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Neuralgia

Neuralgias


Presentation

  • In the present case, a branching tributary of the occipital artery at the crossing point forming a constricting loop above the course of the GON was found to be the cause of entrapment.[ncbi.nlm.nih.gov]
  • We aimed to explore the clinical characteristics, early diagnosis, and microneurosurgical techniques for CPA cholesteatoma that presented as trigeminal neuralgia.[ncbi.nlm.nih.gov]
  • BACKGROUND: NMOSD is an inflammatory demyelinating disease that commonly presents with pain; however, headache symptoms have received little attention.[ncbi.nlm.nih.gov]
  • CASE PRESENTATION: We report a case of 54-year-old male who presented with post-operative pain after 1 month and sensory disturbances of the right lower limb.[ncbi.nlm.nih.gov]
  • The causes, presentation, diagnosis, management, prognosis, and prevention of PON were reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.[ncbi.nlm.nih.gov]
Axillary Pain
  • The third case initially presented with axillary pain and lateral shoulder pain 1 year out from radical mastectomy.[ncbi.nlm.nih.gov]
Malingering
  • ., Malingering and the Simulation of Disease ( London : William Heinemann, 1917 ). Google Scholar Lawson, H., Sciatica, Lumbago, and Brachialgia ( London : Robert Hardwicke, 1872 ).[doi.org]
  • Lorenz J, Kunze K, Bromm B (1998) Differentiation of conversive sensory loss and malingering by P300 in a modified oddball task. Neuroreport 9: 187–191 PubMed CrossRef Google Scholar 32.[doi.org]
Inguinal Hernia
  • BACKGROUND: Neuralgia after inguinal hernia repair is a known but potential invalidating complication with a reported incidence of 10-12%. Diagnosis and treatment can be challenging.[ncbi.nlm.nih.gov]
Orthostatic Hypotension
  • The adverse effects of tramadol include dizziness, nausea, constipation, somnolence, and orthostatic hypotension.[doi.org]
Dry Eyes
  • Distinguishing this syndrome from typical post-LASIK dry eye remains a challenge.[ncbi.nlm.nih.gov]
  • Citing Literature Number of times cited according to CrossRef: 9 Vannarut Satitpitakul, Ahmad Kheirkhah, Alja Crnej, Pedram Hamrah and Reza Dana, Determinants of Ocular Pain Severity in Patients With Dry Eye Disease, American Journal of Ophthalmology,[doi.org]
  • Complications include facial numbness and dry eye. In about 30% of patients, pain recurs 3 to 5 years after treatment [4]. Repeat radiosurgery can be effective; however, the risk of facial numbness is increased. Figure 6.[mayfieldclinic.com]
  • There were no reports of decreased corneal sensation (dry eye syndrome). Figure 3 Kaplan-Meier curve for time from CyberKnife radiosurgery (CKRS) to improvement in Barrow Neurologic Institute (BNI) numbness score.[ro-journal.biomedcentral.com]
Muscle Tenderness
  • The pain is most often located in the axilla, along the course of the ulnar nerve, and when the circumflex nerve is involved, in the deltoid muscle.[henriettes-herb.com]
  • Other musculoskeletal symptoms and signs include decreased range of motion, stiffness of joints, spontaneous muscle spasms, localized muscle tenderness, and myofascial trigger points.[doi.org]
Myofascial Trigger Point
  • Other musculoskeletal symptoms and signs include decreased range of motion, stiffness of joints, spontaneous muscle spasms, localized muscle tenderness, and myofascial trigger points.[doi.org]
Wrist Pain
  • Cleland, Differential Diagnosis and Physical Therapy Management of a Patient With Radial Wrist Pain of 6 Months' Duration: A Case Report, Journal of Orthopaedic & Sports Physical Therapy, 40, 6, (361), (2010).[doi.org]
Hyperpigmentation
  • Thus, symptoms such as pain, edema, and skin hyperpigmentation on the left leg should be closely noted. Copyright 2018 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
Otalgia
  • […] edema - Reye's syndrome - Syringomyelia - Syringobulbia - Spinal cord compression - Susac's syndrome - Krabbe disease - metachromatic leukodystrophy - adrenoleukodystrophy v t e الألم وnociception الرأس والرقبة صداع • الرقبة • Odynophagia (swallowing) • Otalgia[marefa.org]
Hysteria
  • 'Hysteria'. In J. R. Reynolds (ed.), A System of Medicine ( Philadelphia : Henry C. Lea's Sons & Co., 1880 ), vol I, 643. Google Scholar Rigal, A., Causes et pathogenie des névralgies ( Paris : J.-B. Baillière et Fils, 1872 ).[doi.org]
Motor Symptoms
  • Motor symptoms and signs are often present, but these deficits can be very subtle.[doi.org]
Apraxia
  • Motor system symptoms and signs include weakness, fatigability, hypotonia, tremor, dystonia, spasticity, ataxia, apraxia, and motor neglect.[doi.org]

Workup

  • Diagnostic workup including magnetic resonance imaging of brain and computerized tomography of the sinuses are usually negative, but there have been few cases of a nasal contact point.[ncbi.nlm.nih.gov]
  • See Workup for more detail.[emedicine.medscape.com]
  • Key points • For several cranial neuralgias, the diagnostic workup should include structural imaging with MRI with and without contrast to evaluate for evidence of inflammation or space-taking lesions, vascular imaging consisting of either MRA or CTA[medlink.com]

Treatment

  • Diagnosis and treatment can be challenging. Based on a case report and literature review, disease aspects and treatment options including laparoscopic (triple) neurectomy are discussed.[ncbi.nlm.nih.gov]
  • […] more comprehensive approach to treatment.[doi.org]
  • Treatments undertaken subsequent to referral included autologous serum tears (three cases), PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) treatment (two cases), and systemic agents for pain, anxiety, or depression (three cases).[ncbi.nlm.nih.gov]
  • The field of neuropathic pain research and treatment is in the early stages of development, with many unmet goals.[ncbi.nlm.nih.gov]
  • Although treatment of neuropathic pain may be difficult, optimum treatment can be achieved if the neurologist has a complete understanding of the therapeutic options, the mainstay of which is pharmacotherapy.[ncbi.nlm.nih.gov]

Prognosis

  • It was managed by several medication and landmark-based great auricular nerve block with poor prognosis. PATIENT CONCERNS: A 25-year-old man presented with a pain in the left lateral neck and auricle.[ncbi.nlm.nih.gov]
  • The causes, presentation, diagnosis, management, prognosis, and prevention of PON were reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.[ncbi.nlm.nih.gov]
  • Patients aged 60 years had the worst prognosis: 18% still had mild pain at 3 months and 6% had moderate or severe pain. At 1 year, 8% had mild pain and 2% had moderate pain.[mdedge.com]
  • Prognosis The condition tends to come and go. Attacks of pain may be experienced off and on all day, or for days or weeks at a time, or no pain may be experienced for a prolonged period of time. However in most cases, the prognosis is good.[brainfoundation.org.au]

Etiology

  • Direct injury to the nerve appears to be the etiology of post-traumatic external nasal neuralgia.[ncbi.nlm.nih.gov]
  • In about 85% of cases, no lesion is identified, even after extensive investigations, and the etiology is labeled idiopathic (classic) by default.[emedicine.com]
  • The majority of this research has focused on nociceptive pain or pain of mixed etiology. There has been less focus on these aspects of neuropathic pain.[ncbi.nlm.nih.gov]
  • The etiology of PON is partially clear, and the pain could be persistent and hard to cure. Reducing the incidence of PON can be realized by improving technique.[ncbi.nlm.nih.gov]
  • We review the anatomy of the intercostobrachial nerve and its variants, etiologies of intercostobrachial neuralgia, and current indications and methods of an intercostobrachial perineural injection.[ncbi.nlm.nih.gov]

Epidemiology

  • In a retrospective epidemiological study [ 5 ], among all cases between 1945 and 1984, glossopharyngeal neuralgia had an incidence of 0.7 cases per 100,000 patients [ 5 ], while an epidemiological study conducted at the Mayo Clinic between 1922 and 1977[karger.com]
  • Smith and Nicola Torrance, Epidemiology of Neuropathic Pain and Its Impact on Quality of Life, Current Pain and Headache Reports, 16, 3, (191), (2012).[doi.org]
  • A case report of trigeminal neuralgia in a patient with spontaneous intracranial hypotension has been reported; both conditions resolved following surgical treatment of a cervical root sleeve dural defect. [3] Epidemiology Frequency Trigeminal neuralgia[emedicine.com]
  • Summary Epidemiology The estimated prevalence in France is 1/6000. Clinical description The disease usually presents between the ages of 50-70 years, with an insidious onset of symptoms.[orpha.net]
  • Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clin J Pain 2002 ; 18 : 350 -4. 10. Davis MP, Walsh D. Epidemiology of cancer pain and factors influencing poor pain control.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • We describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiologic mechanisms.[ncbi.nlm.nih.gov]
  • METHODS: The exact pathophysiology is still not fully understood and occipital neuralgia often develops spontaneously. There are no specific guidelines for evaluation of patients with occipital neuralgia.[ncbi.nlm.nih.gov]
  • Important pathophysiologic mechanisms include sodium-and calcium-channel upregulation, spinal hyperexcitability, descending facilitation and aberrant sympathetic-somatic nervous system interactions.[ncbi.nlm.nih.gov]
  • Pathophysiology for idiopathic nasal neuralgia is poorly understood but it appears to be of a central etiology given lack of response to intranasal anesthetics.[ncbi.nlm.nih.gov]
  • Pathophysiological Basis of Surgical Treatment The pathophysiological basis of the surgical treatment relies on our knowledge about the pathophysiology of trigeminal neuralgia.[omicsonline.org]

Prevention

  • Data on surgical procedures, incidence, cause of PON, management, outcomes, and preventive technique were extracted.[ncbi.nlm.nih.gov]
  • Simultaneously, the neural foramen was packed with autogenous bone fragments to prevent recurrence.[ncbi.nlm.nih.gov]
  • Objectives: To examine the efficacy of corticosteroids in preventing postherpetic neuralgia.[cochrane.org]
  • Another medication used as prevention is pregabalin with good results as well. Most patients respond to nerve blockade with local anesthetic to the external nasal nerve and sphenopalatine ganglion block and radiofrequency ablation.[ncbi.nlm.nih.gov]
  • Prevention Antiviral Drugs The prevention of postherpetic neuralgia (PHN) includes the use of a vaccine and several drugs during the acute phase of the disease.[asra.com]

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