1/16. Phantom endometriosis of the sciatic nerve.OBJECTIVE: To assess the efficacy and diagnostic value of GnRH agonist (GnRH-a) therapy in cases of hidden sciatic nerve endometriosis. DESIGN: Case report. SETTING: Academic tertiary referral center for endometriosis treatment. PATIENT(S): Three patients with cyclic, catamenial sciatica associated with pelvic endometriosis who had electromyographic evidence of sciatic nerve damage but negative computed tomography and magnetic resonance imaging findings. INTERVENTION(S): Monthly administration of the GnRH-a leuprolide acetate plus daily transdermal E2 (25 microg). MAIN OUTCOME MEASURE(S): Relief of pain symptoms and improvement in motor function. RESULT(S): All three patients had clear decreases in pain and partial amelioration of claudication. CONCLUSION(S): endometriosis of the sciatic nerve may be hard to diagnose with the use of current imaging techniques but may be proved by clinical response to GnRH analogue treatment and may be more frequent than previously thought.- - - - - - - - - - ranking = 1keywords = sciatica (Clic here for more details about this article) |
2/16. Pharmacologic management part 1: better-studied neuropathic pain diseases.Neuropathic pain impacts millions of people in the united states and around the world. patients experience one of many symptoms, such as pain, paresthesia, dysesthesia, hyperalgesia, and allodynia, for many years because of unavailable or inadequate treatment. One of the major challenges in treating patients with neuropathic pain syndromes is a lack of consensus concerning the appropriate first-line treatment options for conditions associated with neuropathic pain, including postherpetic neuralgia, diabetic peripheral neuropathy, and trigeminal neuralgia. This review summarizes the published results of randomized trials involving treatment for neuropathic pain conditions. anticonvulsants, such as gabapentin, carbamazepine, and lamotrigine, and tricyclic antidepressants, including amitriptyline and desipramine, have demonstrated efficacy in relieving pain associated with postherpetic neuralgia, diabetic peripheral neuropathy, and trigeminal neuralgia, in several studies. However, the lack of head-to-head comparison studies of these agents limits the conclusions that can be reached. Clinicians who must make decisions regarding the care of individual patients may find some guidance from the number of randomized trials with a positive outcome for each agent. Using quality-of-life study outcomes, treatment strategies must encompass the impact of therapeutic agents on the comorbid conditions of sleep disturbance and mood and anxiety disorders associated with neuropathic pain. Looking to the future, emerging therapies, such as pregabalin and newer N-methyl-D-aspartate-receptor blockers, may provide physicians and patients with new treatment options for more effective relief of pain.- - - - - - - - - - ranking = 1.1988107423269keywords = neuralgia (Clic here for more details about this article) |
3/16. trigeminal neuralgia in a patient with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE).Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is an autosomal-recessive disease associated with multiple deletions of mitochondrial dna in skeletal muscle. MNGIE is a multisystem syndrome affecting muscle, peripheral, and central nervous systems and the gastrointestinal tract. A 25-year-old man is presented with 3 years history of right sided trigeminal neuralgia. He has been diagnosed as MNGIE based on clinical, neurophysiological and pathological findings. He had also received medical therapy and two radiofrequency thermocoagulations for the treatment of trigeminal neuralgia. Gamma Knife radiosurgery was performed and resulted in partial relief. To our knowledge, this is the first case in the literature of MNGIE with trigeminal neuralgia. An analogy is suggested between multiple sclerosis and MNGIE as a cause for trigeminal neuralgia in this patient.- - - - - - - - - - ranking = 2.3976214846539keywords = neuralgia (Clic here for more details about this article) |
4/16. aneurysm of the common iliac artery presenting as a lumbosacral plexopathy.We describe a case of lumbosacral plexopathy caused by an isolated aneurysm of the common iliac artery. The patient presented with worsening low back pain, progressive numbness and weakness of the right leg in the L2-L4 distribution. This had previously been diagnosed as sciatica. A CT scan showed an aneurysm of the right common iliac artery which measured 8 cm in diameter. Despite being listed for emergency endovascular stenting, the aneurysm ruptured and the patient died. It is important to distinguish a lumbosacral plexopathy from sciatica and to bear in mind its treatable causes which include aneurysms of the common and internal iliac arteries.- - - - - - - - - - ranking = 2keywords = sciatica (Clic here for more details about this article) |
5/16. Retrolabyrinthine approach: technique and newer indications.Excellent exposure of the cerebellopontine angle is obtained by an approach through the mastoid posterior to the labyrinth. Since the major portion of the dissection is extradural, this approach is associated with a very low morbidity. The retrolabyrinthine approach has been used for several years for selective partial section of the posterior root of the trigeminal nerve in cases of trigeminal neuralgia. Complete relief of pain has been accomplished in 25 of 28 cases, and the other 3 patients had partial relief of pain. The only complications in these patients were partial hearing impairment in 2, and 1 partial abducens nerve paralysis which subsequently recovered completely. Two patients required secondary closure of cerebrospinal fluid leaks. This approach has also been used for exploration and biopsy of cerebellopontine angle tumors and for treatment of other cranial nerve problems. We conclude that the retrolabyrinthine approach is the preferred route to the cerebellopontine angle in a variety of clinical conditions.- - - - - - - - - - ranking = 0.29970268558174keywords = neuralgia (Clic here for more details about this article) |
6/16. Mental nerve neuropathy in systemic cancer. Report of three cases.Mental nerve neuropathy (MNN), an uncommon neurologic symptom, was observed in three patients with cancer. In the first patient, MNN was the primary manifestation of an occult carcinoma of the lung. The second patient had bilateral MNN. In the third patient, MNN coexisted with symptomatic trigeminal neuralgia as a consequence of a cavum adenocarcinoma. A nontraumatic MNN must be considered a potentially ominous symptom that should prompt a search for cancer.- - - - - - - - - - ranking = 0.29970268558174keywords = neuralgia (Clic here for more details about this article) |
7/16. Neurological manifestations in systemic sclerosis (scleroderma).One hundred and twenty-five patients with systemic sclerosis were surveyed for neurological manifestations in a prospective study. Seven (5.6%) were found to have a defined neurologic lesion: 4 with carpal tunnel syndrome and one each with trigeminal neuralgia, mononeuritis multiplex and peripheral neuropathy. Neurological involvement occurs but is uncommon in this connective tissue disorder.- - - - - - - - - - ranking = 0.29970268558174keywords = neuralgia (Clic here for more details about this article) |
8/16. Multiple cranial neuropathies, trigeminal neuralgia, and vascular headaches in sickle cell disease, a possible common mechanism.patients with sickle cell disease are subject to a variety of neurologic complications. A patient with sickle cell disease and rarely noted features or complications is described. The association of abnormal (sickle-type) hemoglobin (Hgb S) with trigeminal and facial neuropathies and vascular headaches appeared to coincide with reactivation of the hematologic disease.- - - - - - - - - - ranking = 1.1988107423269keywords = neuralgia (Clic here for more details about this article) |
9/16. lumbosacral plexus neuropathy.We describe 10 cases of lumbosacral plexus neuropathy in which no underlying condition was discovered on initial evaluation or on follow-up examination after an average of 6 years. The patients presented with pain and weakness. Recovery was delayed and often incomplete. When the lower plexus is involved, it may be confused with disk disease manifesting as "sciatica." This syndrome may be a counterpart to the well-described idiopathic brachial plexus neuropathy.- - - - - - - - - - ranking = 1keywords = sciatica (Clic here for more details about this article) |
10/16. High thoracic neurinoma mimicking femoral neuralgia.We report a case of spinal neurinoma at a high thoracic level, whose main presentation was intractable pain in a body part innervated by the right femoral nerve. Sensations of pain and temperature were impaired in the right thigh, but usual symptoms of myelopathy were undetectable. In conjunction with the other reports, this case suggests that spinal tumors at high thoracic levels can produce remote symptoms mimicking peripheral neuropathy such as femoral or sciatic neuralgia.- - - - - - - - - - ranking = 1.4985134279087keywords = neuralgia (Clic here for more details about this article) |
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