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At least 19 recordsLinked to original sources
PubMed1979

Paresthesiae or no paresthesiae? Nerve lesions after axillary blocks.

Seeking paresthesiae when performing a peripheral nerve block may increase the risk of post-anesthetic neurological sequelae. To test this hypothesis, we prospectively followed two groups of patients who underwent hand surgery with an axillary block. In one group, the axillary plexus was located by actively seeking paresthesiae; in the other, pulsations of the axillary artery indicated an adequate position of the injection needle. Mepivacaine 10 mg/ml, with or without adrenaline, was used. The study included 533 patients, 290 in the paresthesia group and 243 in the artery group. Although unintentional, paresthesiae were elicited in 40% of patients in the artery group. Postanesthetic nerve lesions were seen in ten patients, eight in the paresthesia group and two in the artery group, all of whom had been blocked by mepivacaine with adrenaline. Symptoms varied between light paresthesiae lasting a few weeks, and severe paresthesiae, ache and paresis lasting more than 1 year. The etiology suspected was needle and perhaps injection trauma to the nerves during blocking. We conclude that whenever possible nerve blocks should be performed without searching for paresthesiae.

Adult↗
PubMed1992

Interscalene brachial plexus block for shoulder surgery: a proximal paresthesia is effective.

This study was designed to determine whether the location of paresthesias is related to the success of interscalene blocks in providing anesthesia for shoulder surgery. Interscalene blocks were performed in 45 patients presenting for elective shoulder surgery. Interscalene injections of 33-55 mL of 1.5% mepivacaine with epinephrine were performed after the first elicited paresthesia to the shoulder, arm, forearm, or hand. In 20 patients (45%), the initial elicited paresthesia was to the shoulder, whereas in 25 patients (55%), the first paresthesia was reported as distal to the shoulder. All patients developed brachial plexus anesthesia adequate for shoulder surgery. The time-course of onset of motor block as evaluated at the shoulder and elbow was not different between patients with shoulder paresthesias and those with more distal paresthesias. Handgrip strength was quantitatively evaluated with a dynamometer, and both paresthesia groups showed similar decrements in hand strength except at the end of the measurement period, when patients with distal paresthesias had a significantly weaker handgrip than patients with shoulder paresthesias. We recommend that paresthesias to the shoulder be accepted in performing interscalene blocks for patients undergoing shoulder surgery.

Adult↗
PubMed1991

Ischemic compression paresthesias in Guillain-Barré syndrome.

An experiment in nine patients tested the similarities and interactions between the paresthesias of Guillain-Barré syndrome (GBS) and tourniquet-induced compression paresthesias. During brachial compression, GBS paresthesias diminished in five of seven patients and new paresthesias occurred in two patients with purely motor GBS. Beginning 1 to 4 minutes after release of the cuff, all patients had new paresthesias, distinguishable from GBS symptoms. The novel finding was that GBS paresthesias diminished or ceased during the postcompression period in five of seven patients. Demyelinated peripheral nerves in GBS apparently can generate and transmit the spontaneous activity associated with paresthesias in the postcompression period. Interference occurs between the two types of paresthesias, possibly because both are caused by spontaneous ectopic activity in tactile nerves.

Foot↗
PubMed1991

Leg paresthesias induced by magnetic brain stimulation in patients with thoracic spinal cord injury.

We studied the induction of leg paresthesias by magnetic stimulation of the brain in seven patients with thoracic T9-12 spinal cord injury and in four normal volunteers by delivering transcranial magnetic stimulation over scalp positions 1 cm apart with a Cadwell MES-10 magnetic stimulator and an 8-shaped magnetic coil at 100% stimulus intensity. We asked subjects to report sensations felt after each stimulus. In all normal subjects, magnetic stimulation evoked sensations described as tingling or a wave descending along the leg, usually accompanied by EMG responses in leg muscles. In three of the seven patients, stimulation evoked sensations of tingling, numbness, touch, or a wave descending along the leg, lasting up to 10 seconds and referred to different parts of the legs and toes. In the patients, sensations were felt more distally the closer the site of stimulation was to the midline. Patients with leg paresthesias had less motor reorganization in abdominal muscles than those without paresthesias. These findings suggest that portions of the cortical representation areas for body parts deafferented by a complete spinal cord injury can remain related to those body parts for up to several years. A central origin of these paresthesias is probable.

Brain↗
PubMed1992

Distal paresthesia in patients with cervical cord lesions.

Nine patients complaining of distal paresthesia were found to have spinal cord lesions with no evidence of peripheral nerve disease. This pattern may be due to central nervous system dysfunction, with a lesion being intramedullary or extramedullary. The sensory deficits were initially asymmetric. Paresthesias could originate from the hands and progress to the stocking-glove pattern. It was usually more severe in hands than in feet. The abnormal somatosensory evoked potentials, found in all patients, indicated a lesion involving the posterior column, a site supposed to be the pathologic basis of paresthesia. As hands and feet have relatively large somatotopic representation in the posterior column of the cervical cord, the paresthesia tends to localize over distal portions of extremities.

Adult↗
PubMed1992

Paresthesia of the inferior alveolar nerve following the extraction of the mandibular third molars: a literature review of its causes, treatment, and prognosis.

Mandibular paresthesia is an unfortunate complication after the extraction of mandibular third molars. Damage to the inferior alveolar nerve may occur via direct or indirect injury. Careful evaluation of pre-operative panoramic radiographs with regard to root configuration and intimacy to the mandibular canal are most important. Various surgical techniques may be dictated by the radiographic presentation. When paresthesia does occur, a simple yet thorough mechanism for documentation is required. This article reviews paresthesia of the inferior alveolar nerve as a result of the extraction of the mandibular third molars.

Humans↗
PubMed1978

Paresthesia from N2. Report of a case.

A number of cases of paresthesia following the use of N2 or other paraformaldehyde-containing root canal cements have been reported. Since paresthesia is longlasting and not only an inconvenience but also disabling at times, such cements should not be used for obturating root canals.

Female↗
PubMedDate not supplied

Distribution of lumbar spinal evoked potentials and their correlation with stimulation-induced paresthesiae.

In 7 awake patients with neuropathic lower extremity pain, spinal somatosensory evoked potentials (SEP) were elicited from the non-painful leg by electrical stimulation of the peroneal nerve and mechanical stimulation of the hallux ball. Recording was made epidurally in the thoraco-lumbar region by means of an electrode temporarily inserted for trial of pain-suppressing stimulation. In response to peroneal nerve stimulation, two major SEP complexes were found. The first complex consisted, as has been described earlier, of an initial positivity (P12), a spike-like negativity (N14), a slow negativity (N16) and a slow positivity (P23). The second complex consisted of a slow biphasic wave, conceivably mediated by a supraspinal loop. Both complexes had a similar longitudinal distribution with amplitude maxima at the T12 vertebral body. The SEP evoked by mechanical hallux ball stimulation had a relatively small amplitude, and there was no significant second complex. The relationship between stimulus intensity and SEP amplitude was negatively accelerating. The longitudinal distribution of spinal SEP was compared with the somatotopic distribution of paresthesiae induced by stimulation through the epidural electrode. It was found that stimulation applied at the level of maximal SEP generally induced paresthesiae in the corresponding peripheral region. Therefore, spinal SEP may be used as a guide for optimal positioning of a spinal electrode for therapeutic stimulation when implanted under general anesthesia. An attempt was made to record the antidromic potential in the peroneal nerve elicited from the dorsal columns by epidural stimulation. The antidromic response was, however, very sensitive to minimal changes of stimulus strength and body position of the patient, and was also contaminated by simultaneously evoked muscular reflex potentials. Thus, peripheral responses evoked by epidural stimulation appeared too unreliable to be useful for the permanent implantation of a spinal electrode for therapeutic stimulation.

Adult↗
PubMed1991

Patient perceptions of pain, paresthesia, and swelling after orthognathic surgery.

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.

Adolescent↗
PubMedDate not supplied

[Paresthesia of the inferior dental nerve: clinical signs, etiological diagnosis and prognosis 1].

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.

Cranial Nerve Diseases↗
PubMedDate not supplied

[Paresthesia of the inferior alveolar nerve: clinical, diagnostic etiologic and prognostic signs, 2].

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.

Humans↗
PubMed1979

[Paresthesia].

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.

Face↗
PubMed1979

Mental nerve paresthesia secondary to sickle-cell crisis.

Two individual cases in which mental nerve paresthesia developed concurrently with sickle-cell crisis are described. A brief review of the hemoglobinopathies follows, with genetic considerations and clinical manifestations discussed.

Adolescent↗
PubMed1990

Lip paresthesia associated with a jaw mass.

A case is reported in which mandibular swelling and lower lip numbness were the first signs of a metastatic adenocarcinoma of the lung. The development of paresthesia, with or without other oral symptoms, requires that a diagnosis of malignancy be considered until confirmed or ruled out by tissue biopsy. A thorough head and neck examination in all patients, especially in those whose history or habits may indicate increased risk of malignancy is necessary.

Adenocarcinoma↗
PubMed1992

[A case of multiple sclerosis with paroxysmal attacks of facial paresthesia, unilateral hand tremor, epigastric pain and urinary incontinence].

A Japanese woman, aged 42, was admitted because of paroxysmal attacks consisting of paresthesia of the left face, tremor in the right hand, epigastric pain and urinary incontinence. A year prior to the admission, she noticed some difficulty in writing, dysarthria and unsteadiness of walking. These symptoms had been persistent since then. At the end of March, 1991, these symptoms rapidly worsened, and she fell down frequently. She also experienced pain behind both eyes, numbness in her left fingers and toe, urinary frequency and the above-mentioned attacks. Neurological examination disclosed bilateral internuclear ophthalmoplegia and upbeating nystagmus on upward gaze, titubation in the head, scanning speech, dysmetria in all limbs, exaggerated reflexes in jaw and both legs, bilateral extensor plantar reflexes and ankle clonus. SEP showed delayed cortical response with stimulation of the median nerves bilaterally and of the right posterior tibial nerve. P40 was absent with the left posterior tibial nerve stimulation. VEP was normal. T2-weighted image of MRI showed multiple high intensity areas located around the third ventricle, crus cerebri and the right upper part of the pons. The diagnosis of multiple sclerosis was made. Each paroxysmal attack started with numbness in the left face and burning sensation in the neck. Almost simultaneously tremor in the right hand began. The surface EMG showed the rhythmic contractions in the dorsal hand muscles and wrist extensors at a frequency of 6-7 Hz, and sometimes it revealed synchronized contractions of finger flexors and the dorsal hand muscles. A few seconds later she felt painful sensation in the epigastric region, and the tremor gradually increased in its intensity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Pain↗
PubMedDate not supplied

[Psychogenic oral paresthesia].

Psychogenic oral paresthesia represent a proteiform condition, more and more frequent. The failure to recognize it can lead to unjustified investigations or/and procedures. These manifestations are secondary to a psychic problem which varies in severity. In most cases, the establishment of a trust relationship, explanations to the patient and eventually a psychotherapy are sufficient to eliminate the symptoms. In severe cases, a psychotherapy or a psychiatric treatment are almost always necessary.

Adult↗