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Kristina Griffin, Michael O'Hearn, Carla C Franck, Carol A Courtney
STUDY DESIGN: Case Report. PURPOSE: Stroke is the most common cause of long-term disability. Dysesthesia, an unpleasant sensory disturbance, is common following thalamic stroke and evidence-based interventions for this impairment are limited. The purpose of this case report was to describe a decrease in dysesthesia following manual therapy intervention in a patient with history of right lacunar thalamic stroke. CASE DESCRIPTION: A 66-year-old female presented with tingling and dysesthesia in left hemisensory distribution including left trunk and upper/lower extremities, limiting function...
March 20, 2018: Disability and Rehabilitation
Stanley Yung-Chuan Liu, Douglas Sidell, Leh-Kiong Huon, Carlos Torre
Large, benign intramandibular lesions are frequently removed by resection followed by extensive free tissue transfer or delayed bone grafting. We outline a protocol to remove benign mandibular lesions using sagittal split osteotomy (SSO) with virtual surgical planning (VSP) to mitigate risks involved with this effective, tissue-saving approach. Patients with benign mandibular lesions accessed by SSO with VSP during 2014 were included in this study. Computed tomographic data were imported into VSP software. Using VSP, the exact locations of mandibular lesions and the inferior alveolar nerve canal were delineated...
March 2018: Ear, Nose, & Throat Journal
Akihiro Koba, Ryuichiro Tanoue, Shogo Kikuta, Shingo Hirashima, Yoshihiro Miyazono, Jingo Kusukawa
Mandibular osteotomy carries with it a risk of damaging blood vessels and nerves when using traditional surgical techniques. Piezosurgery® , is a new technique that uses ultrasonic vibration to enable bone-selective sectioning without damage to the surrounding soft tissues. However, paralysis may not be completely eliminated using Piezosurgery® for osteotomy. We investigated how piezoelectric surgery in bilateral sagittal splitting ramus osteotomy (BSSRO) affected the surrounding soft tissue. Forty-four patients with skeletal mandibular prognathism underwent mandibular setback with BSSRO...
March 16, 2018: Kurume Medical Journal
Steven M Falowski, Ashwini Sharan, James McInerney, Darren Jacobs, Lalit Venkatesan, Filippo Agnesi
BACKGROUND: Spinal cord stimulation (SCS) is a common intervention for managing intractable pain. Generally, leads are implanted in a minimally invasive procedure with verbal feedback regarding the location and nature of generated paresthesias by active stimulation; in this way their optimal location can be confirmed. However, lead placement under general anesthesia can have additional benefits. OBJECTIVE: To investigate the outcomes of awake vs asleep lead placement procedures...
March 14, 2018: Neurosurgery
Deed E Harrison, Paul A Oakley, Joseph W Betz
[Purpose] To present the case of the dramatic reduction in pain, disability, and neurologic symptoms following the reduction of forward head translation and increased cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip strength for 12 years following a C5-C6 cervical discectomy and fusion. Outcome measures included the neck disability index, the numerical pain rating scale, and the Zebris cervical range of motion system...
February 2018: Journal of Physical Therapy Science
Narayanam Anantha Sai Kiran, Veldurti Ananta Kiran Kumar, Laxminadh Sivaraju, Valluri Anil Kumar, Chintakunta Rajesh Reddy, Amit Agrawal
BACKGROUND: Aberrant medial retropharyngeal prevertebral course of internal carotid arteries (ICAs) is extremely uncommon. In oropharyngeal surgeries like trans oral odontoidectomy (TOO) this unrecognized aberrant retropharyngeal course of ICAs can result in devastating complications secondary to inadvertent injury of ICAs. Authors describe this aberrant course of ICAs in a patient with craniovertebral junction (CVJ) anomaly with dysmorphic C1 lateral mass on one side and discuss in detail various management issues in this complex case...
March 12, 2018: World Neurosurgery
Raquel Guimarães-Costa, Yoland Schoindre, Arnaud Metlaine, Jean-Pascal Lefaucheur, Jean-Philippe Camdessanché, Thierry Maisonobe, Jean-Marc Léger
A 59-year old woman presented with progressive paresthesias of all of her limbs for 4 years, associated with neuropathic pain, tingling in the tongue and allodynia, consistent with small-fiber neuropathy (SFN). Several systemic symptoms and signs were found on clinical examination and laboratory work-up. Neurological investigations including neurophysiologic test and skin biopsy supported the diagnosis of SFN. Chronic exposure to N-hexane was then disclosed and suspected to be the cause of the disease. Following the discontinuation of chronic N-hexane exposure, the patient had a progressive improvement of all signs and symptoms, reinforcing the correlation between exposure to N-hexane and development of SFN...
March 15, 2018: Journal of the Peripheral Nervous System: JPNS
Thomas Krøigård, Martin Wirenfeldt, Toke K Svendsen, Søren H Sindrup
Background: Cold-induced peripheral neuropathy has been described in individuals exposed to severe cold resulting in pain, hypersensitivity to cold, hyperhidrosis, numbness, and skin changes. Nerve conduction studies and thermal detection thresholds are abnormal in symptomatic patients, and intraepidermal nerve fiber density (IENFD) in skin biopsies is reduced. Case presentation: A 41-year-old male was included as a healthy subject in a study of the spontaneous variability of quantitative sensory testing (QST), nerve conduction studies (NCS), and IENFD...
March 2018: Brain and Behavior
Maha Ahmad
Dental paresthesia is loss of sensation caused by maxillary or mandibular anesthetic administration before dental treatment. This review examines inferior alveolar block paresthesia symptoms, side effect and complications. Understanding the anatomy of the pterygomandibular fossa will help in understanding the nature and causes of the dental paresthesia. In this review, we review the anatomy of the region surrounding inferior alveolar injections, anesthetic agents and also will look also into the histology and injury process of the inferior alveolar nerve...
2018: Open Dentistry Journal
Yakup Bozkaya, Gökmen Umut Erdem, Nebi Serkan Demirci
Arthralgia, myalgia, paresthesia, reduced bone mineral density, vasomotor side effects including hot flashes and night sweats, genitourinary symptoms including decreased libido, vaginal dryness and dyspareunia are common side effects of aromatase inhibitors. Unlike the common side effects, the information on neurological side effects like hallucination of aromatase inhibitor was limited in literature cases. Herein, we reported a case of hallucination related to anastrozole in a patient with metastatic breast cancer...
January 1, 2018: Journal of Oncology Pharmacy Practice
Andrew T Koogler, Michael Kushelev
A 76-year-old male presented for reverse total shoulder arthroplasty (TSA) in the beach chair position. A preoperative interscalene nerve catheter was placed under direct ultrasound-guidance utilizing a posterior in-plane approach. On POD 2, the catheter was removed. Three weeks postoperatively, the patient reported worsening dyspnea with a subsequent chest X-ray demonstrating an elevated right hemidiaphragm. Pulmonary function testing revealed worsening deficit from presurgical values consistent with phrenic nerve palsy...
2018: Case Reports in Anesthesiology
Meletis Rozis, Ioannis Benetos, Panagiotis Karampinas, Vasilios Polyzois, John Vlamis, Spyros Pneumaticos
BACKGROUND: Conservative treatment of an acute Achilles rupture remains a viable and acceptable option as does surgical fixation, with open and percutaneous repair consisting the main operative techniques. The purpose of this study was to compare the outcomes and complication rates of open versus percutaneous surgical procedures. METHODS: From 2009 to 2016, 131 patients were admitted to our department with clinically and radiologically confirmed acute Achilles tendon ruptures...
March 1, 2018: Foot & Ankle International
Jiajia Wu, Yechen Lu, Xuyun Hua, Shujie Ma, Jianguang Xu
OBJECTIVE: We utilized fMRI to provide a longitudinal description of cortical plasticity caused by electroacupuncture(EA) of sciatic nerve transection and direct anastomosis rats. METHODS: Sixteen rats of sciatic nerve transection and direct anastomosis model were randomly divided into intervention and control group. EA intervention in the position of ST-36, GB-30 was conducted continuously for 4 months in the intervention group. Functional MRI and gait assessment was performed every one month after intervention...
March 7, 2018: World Neurosurgery
Michael A Silva, Rodolfo E Alcedo Guardia, Mohammad Ali Aziz-Sultan, Nirav J Patel
High flow extracranial-intracranial (EC-IC) bypass with a saphenous vein graft (SVG) has been used for more than 40 years in patients with giant aneurysms of the posterior circulation refractory to medical management, and has demonstrated high long term patency rates. We report the case of a patient treated with external carotid artery (ECA)-posterior cerebral artery SVG bypass in 1989 who presented 27 years later with paresthesias and confusion, and was found to have partial occlusion of her SVG bypass graft and a basilar occlusion...
March 8, 2018: BMJ Case Reports
Thaís Miranda Xavier de Almeida, Édila Figuerêdo Feitosa Cavalcanti, Alessandra da Silva Freitas, Roberto José Pessoa de Magalhães, Angelo Maiolino, Sandra Regina Torres
OBJECTIVE: To review published data on oral manifestations of multiple myeloma. METHODS: An electronic database search was performed of articles published from 1971 to November 2016 in order to identify studies that reported oral manifestations of patients with multiple myeloma. Case reports and case series with oral manifestations of multiple myeloma in English were included in the study. An additional search was performed of the references of the selected articles...
January 2018: Revista Brasileira de Hematologia e Hemoterapia
Dan Ziegler, Rüdiger Landgraf, Ralf Lobmann, Karlheinz Reiners, Kristian Rett, Oliver Schnell, Alexander Strom
AIMS: We conducted a nationwide educational initiative to determine the prevalence and risk factors of diagnosed and undiagnosed painful and painless distal sensory polyneuropathy (DSPN). METHODS: Among 1,850 participants, 781 had no history of diabetes (ND), 126 had type 1 diabetes (T1D), and 943 had type 2 diabetes (T2D). Painful DSPN was defined as polyneuropathy detected by bedside tests with pain and/or burning in the feet, while painless DSPN was defined as polyneuropathy with paresthesias, numbness, or absence of symptoms...
March 5, 2018: Diabetes Research and Clinical Practice
B González-García, S García-Isidoro, J Contreras-Alcántara, J A Martínez-Gil, M A Díaz Y Orea, V O Castellanos-Sánchez
The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal» or «rustic» systems that hamper their adaptation process...
September 2017: Acta Ortopédica Mexicana
Yang Meng, Xiaofei Wang, Beiyu Wang, Tingkui Wu, Hao Liu
RATIONALE: Cervical open-door laminoplasty can enlarge the volume of the cervical vertebral canal and thus has become an effective and safe treatment for multilevel cervical disc herniation and cervical stenosis. Some post-surgery complications exist, such as reduction of cervical alignment and local kyphosis. However, aggravation of cervical disc herniation at the surgical level during short-term follow-up has not been discussed. Additionally, spontaneous disappearance of herniated disc pulposus is a common phenomenon in the lumbar region but is relatively rare in the cervical region...
March 2018: Medicine (Baltimore)
Natalia C Drosu, Elazer R Edelman, David E Housman
We present the case of an HIV-negative patient clinically diagnosed with relapsing-remitting MS who achieved significant disease improvement on Combivir (zidovudine/lamivudine). Within months of treatment, the patient reported complete resolution of previously unremitting fatigue and paresthesiae, with simultaneous improvements in lesion burden detected by MRI. All improvements have been sustained for more than three years. This response may be related to the action of zidovudine as a known inhibitor of EBV lytic DNA replication, suggesting future directions for clinical investigation...
February 27, 2018: Multiple Sclerosis and related Disorders
QiHao Ong, Janice Wong, Sanjay Sinha, Nand Kejriwal
We report a case of desmoid fibromatosis of the chest wall. A 70-year-old woman was referred to our hospital with right shoulder blade pain and paresthesia over the right upper breast. Chest X-ray and computed tomography demonstrated a 5 cm right apical mass in the chest. Biopsy of the mass demonstrated features of desmoid fibromatosis. The patient subsequently underwent surgical resection of the mass and received adjuvant radiation therapy for microscopic positive margins. In conclusion, although desmoid tumour of the chest is rare, it is worth considering in the differential diagnoses of chest wall tumours...
May 2018: Respirology Case Reports
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