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https://www.readbyqxmd.com/read/29780700/sporadic-nf2-mosaic-multiple-spinal-schwannomas-presenting-with-severe-intractable-pain-following-pregnancy
#1
Jeffrey H Zimering, Bryan D Choi, Matthew J Koch, John C Dewitt, Anat Stemmer-Rachamimov, John H Shin
The aim of the present paper is to report undiagnosed sporadic neurofibromatosis type 2 presenting with symptomatic compressive spinal tumors following pregnancy. A 36-year-old woman experienced progressive, severe lumbar radicular pain in the second trimester of pregnancy which became intractable soon after delivery. Magnetic resonance imaging revealed a complex heterogeneous hypointense mass lesion around the conus. There were two small punctate lesions in the cauda equina suggestive of myxopapillary ependymoma with 'drop metastases...
December 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/29776002/the-chaos-of-hospitalisation-for-patients-with-critical-limb-ischaemia-approaching-major-amputation
#2
Susan Monaro, Sandra West, Jana Pinkova, Janice Gullick
AIMS AND OBJECTIVES: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI). BACKGROUND: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29775161/surgical-treatment-of-middle-cluneal-nerve-entrapment-neuropathy-technical-note
#3
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Daijiro Morimoto, Masanori Isobe
OBJECTIVE The etiology of low-back pain (LBP) is heterogeneous and is unknown in some patients with chronic pain. Superior cluneal nerve entrapment has been proposed as a causative factor, and some patients suffer severe symptoms. The middle cluneal nerve (MCN) is also implicated in the elicitation of LBP, and its clinical course and etiology remain unclear. The authors report the preliminary outcomes of a less invasive microsurgical release procedure to address MCN entrapment (MCN-E). METHODS The authors enrolled 11 patients (13 sites) with intractable LBP judged to be due to MCN-E...
May 18, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29770873/xiphoidectomy-for-intractable-xiphodynia
#4
Patrick Dorn, Michael A Kuhn, Barbara A Schweizer, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Xiphodynia is a rare condition with hardly any data published regarding xiphoidectomy as a valid treatment option for intractable disease. It is necessary to bear this syndrome in mind after having filtered out other differential diagnoses. METHODS: Between 2003 and 2015, 11 patients underwent xiphoidectomy for intractable xiphodynia at our institution. Patients' charts were reviewed including preoperative workup, operative technique, and results. Every patient had routine follow-ups, 4 weeks after the procedure and 1 year after surgery...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29764303/relief-from-intractable-phantom-pain-by-combining-psilocybin-and-mirror-visual-feedback-mvf
#5
Vilayanur Ramachandran, Chaipat Chunharas, Zeve Marcus, Timothy Furnish, Albert Lin
AL's leg was amputated resulting in phantom-limb pain (PLP). (1) When a volunteer placed her foot on or near the phantom - touching it evoked organized sensations in corresponding locations on AL's phantom. (2) Mirror-visual-feedback (MVF) relieved PLP, as did, "phantom massage". (3) Psilocybin-MVF pairing produced synergistic effects, complete elimination of PLP, and reduction in paroxysmal episodes. (4) Touching the volunteer's leg where AL previously had external fixators, evoked sensation of nails boring through the leg...
May 15, 2018: Neurocase
https://www.readbyqxmd.com/read/29763654/obturator-neuromodulation-with-laparoscopic-placement-of-an-obturator-lead-for-the-treatment-of-intractable-opioid-dependent-chronic-pelvic-pain-due-to-obturator-neuralgia
#6
Richard P Marvel
Chronic pelvic pain(CPP) is a common condition in women that can have a devastating effect on quality of life. Some of the most severe forms of CPP are related to peripheral nerve injuries causing persistent neuropathic pain. This is a case of a young woman with severe opioid dependent chronic pelvic and right groin pain due to obturator neuralgia. She had failed a multitude of treatments including multiple medications, manual physical therapy, nerve blocks, surgical neurolysis and spinal cord stimulation without significant benefit...
May 12, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29761638/ultra-sound-guided-neurolysis-of-six-genicular-nerves-of-knee-for-intractable-pain-from-knee-osteoarthritis-a-case-series
#7
Arif Ahmed, Divesh Arora
INTRODUCTION: Among the elderly populations, the chronic osteoarthritis of knee joint is one of the leading cause of disability and causes considerable pain, joint stiffness and functional limitations. Although knee replacement is a good option for the grade IV osteoarthritis, but many patients failed to undergo surgery due to co-morbidities or other reasons. METHODS: Four patient with severe pain from grade III and IV osteoarthritis of knee joint had underwent ultrasound guided alcohol neurolysis of the six genicular nerves of knee joint after a positive genicular nerve block with local anesthetics...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29753349/can-severity-outweigh-smaller-numbers-a-deliberative-perspective-from-canada
#8
Monica Magalhaes
OBJECTIVES: To use structured deliberation to elicit and describe the values of the public in Alberta, Canada, on the question of whether the severity of a rare condition can justify it being given priority in funding over common conditions affecting larger numbers of patients, and what aspects of a condition drive this judgment. METHODS: Thematic analysis of transcripts of a group deliberative exercise carried out as part of two citizens' juries. The exercise was designed to elicit participants' conception of disease severity, and trade-offs between helping small groups with severe conditions and larger groups with less severe conditions...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29737933/case-report-utility-of-ketamine-lidocaine-and-mexiletine-as-nonopioid-adjuvants-in-complex-cancer-associated-pain
#9
Robert C Hakim, Kyle P Edmonds, Rabia S Atayee
Ketamine, lidocaine, and mexiletine are potential nonopioid adjuvant medications for the use of refractory cancer-related pain, particularly when opioids are demonstrating limited objective benefit. This is a case report of a single patient admitted to a large academic medical center in the United States. The patient is a 43-year-old woman with a history of Crohn's disease complicated by rectal squamous cell carcinoma and complex, progressive, and intractable pelvic and rectal pain. Over the course of hospitalization, her pain demonstrated limited opioid responsiveness despite marked fluctuations of her oral morphine equivalent doses...
May 8, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29734945/subtle-elbow-instability-associated-with-lateral-epicondylitis
#10
Sang Ho Kwak, Seung-Jun Lee, Hee Seok Jeong, Min Uk Do, Kuen Tak Suh
BACKGROUND: In lateral epicondylitis, even in the absence of apparent instability, subtle instability can be found under anesthesia. We wanted to ascertain the following: (1) how many elbows surgically treated with lateral epicondylitis showed subtle instability during examination under anesthesia (EUA), (2) how effective magnetic resonance imaging (MRI) was in predicting subtle instability, and (3) if any difference existed in preoperative clinical data between elbows with and without subtle instability during EUA...
May 7, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29729250/application-of-optogenetics-in-the-study-of-pain-modulation
#11
REVIEW
Yu-Feng Xie, Jing Wang, Robert P Bonin
Intractable pain is the single most common cause of disability, affecting more than 20% of the population world-wide. There is accordingly a global effort to decipher how changes in the activity of nociceptive sensory afferents and dorsal horn cell populations contribute to the onset and maintenance of chronic pain. Through the application of advances in genetic techniques, there has been a surge in the success of efforts along this front. In particular, the past several years have brought rapid progress in the adaptation of optogenetic approaches to study and manipulate the activity of sensory afferents and spinal cord neurons in freely behaving animals...
May 2, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29726593/surgical-management-of-neck-pain-and-headache-associated-with-pediatric-hashimoto-s-thyroiditis
#12
Paul Krakovitz, Christine Cairns, Bahareh Michelle Schweiger, Brian Burkey
OBJECTIVES/HYPOTHESIS: Case reports of a painful variant of Hashimoto's thyroiditis exist in the literature; however, these cases have only been documented in adult patients and there are no standard treatment guidelines. The aim of this study was to describe an alternative management for Hashimoto's thyroiditis associated with medically intractable head and neck pain in the pediatric population. STUDY DESIGN: Case series with chart review. METHODS: The study was conducted in the Section of Pediatric Otolaryngology at the Cleveland Clinic...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29720816/short-lasting-unilateral-neuralgiform-headache-attacks
#13
REVIEW
Andrew Levy, Manjit S Matharu
Short-lasting unilateral neuralgiform headache attacks (SUNHA) is characterized by strictly unilateral trigeminal distribution pain that occurs in association with ipsilateral cranial autonomic features. There are two subtypes: short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). These disorders are rare but highly disabling. The management of SUNHA can be challenging...
April 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29720798/mercury-toxicity-following-unauthorized-siddha-medicine-intake-a-mimicker-of-acquired-neuromyotonia-report-of-32-cases
#14
G Gnanashanmugam, R Balakrishnan, S P Somasundaram, N Parimalam, P Rajmohan, M B Pranesh
Context: Mercury is used extensively in the preparation of Siddha medicines, after purification. In this study, we present 32 patients of mercury toxicity following unauthorized Siddha medicine intake who mimicked neuromyotonia clinically. We analyzed the clinical features of these patients, the role of autoimmunity in etiopathology, and compared it with acquired neuromyotonia. Subjects and Methods: This is a retrospective study to analyze inpatients in a tertiary care center, admitted with mercury toxicity following Siddha medicine intake from August 2012 to October 2016...
January 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29713362/tanshinone-iia-attenuates-diabetic-peripheral-neuropathic-pain-in-experimental-rats-via-inhibiting-inflammation
#15
Baojian Zhang, Yanbing Yu, Gele Aori, Qi Wang, Dawei Kong, Wenqiang Yang, Zhuangli Guo, Li Zhang
Diabetic peripheral neuropathic pain (DPNP) is a common and intractable complication of diabetes. Conventional therapies are always not ideal; development of novel drugs is still needed to achieve better pain relief. Recent evidences have demonstrated that inflammation is involved in the onset and maintenance of DPNP. The anti-inflammatory property of Tanshinone IIA (TIIA) makes it a promising candidate to block or alter the pain perception. This study was conducted to investigate whether TIIA could attenuate DPNP in streptozotocin- (STZ-) induced rats model and its potential mechanisms...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29709741/long-term-follow-up-of-patients-with-metastatic-epidural-spinal-cord-compression-mescc-from-solid-tumors-submitted-surgery-followed-by-radiation-therapy
#16
Federico Pessina, Pierina Navarria, Giulio Alberto Carta, Giuseppe Roberto D'Agostino, Elena Clerici, Marco Conti Nibali, Francesco Costa, Maurizio Fornari, Marta Scorsetti
OBJECTIVE: To evaluate the outcome of patients, with epidural spinal cord compression (MESCC) from different solid tumors, treated with a combined approach, surgery plus radiotherapy (RT), with a follow-up longer than 10 years. METHODS: Ninety-seven patients treated between 2002 and 2009 were included. Surgical treatment was performed in patients with good performance status, limited metastatic disease, life expectancy longer than 3 months and progressive neurologic deficit and/or intractable pain...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29701900/single-s1-dorsal-root-ganglia-stimulation-for-intractable-complex-regional-pain-syndrome-foot-pain-after-lumbar-spine-surgery-a-case-series
#17
Ioannis M Skaribas, Christian Peccora, Elena Skaribas
INTRODUCTION: Intractable complex regional pain syndrome (CRPS)-related chronic foot pain, is a common therapeutic challenge for interventional pain management physicians and patients alike. Dorsal root ganglia (DRG) stimulation is a very target specific dorsal column stimulation technique with very promising clinical outcomes. Patients with CRPS foot pain and previous back surgery can benefit from DRG stimulation but also run a significant risk of epidural trauma from the DRG sheath advancement...
April 27, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29699887/repetitive-transcranial-magnetic-stimulation-accuracy-as-a-spinal-cord-stimulation-outcome-predictor-in-patients-with-neuropathic-pain
#18
Takeshi Shimizu, Koichi Hosomi, Tomoyuki Maruo, Yuko Goto, Toshio Shimokawa, Kishima Haruhiko, Youichi Saitoh
OBJECT: Spinal cord stimulation (SCS) is an effective albeit invasive and relatively expensive treatment of neuropathic pain. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) is a non-invasive treatment of neuropathic pain. The aim of the current study was to investigate whether rTMS can predict the successful outcome of SCS. METHODS: The study population consisted of 22 patients with neuropathic pain who had undergone SCS and rTMS...
April 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29694467/continuous-dentoalveolar-neuropathic-pain-response-to-repeated-intravenous-ketamine-infusions-a-case-report
#19
Isabel Moreno-Hay, John Lindroth
This article describes a case of continuous dentoalveolar neuropathic pain in which relief was obtained following repeated administration of intravenous infusions of a subanesthetic dose of ketamine. A 50-year-old female presented in 2006 with a 1-year history of constant sharp pain in the gingiva surrounding the maxillary left second premolar and second molar rated as 10/10 on a pain intensity scale. After multiple systemic medications failed to adequately manage the patient's pain, partial pain reduction was obtained (4/10) with daily use of methadone 50 mg in combination with application of a topical compound including lidocaine, amitriptyline, and carbamazepine to the affected area as needed...
April 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29693428/luisa-s-ghosts-haunted-legality-and-collective-expressions-of-pain
#20
Amy Krauss
Feminist health care providers have debated the efficacy of the decriminalization of abortion in Mexico City. Luisa, a counselor in a private clinic, suggested that while the law has expanded the visibility of, and access to safe abortion, it has also called forth "other ghosts." In this article, I take Luisa's critical perspective as a starting point for examining ongoing criminalization and moral stigma as forms of haunting that arise in the wake of the Mexico City abortion policy. Drawing on ethnographic research, I explore how Luisa's ghosts materialize in the embodied- affective relations between patients in new legal clinics...
April 25, 2018: Medical Anthropology
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