that led him to ask this examination?" Paresthesia and/or pain were answered as the main reason by 175 of them (26% UNIFESP and 40% UNEF). The electromyographical examinations were normal in 30.8% and 35.3% and involvement of the median nerve at the wrist was detected in 5 9% and 51.5% of them. Nocturnal symptoms and paresthesia were commonly noted in both groups of patients; they, however, were not able to separate the patients with and without median nerve compression at the wrist. The question asked seems to be a useful selection instrument, to select two similar symptomatic samples of patients from two laboratories serving with very different target populations.
A 69-year-old woman was referred to our department for evaluation of hypokalemia, which had been treated by oral potassium for more than ten years. She complained of headache, knee joint pain, sleeplessness and paresthesia in extremities and, most prominently, depression. Laboratory data suggested Gitelman's syndrome, which is caused by mutations in the gene encoding the thiazide-sensitive Na-Cl cotransporter. Direct sequencing of the gene in this patient revealed homozygous mutation R964Q in exon 25. Intravenous supplement of MgSO4 dramatically improved both the depression and the paresthesia, suggesting that hypomagnesemia played a role in the clinical manifestations.
The aims of this study were to determine patients' perceptions of pain, paresthesia, and swelling after orthognathic surgery and to analyze the association between these perceptions and neuroticism, temporomandibular joint dysfunction, and mood states among the patients. Levels of pain, paresthesia, and swelling were measured by two self-appraisals that were developed for this research. Perceptions of facial discomfort decreased with time and varied according to the surgical procedure. Patients who scored high on neuroticism tests reported greater levels of temporomandibular joint symptoms before surgery and greater experiences of pain 2 years after surgery. Perceived pain appeared to exert a negative influence on mood states up to 2 years following surgery. These results reveal the importance of continued psychological support for orthognathic surgery patients throughout their course of treatment.
This article is about the different iatrogenic (or others) mechanical and/or chemical trauma that can affect the mandibular nerve and which can lead to paresthesia. Depending on the different causes of the paresthesia, the prognosis for nerve sensitivity regeneration will vary: In some cases treatment is necessary to make the symptoms disappear, in others expectation will be the rull and the prognosis is very poor.
This article is about the different iatrogenic (or others) mechanical and/or chemical trauma that can affect the mandibular nerve and which can lead to paresthesia. Depending on the different causes of the paresthesia, the prognosis for the nerve sensitivity regeneration will vary: in some cases treatment is necessary to make the symptoms disappear, in others expectation will be the rule and the prognosis is very poor.
Paresthesias originate from different causes, such as central nervous processes, accidental trauma, surgery, inflammations, tumors, general or systemic affections, degenerative processes of the TM Articulation or of the cervical vertebrae. Treatment may be conservative or surgical, but since paresthesias are always of inaccurate character, it is often difficult to choose adequate treatment.
The incidence of paresthesias and motor dysfunction associated with 23,827 deliveries at Winnipeg Women's Hospital during a 9-yr period (1975-1983) was 18.9/10,000 deliveries. All the symptoms resolved within 72 hr after supportive therapy only. The frequency of paresthesias and motor dysfunction was greater in primiparas, women who had forceps- or vacuum-assisted deliveries, and women who had epidural or general anesthesia. Significant neurologic deficits after labor and delivery with or without epidural anesthesia were rare. Epidural anesthesia is a safe technique in this regard.
Occupational exposure to fenvalerate, a synthetic pyrethroid insecticide, has been reported to cause paresthesia. An assay was devised in our laboratory for subjective grading of the sensation produced by the topical application of this compound. The present double-blind study compared human discrimination of topically applied technical fenvalerate, the heavy-ends fraction of fenvalerate, and ethyl alcohol (vehicle). Both forms of fenvalerate showed a statistically significant increase in inducing paresthesia over the vehicle alone. The onset of the cutaneous sensations occurred at one hour, peaked at three to six hours, and lasted approximately 24 hours. Numbness, itching, burning, tingling, and warmth were the most frequently reported sensations. The difference between the two fractions of fenvalerate was not statistically significant.
A case is presented in which the only positive subjective and clinical finding was mental nerve paresthesia. After appropriate and careful workup, in conjunction with medical colleagues, no definitive diagnosis was made until a biopsy of the mandibular canal was performed. The biopsy specimen in this case showed the presence of adenocarcinoma, metastatic to the mandible, thus upholding the axiom that mental nerve paresthesia suggests the existence of a malignant neoplasm. Retrospective comparisons with previous bone marrow aspirates demonstrated widespread, previously unrecognized adenocarcinoma.
Paresthesias of the lower dental nerve can occur after many procedures: surgery of impacted teeth, apicectomy, endodontic treatment, etc. This article is based on a clinical case and deals with a paresthesia resulting from an endodontic treatment, its means of prevention and its cure.
Three instances of paresthesia in the oral cavity were resolved by nonsurgical endodontic therapy. Resolution of the condition supports the theory that pressure caused by an expanding infection and the associated inflammatory response result in paresthesia.
Paresthesia is a condition that involves perverted sensations of pain, touch, or temperature. It has a variety of possible causes. This article presents a literature review and case reports of endodontically related inferior alveolar nerve and mental foramen paresthesia. Nondrug prevention methods and the dental uses of dexamethasone are also discussed.