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PubMed1991

Cheiro-oral syndrome: identification of the lesion sites and a proposal for its clinical classification.

Five cases suffering from unilateral paresthesia over the corner of the mouth and the hand on the same side were examination for cheiro-oral syndrome. Of these, three cases were typical and the other were variant cases associate with transient hemi-signs. Lesion sites were identified by computed tomographic (CT) scan, magnetic resonance imaging (MRI) or both. Of the five patients, lesions were due to thalamic infarction in three cases, pontine hemorrhage in one case, and tumor compression on the right frontoparietal lobe in the last case. The pathophysiology of all cases were classified according to location of the lesion on the thalamus, the pons, and the parietal lobe, which are the usual anatomical sites responsible for this syndrome. Based on the three typical cases and thirteen cases cited from the English literature, a clinical classification has been established. The classification is based on age at the time of onset, gender, lesion site, etiology, risk factors, and certain clinical features. These sixteen cases fell into three distinct groups: a) those in which the thalamic lesions were related to infarction, b) those in which tumors, or in rare cases infarction, were found in the parietal lobe, and c) those in which hemorrhage occurred in the pons. Using this classification, the cheiro-oral syndrome can be more systematically defined.

Female↗
PubMed1991

Survey of the use of epidural analgesia in China.

It is generally believed that epidural blocks are most widely used in China. However, there is yet no substantial study in this respect. A nation-wide survey appears to be necessary. Questionnaires were sent to 237 hospitals located in 6 geographically wide-scattered areas and to some military hospitals as well. 90 answers were obtained with complete data necessary for this survey. There are 1,304,214 administrations of epidural blocks documented in these 90 hospitals. Of which 38.8% are lumbar, 32% lower thoracic, 23% middle thoracic, 4.6% upper thoracic and 1.6% cervical blocks. These data showed that operations from the neck down to the lower extremities were performed under epidural block without discrimination of puncture location. 98.33% of the blocks were satisfactory to meet the need of operations. Persisting paresthesia occurred in 0.013% of these cases. The incidence of accidental puncture of dura was 0.32%. About 2/3 of these dura punctured cases received 1-4 times of repuncture. No correlation was found between repuncture and development of total spinal anesthesia. Among the complications, incidence of respiratory depression was 0.54%. However, only 5% of these depressed cases needed intubation and artificial ventilation. No signs of dura puncture were noticed, but subarachnoid block did appear in 0.04 of cases. Incidence of total spinal anesthesia was 0.013%. Not all, but a little more than half (54.6%) of the total spinal cases needed intubation and artificial ventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1991

Eosinophilic myelomeningoencephalitis caused by Angiostrongylus cantonensis: a report of three cases.

Three members of a family developed eosinophilic myelomeningoencephalitis following ingestion of Pila snails. They were father, daughter and son and had similar clinical presentations. Two days after ingestion of snails, they developed a generalized itchy maculopapular rash followed by myalgia, marked paresthesia, fever and headache. Two days later there was weakness of the extremities which was progressive in severity involving the legs more than the arms. They later developed urine retention and cloudiness of consciousness. Two patients progressed to coma, one of whom died after 3 weeks and the other died at home 9 months after the onset. Autopsy of the fatal case revealed multiple tracks and cavities with the presence of Angiostrongylus cantonensis in the brain and various levels of the spinal cord.

Adult↗
PubMed1990

[Characteristics of disorders of general sensitivity in patients with depression].

In 135 patients with the depressive syndrome within the framework of manic-depressive psychosis, spontaneous sensory disorders (paresthesia, somatalgias, visceralgias, cenesthopathies) as well as sensory disorders revealed on special objective investigation of the sensitivity (disorders of the protopathic and epicritical types of reception, ++musculo-articular feeling) are described depending on different syndromal coloration of depression. The use of factorial analysis allowed the establishment of a relation of different disorders of general sensitivity to the formation of the psychopathological manifestations of depression: vital character of affect, hypochondriac symptomatology, anesthetic disturbances.

Adult↗
PubMed1991

Meralgia paresthetica after coronary bypass surgery.

Meralgia paresthetica is a neurologic disorder characterized by localized paresthesia and numbness on the anterolateral aspect of the thigh and involving the lateral femoral cutaneous nerve. It involves no motor deficits. Meralgia paresthetica, which may result from a variety of causes, has been observed as a rare complication in heart operations. Its cause when associated with such operations is uncertain but may be prolonged relaxed positioning on the operating table and recovery room stretcher. Another possible cause of meralgia paresthetica after heart operations is the "frog-leg" position of the legs during vein harvesting. Patients with this condition should be advised of its untreatable, but benign and self-limiting, nature.

Aged↗
PubMed1991

[Histiocytic necrotizing lymphadenitis; Kikuchi's disease].

The case is reported of a woman aged 26 with painful swelling of the left cervical lymph nodes. These symptoms were preceded by paresthesias and pain at the left side of her body, especially the left leg and the left arm. A lymph node biopsy revealed the diagnosis of histiocytic necrotizing lymphadenitis (Kikuchi's disease). Physical examination and laboratory data showed no other abnormalities. The patient recovered soon without any therapy. The morphological findings are described and a review of the literature is given.

Adult↗
PubMed1991

Incidence of inferior alveolar nerve injury in mandibular third molar surgery.

This paper documents the incidence of inferior alveolar nerve injury and resultant sensory disturbance encountered in the removal of 100 consecutive impacted mandibular third molars. Five cases of anesthesia and/or paresthesia resulted and all but one of these resolved within six months. The lack of direct correlation between surgical exposure of the neurovascular bundle intraoperatively and the proximity of radiographic images of tooth root and mandibular canal, with the occurrence of sensory deficit, is noted. Our findings support the 1979 Recommendations of NIHCDCRTM*, upon which the policy of informed consent regarding nerve injury was based.

Adolescent↗
PubMed1990

Raynaud's phenomenon of occupational origin.

Vibration delivered to the hand and arm by industrial pneumatic tools is a common cause of vascular and neurovascular problems, including cold-induced vascular spasm (vibration white finger) and peripheral neuropathies with paresthesias, dysesthesias, and sensory abnormalities. A decade ago, the US Public Health Service estimated that 1.2 million American workers were at risk. Differentiation of primary and secondary Raynaud's phenomenon from the thoracic outlet syndrome and from the carpal tunnel syndrome pose potential diagnostic difficulties. Despite growing public recognition of upper extremity problems caused by repetitive trauma, there have been few investigations of vibration-induced disorders in the United States. This is not true worldwide, particularly in Northern Europe, where there has been significant intervention in medical surveillance and tool design. There does appear to be, however, frequent misdiagnosis and misdirected surgery. This has particular significance for the clinician, since in the 1990s, cumulative trauma injuries are expected to exceed all other work-related injuries.

Cumulative Trauma Disorders↗
PubMedDate not supplied

Neurovascular assessment.

This article discusses the process for monitoring a client's neurovascular status. Assessment of neurovascular status is monitoring the 5 P's: pain, pallor, pulse, paresthesia, and paralysis. A brief description of compartment syndrome is presented to emphasize the importance of neurovascular assessments.

Compartment Syndromes↗
PubMed1990

Mandibular osteomyelitis in a patient with sickle cell anemia: report of case.

A case is presented in which mandibular osteomyelitis and mental nerve paresthesia developed in a patient with sickle cell anemia. This infection appeared to precipitate a sickle cell crisis. The mechanisms for these patients' propensity to infection and the diagnosis and management of sickle cell osteomyelitis of the jaws are discussed.

Adult↗
PubMed1990

[Pain symptoms in paraplegic patients].

The number of paraplegics who survive their initial trauma by decades is on the increase. A considerable percentage of these patients will, sooner or later, temporarily or permanently, manifest a pain syndrome and/or phantom pain. Accurate differentiation of the disagreeable sensations, which are often difficult to describe (dysesthesia, paresthesia), is frequently a big problem. The pathogenesis still remains unclear, and therapy often proves unsatisfactory.

Adult↗
PubMed1990

[Gas gangrene].

A 66-year-old woman presented with left lower abdominal pain and paresthesias of the left thigh of 6 hours duration. 10 years previously she had undergone massive abdominal irradiation for retroperitoneal lymphoma. 3 days prior to admission she underwent rectal biopsy as part of a work-up for suspected inflammatory bowel disease. Within a few hours she developed fulminating gas gangrene of the left thigh and lower abdomen. In spite of aggressive surgical debridement she died 12 hours after admission. The incidence of gas gangrene is decreasing, but the mortality is still high. The diagnosis requires a high index of suspicion, especially in immunodepressed patients after invasive procedures or even minor trauma.

Abdominal Pain↗
PubMed1989

Ciguatera fish poisoning.

Cases of ciguatera fish poisoning no longer are confined to endemic areas. This makes awareness of this entity important. The diagnosis usually is made by the presence of gastrointestinal symptoms, nausea, vomiting, and diarrhea, and of neurological symptoms such as paresthesias, paresis, and pruritus. The detection of ciguatoxin in the ingested fish by any of the available bioassays, will confirm the diagnosis. The treatment of this food poisoning is supportive, although intravenous mannitol is reported to be safe and effective. The prognosis is good and complete recovery is to be expected. However, relapses can occur, especially on re-exposure to the toxin.

Adult↗
PubMed1988

[Cervical spondylotic myelopathies. Apropos of 121 cases. Prognostic value of sensitive symptoms].

121 patients have been treated for cervical spondylotic myelopathy between 1972 and 1985; 88 patients have been operated on, most of them (84) by laminectomy and 4 cases by anterior approach; 33 patients have been treated conservatively in absence of evolution. We have used a clinical classification based on the different sensitive symptoms, the best predictive factor in our opinion; the typical form (2/3 of all cases) associates numbness and paresthesias of extremities of both hands, difficulties for manipulation, astereognosia, with a moderate pyramidal deficit of the lower limbs; this typical form obtains the best post-operative score with 75% of good results; the more the clinical sensitive form is far from the typical one, the poorest may be the evolution. Our results are similar with large series of literature, using either the posterior or the anterior approach; we have noted the frequency (1/4 of cases) of very late worsening, several years after initial good result, without residual compressive factor; it is supposed that organised intra-medullary lesions, may be of venous origin, continue to evolve for their own. 33 non operated patients have been treated conservatively, because of spontaneous stabilization of their disease, suggesting to try immobilization by cervical collar during few weeks before surgery.

Adult↗
PubMed1988

[Long-term results and complications of uvulopalatopharyngoplasty in snoring without sleep apnea syndrome].

Results and complications were analyzed in 201 patients operated upon by uvulopalatopharyngoplasty for benign or moderately severe rhonchopathy, after elimination of the sleep apnea syndrome as confirmed after follow up for between 15 and 30 months, and showed total recovery from snoring in 60% of cases, an improvement in 26.5% and lack of efficacy in 13.5%. Social and familial relations were improved concomitantly as well as the functional and general disorders usually attributed to snoring (asthenia, somnolence, sleep hypopnea). Various usually minor functional disorders remain, including the sensation of a pharyngeal paresthesia, the most frequent sequela (19.5% of cases).

Chronic Disease↗
PubMed1986

The neuro-ophthalmologic signs of ciguatera poisoning: a case report.

Twenty-four hours after the ingestion of black grouper, lower-extremity paresthesias, left retrobulbar pain, pruritus, diarrhea, and urinary frequency developed in a 57-year-old woman. Over a three-month period, her symptoms gradually resolved completely. A review of the systemic and neuro-ophthalmologic manifestations of ciguatera poisoning is presented.

Ciguatera Poisoning↗