1/9. multiple sclerosis and oral care.multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
2/9. multiple sclerosis and coexisting intradural extramedullary spinal cord tumour: a case report.We report the coexistence of multiple sclerosis (MS) and an intradural extramedullary spinal cord tumour in a 46-year-old woman with a 2-year history of MS. The patient presented with right hemitrunk and lower extremity paraesthesias, urinary incontinence, and intermittent lower right back and abdominal pain, which did not respond to pulse steroid therapy. A spinal magnetic resonance imaging (MRI) study revealed an intradural extramedullary spinal cord tumour in the lower thoracic spine, later diagnosed as schwannoma. We call attention to this rare association of MS and a spinal cord tumour, and emphasize the need for scrutiny of new and uncommon symptoms during the follow-up of MS patients.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
3/9. Familial multiple sclerosis: case study of three affected siblings.We report on three sisters with new-onset multiple sclerosis (MS). The symptoms of the eldest sister began in 1993 with lower-limb weakness and paraesthesia. In 1998, she had limb weakness, nystagmus and ataxia. magnetic resonance imaging (MRI) of the brain, the cerebrospinal fluid (CSF) examinations, and evoked potentials verified MS. The middle sister exhibited left-side optic neuritis in 1998. All findings pointed to MS. The third sister had subjective complaints such as paraesthesias and vertigo. MRI and CSF results supported the diagnosis. Both parents and all four grandparents are without neurological signs; the brain MRI examinations on the parents were negative. The prevalence of familial MS in first-degree relatives is 5-10%, while that in twins is 20-30%. In this case, environmental factors seem to play the crucial role. Although the anamnesis as concerns MS proved negative in the other family members examined here, further genetic examination of the sisters is needed.- - - - - - - - - - ranking = 2keywords = paraesthesia (Clic here for more details about this article) |
4/9. Somatosensory-evoked cortical potential during attacks of paroxysmal dysesthesia in multiple sclerosis.Paroxysmal dysesthesia is considered to be one of the characteristic symptoms of multiple sclerosis (MS), but the lesion responsible and the pathophysiology of this dysesthesia are not known. We report the interesting finding of somatosensory-evoked potentials (SEPs) in a patient with MS during a paroxysmal dysesthesia attack.- - - - - - - - - - ranking = 191.33181395374keywords = dysesthesia (Clic here for more details about this article) |
5/9. multiple sclerosis following splenectomy as a treatment for idiopathic thrombocytopenic purpura.A 27-year-old woman was admitted to our hospital with tetraparesis, dysesthesia and hypoesthesia of all regions below the breasts, urinary disturbance, and difficulty in breathing. Since age 21 idiopathic thrombocytopenic purpura (ITP) was diagnosed and steroid therapy was continued. At age 26, she had splenectomy for her ITP. On admission, steroid pulse therapy was administered with a tentative diagnosis of transverse myelitis. Symptoms gradually ameliorated. At age 29, she gradually lost her left vision, and multiple sclerosis was diagnosed and steroid therapy was administered, and her left vision gradually ameliorated. There are several reports describing other autoimmune disorders that arise after splenectomy. Since the spleen acts as a major pool of type 2 helper T cells, it is plausible that peripheral type 1 helper T cell activity may increase after splenectomy, promoting the development of autoimmune disorders. We considered there would be a close relation between splenectomy for ITP and multiple sclerosis in this case.- - - - - - - - - - ranking = 27.333116279106keywords = dysesthesia (Clic here for more details about this article) |
6/9. The role of spinal cord imaging in the diagnosis of multiple sclerosis.BACKGROUND: A 29-year-old male presented with fluctuating but progressive sensory disturbances comprising tingling and dysesthesia in his right leg. MRI of the brain showed white matter lesions initially thought to be caused by multiple sclerosis. INVESTIGATIONS: Neurological examination, cerebrospinal fluid examination, laboratory blood testing, brain and spinal MRI scans. diagnosis: spinal cord schwannoma. MANAGEMENT: Surgical removal of the schwannoma. An algorithm is provided that clarifies the appropriate MRI work-up for cases where the clinical presentation is suggestive of multiple sclerosis.- - - - - - - - - - ranking = 27.333116279106keywords = dysesthesia (Clic here for more details about this article) |
7/9. Two cases of multiple sclerosis with painful tonic seizures and dysesthesia ameliorated by the administration of mexiletine.mexiletine was administered in two patients suffering from multiple sclerosis with severe dysesthesia and painful tonic seizures. In both patients the painful tonic seizures disappeared and dysesthesia improved as well. The effects of mexiletine on painful symptoms have been previously reported in diabetic neuropathy, but not in diseases of the central nervous system.- - - - - - - - - - ranking = 163.99869767464keywords = dysesthesia (Clic here for more details about this article) |
8/9. Chronic intractable pain: an atypical presentation of multiple sclerosis.Both acute paroxysmal pains and a variety of chronic pain syndromes have been described in multiple sclerosis. These usually occur in the setting of well-established disease. Although paroxysmal pain has been recognized as a rare first symptom in this disorder, presentation with severe, continuous dysesthesias of long duration has not been previously appreciated. We report the cases of three patients in whom refractory continuous pain signalled the onset of demyelinating disease. These observations further define the clinical spectrum of multiple sclerosis and have implications for the evaluation of patients with chronic neuropathic pains of unknown etiology.- - - - - - - - - - ranking = 27.333116279106keywords = dysesthesia (Clic here for more details about this article) |
9/9. Paroxysmal dysesthesia in multiple sclerosis.Seven cases of multiple sclerosis with paroxysmal dysesthesias of an upper extremity were reported. This seizure characteristically is a purely sensory one induced by movements and is not accompanied by convulsions or a disorder of voluntary movements. In other ways it shares some features with other paroxysmal manifestations seen in MS. Clinical observations with subsequent neurophysiologic considerations have led to the hypothesis that paroxysmal dysesthesias are segmental symptoms with their foci lying in or about the spinal cord.- - - - - - - - - - ranking = 163.99869767464keywords = dysesthesia (Clic here for more details about this article) |