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At least 19 recordsLinked to original sources

Reappraisal of somatosensory disorders in methylmercury poisoning.

The first well-documented methylmercury (MeHg) poisoning by consumption of fish arose in Minamata, Japan in 1953. MeHg had dispersed from Minamata to the Shiranui Sea. The temporal changes in MeHg in the umbilical cords indicate that residents living around that Sea had been exposed to low-dose MeHg through fish consumption for about 20 years (at least from 1950 to 1968). They have complained of paresthesia at the distal parts of the extremities and around the lip even 30 years after the cessation of exposure to anthropogenic MeHg. The thresholds of touch and two-point discrimination of those residents and Minamata disease (MD) patients were examined using the quantifiable instruments. They could perceive the stimulation of touch although their touch thresholds significantly increased in comparison to those of the control people. Their touch thresholds increased at the proximal extremities and the trunks as well as at the distal extremities. The evenly distributed increases at both distal and proximal parts revealed that the persistent somatosensory disturbances were not caused by the injuries to their peripheral nerves. The thresholds of two-point discrimination, which are associated with the function of the somatosensory cortex, increased at both forefingers and the lip in both groups. Taking into consideration that, the apraxia limb kinetics, astereognosis and disorder of active sensation, which are all associated with damage to the somatosensory cortex, were detected, it is proposed that the persisting somatosensory disorders after discontinuation of exposure to MeHg were induced by diffuse damage to the somatosensory cortex.

Aged↗

[Somatosensory disorders in patients with extrapyramidal pathology: the effect of a stereotaxic intervention].

The authors compared somatosensory evoked potentials (SSEP) recorded in 16 patients with infantile cerebral paralysis (ICP), 16 patients with parkinsonism (P), 18 patients with torticollis (T), and 15 healthy individuals. Structural changes of SSEP were found in all patients with ICP and in most patients with P and T. The structural changes of SSEP in these patients were mainly associated with the absence or suppression of one or two components of SSEP of a healthy individual. It is assumed that one and the same pathological process underlies these three diseases, but it differs in the degree of manifestation in each one. Two groups of patients with parkinsonism which differed in age were distinguished, which represent, probably, two different pathological processes. Certain normalization of the muscular tonus and inhibition of hyperkinesia in most patients as the result of stereotaxic operation was not attended by normalization of the SSEP structure.

Adolescent↗

Compensation and non-compensation chronic pain patients compared for DSM-III operational diagnoses.

Two hundred and eighty-three mixed chronic pain patients, consecutive admissions, were diagnostically evaluated as per DSM-III, Axis I, Axis II or personality type psychiatric operational criteria. Controlling for primary organic treatment diagnosis, age and race, statistical comparisons were made between male compensation patients (n = 93) and male non-compensation patients (n = 23) and between female compensation patients (n = 38) and female non-compensation patients (n = 28) for all DSM-III diagnoses. Male compensation patients were significantly overrepresented for these diagnostic groups: conversion disorder (somatosensory type); combined personality disorders; and passive-aggressive personality disorder. Male non-compensation patients were significantly overrepresented for these diagnostic groups: no diagnosis on Axis I; combined personality types; and compulsive personality type. Female compensation patients were significantly overrepresented for conversion disorder (somatosensory) only. Female non-compensation patients were significantly overrepresented for generalized anxiety disorder and combined anxiety syndromes. Compensation chronic pain patients may be at risk for some psychiatric disorders not previously identified: conversion disorder (somatosensory), and personality disorders.

Adult↗

Effects of aldose reductase inhibitor and vitamin B12 on myocardial uptake of iodine-123 metaiodobenzylguanidine in patients with non-insulin-dependent diabetes mellitus.

This study was undertaken to examine the effects of aldose reductase inhibitor (ARI) and vitamin B12 (VB12) on myocardial uptake of iodine-123 metaiodobenzylguanidine (MIBG) in patients with diabetic autonomic disorder. Myocardial scintigraphy using 123I-MIBG was performed on 20 healthy volunteers (controls) and 56 patients with non-insulin-dependent diabetes mellitus (NIDDM), in order to obtain the heart/mediastinum ratio in the initial (HMi) and the delayed images (HMd), and the washout rate (%WR). Thirty-four of the 56 NIDDM patients could be diagnosed as having diabetic autonomic disorder by evaluating their scintigraphic findings in comparison with the controls. Seventeen of these 34 patients received 150 mg/day of doses before meals, and the other 17 received 1.5 mg/day of mecobalamin (VB12 group) in three divided doses after meals, for 3-5 months. According to the presence or absence of clinical symptoms of autonomic or peripheral somatic nerve disorder, the patients were subclassified into four groups. group 1=patients, with autonomic symptoms or somatosensory disorder in the ARI group; group 2=patients without autonomic symptoms or somatosensory disorder in the ARI group; group 3=patients with autonomic symptoms or somatosensory disorder in the VB12 group; and group 4=patients without autonomic symptoms or somatosensory disorder in the VB12 group. After completion of the treatment, myocardial scintigraphy was performed again. Comparing the results obtained before and after the treatment, it was seen that ARI improved only the HMi in group 1 (P=0.046), whereas VB12 significantly improved HMi in the group 3 (P=0.018) and HMi, HMd and %WR in group 4 (P=0.043, P=0.018 and P=0.043, respectively). We conclude that VB12 is more efficacious than ARI in the treatment of diabetic cardiovascular autonomic disorder.

3-Iodobenzylguanidine↗

Stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation.

Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.

Adult↗

[Somatosensory evoked potentials in panic disorders].

BACKGROUND: Panic disorders are at present the most intensely studied psychiatric entity calling for a multidisciplinary approach. After promising results following the use of evoked auditory potentials for the first time in panic disorders the somatosensory evoked potential was tested. METHODS AND RESULTS: Fifteen patients with panic disorders or agoraphobias or without the latter (12 women, 3 men, average age 33.7 +/- 9.3 years) were subjected during the interparoxysmal period to examination of the somatosensory evoked potential (SEP) of the n. medianus, bilaterally. The control group was formed by 20 healthy subjects (12 women and 8 men), age 20-45 years, average age 34 +/- 8.5 years). An EMG apparatus Madaus Electronic 15 was used. The authors revealed significant changes of some parameters of SEP only in patients with panic disorders: bilateral shortening of the mean latency P17 (P < 0.01). Bilateral shortening of the mean conduction time N13-P17 and P14-P17 (P < 0.01). CONCLUSIONS: The assembled findings are consistent with the pathophysiological concept of panic disorder at the brain stem level. The findings are confronted with changes of auditory evoked potentials and are consistent with contemporary views as regards pathomechanisms of panic disorders.

Adolescent↗

Assessment of somatosensory indicators of polyneuropathy in patients with eating disorders.

The somatosensory functions of small-diameter nerve fibres were tested on the lower and upper extremities in nine patients with anorexia nervosa, ten patients with bulimia nervosa and ten control subjects, by analysing warmth, cold, and pain thresholds. To test large-diameter nerve fibres, the vibration threshold was also measured. Both patient groups had markedly elevated pain thresholds compared with the control subjects. In contrast, warmth and cold thresholds were only suggestively elevated while vibration thresholds were not at all increased in the patients. A distal-proximal pattern of somatosensory deficits, suggestive of peripheral polyneuropathy, was not observed. Hence, a peripheral polyneuropathy affecting small or large afferent fibres as a consequence of an eating disorder seems to be a rare event.

Adult↗

Comparison of tactile preferences in children with and without cerebral palsy.

Fifteen normal preschool children and 15 preschool children with cerebral palsy were presented with 10 pairs of objects and asked to identify their preference for one of the objects in each of the pairs. Five objects of different textures were used. The children only handled the objects; they did not view them during testing. The children with cerebral palsy chose hard objects significantly more often than they chose soft objects; the normal children had no significant choice preferences. Eleven of the children with cerebral palsy had choice patterns significantly different from those of the normal children. The apparent preference of the children with cerebral palsy for hard objects and their avoidance of soft objects suggests that they may have decreased tactile awareness and need the greater proprioceptive input that hard objects provide. The findings of this study indicate that preschool children with cerebral palsy may be at high risk for somatosensory disorders, which could markedly affect their hand function.

Cerebral Palsy↗

The clinical role of somatosensory evoked potential studies: a critical appraisal.

The clinical utility and limitations of somatosensory evoked potential (SEP) studies are reviewed. Somatosensory evoked potentials may help to identify a lesion in the sensory pathways, but do not indicate its nature. In multiple sclerosis subjects, the SEP findings may help to establish that there is a multiplicity of lesions, but multimodality evoked potential abnormalities may occur in other disorders. Somatosensory evoked potential abnormalities do not reflect either the severity or the prognosis of cervical spondylosis and do not reliably permit early recognition of the totality of traumatic cord lesions, while the role of SEPs in monitoring cord function intraoperatively awaits definition. Somatosensory evoked potentials do not reliably indicate the individual prognosis after severe head injury, and discrepancies in published findings suggest that their use in the evaluation of brain death is premature. In hereditary spinocerebellar degenerations, SEP abnormalities may reflect central or peripheral pathology. Somatosensory evoked potentials can be used to determine conduction velocity in peripheral nerves and to identify inaccessible proximal lesions of these nerves, but the findings may lead to misleading conclusions about brachial plexus lesions, especially if pre- and postganglionic lesions coexist.

Brain Death↗

Directional sensibility for quantification of tactile dysfunction.

Examination of tactile directional sensibility, i.e., the ability to tell the direction of an object's motion across the skin, has been recommended by several authors for examination of patients with somatosensory disorders. Recent findings about the physiological mechanisms underlying directional sensibility suggested possibilities to further improve the test. In the present investigation a test was constructed that allowed a semiquantification of the directional sensibility of six body areas within 20 min. Normal values were obtained by testing healthy subjects (n = 40), and the normal values were compared to those obtained in a group of patients with tactile symptoms (n = 20). Ten of the patients had abnormal sensory conduction in one or several nerves, and they also had abnormal directional sensibility. Hence, examination of directional sensibility, according to the present protocol, provides a semiquantitative test that appears to be as sensitive as electrophysiological measurement of conduction in detecting dysfunction in tactile nerves.

Adult↗

Rhythmic movements during sleep: a physiological and pathological profile.

Rhythmic movement disorder (RMD) consists of rhythmic movements (RMs) that occur on falling asleep or during sleep, can involve any part of the body and have a reported frequency ranging from 0.5 to 2 Hz. RMs have been reported to occur in a high proportion of normal children as a self-limiting phenomenon starting and remitting within early infancy. However, there have also been descriptions of forms of RMD occurring against a background of mental retardation or persisting beyond childhood, or having onset in adulthood. So, the occurrence of RMs can be regarded as both a physiological and a pathological phenomenon. The few polysomnographic studies conducted in this field have shown that, in some forms of RMD, RMs are highly linked to arousal fluctuations. However, the mechanisms that underlie the genesis of RMs and are capable of leading to both physiological and pathological patterns of RMs are not fully understood. Here we emphasise the possibility that the central motor pattern generator, recently hypothesised to play a role in the genesis of motor phenomena during sleep in the cases of parasomnia and epileptic seizures, might account for the occurrence of RMs in both physiological and pathological conditions.

Adolescent↗

Dyspnea: the role of psychological processes.

Breathlessness or dyspnea-the subjective experience of breathing discomfort-is a symptom in many pulmonary, cardiovascular, and neuromuscular diseases. It occurs in normals as well during intense emotional states and heavy labor or exercise. In clinical cases, it generally causes severe suffering. Dyspnea has multifactorial causes and the explanation for the symptom may differ largely among patients. Explanatory models imply the involvement of mechanisms at several levels of functioning, such as afferent signals from the respiratory muscles or blood gas levels related to hypercapnia and hypoxia. Depending on the relative involvement of specific mechanisms and their interactions, dyspnea may be experienced differently and subtypes can be distinguished. More recently, perceptual-cognitive and emotional processes related to symptom perception and interpretation have been investigated in the context of dyspnea. In this review, we focus on the psychological processes that play part in the perception of dyspnea and formulate some practical guidelines for those who are confronted with dyspnea.

Arousal↗

Prostaglandin E1 in lipid microspheres ameliorates diabetic peripheral neuropathy: clinical usefulness of Semmes-Weinstein monofilaments for evaluating diabetic sensory abnormality.

We investigated the effect of Prostaglandin E1 in lipid microspheres (Lipo-PGE1) on diabetic peripheral neuropathy from view of symptoms, neurological examinations including sensory threshold evaluated with Semmes-Weinstein monofilaments (SWM). Type 2 diabetic patients with diabetic peripheral neuropathy were participated in this study. The patients were randomly assigned to two groups, 11 Lipo-PGE1-treated patients and 16 control patients. Lipo-PGE1 at a dose of 10mg in 20ml of saline was injected intravenously as a bolus once daily for 2 weeks. Before and, 1, 2 and 4 weeks after the start of treatment with Lipo-PGE1, sensory threshold was evaluated with Semmes-Weinstein monofilaments at total 18 touch sites on the feet. Administration of Lipo-PGE1 improved subjective symptoms especially in items of numbness and imperception. Such improvement in subjective symptoms correlated well with the improvement in Semmes-Weinstein monofilaments examination, whereas the improvement was not recognized in motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV) and coefficient variation of R-R interval on ECG (CVR-R). The improvement lasted for at least 6 months. This study demonstrated that Lipo-PGE1 has long term amelioration effects on diabetic neuropathy especially in symptoms and sensory threshold, and that Semmes-Weinstein monofilaments examination is a simpler, more valid and quantitative tool for assessing the clinical effect of Lipo-PGE1 on diabetic peripheral neuropathy.

Alprostadil↗

Effects of the novel analgesic, cizolirtine, in a rat model of neuropathic pain.

Cizolirtine (5-9[(N,N-dimethylaminoethoxy)phenyl]methyl0-1-methyl-1H-pyrazol citrate) is a centrally acting analgesic with a currently unknown mechanism of action, whose efficacy has been demonstrated in various models of acute and inflammatory pain in rodents. Further studies were performed in order to assess its potential antinociceptive action in a well-validated model of neuropathic pain, i.e. that produced by unilateral sciatic nerve constriction in rats. Animals were subjected to relevant behavioural tests based on mechanical (vocalization threshold to paw pressure) and thermal (struggle latency to paw immersion in a cold (10 degrees C) water bath) stimuli, 2 weeks after sciatic nerve constriction, when pain-related behaviour was fully developed. Acute pretreatment with 2.5-10 mg/kg p.o. of cizolirtine reversed both mechanical and thermal allodynia. These effects were antagonized by prior injection of the alpha(2)-adrenoceptor antagonist idazoxan (0.5 mg/kg i.v.), but not the opioid receptor antagonist naloxone (0.1 mg/kg i.v.). On the other hand, cizolirtine (10 mg/kg p.o.) produced no motor deficits in animals using the rotarod test. Our study showed that cizolirtine suppressed pain-related behavioural responses to mechanical and cold stimuli in neuropathic rats, probably via an alpha(2)-adrenoceptor-dependent mechanism. These results suggest that cizolirtine may be useful for alleviating some neuropathic somatosensory disorders, in particular cold allodynia, with a reduced risk of undesirable side effects.

Analgesics↗

[Ossification of the common posterior longitudinal ligament of the spine and spinal cord compression in a patient from Senegal].

INTRODUCTION: Ossification of the posterior longitudinal ligament of the spine is a rare cause medullar compression. OBSERVATION: A 50-year-old man from Senegal was referred with recent-onset mechanical lumbar pain with proximal motor deficiency of the lower limbs and somatosensory disorders. Magnetic resonance imaging revealed layered medullar compression, due to anterior cervical and mixed anterior and posterior thoracic ossification. Corticosteroid treatment led to regression of the pain and neurological disorders within a few days. DISCUSSION: This case report of ossification of the posterior longitudinal ligament of the spine appears to be an idiopathic form corresponding to the "Japanese disease" initially thought to be limited to that population.

Anti-Inflammatory Agents↗