1/13. diagnosis of acromegaly in orofacial pain: two case reports.acromegaly is an uncommon condition, with an annual incidence in the UK of three per million. The gradual onset of the clinical features mean that often friends and relatives are unaware of the underlying pathology. In view of the morbidity, and indeed mortality, arising from undiagnosed cases, general dental practitioners and other healthcare workers should routinely take note of systemic as well as intra-oral changes occurring in their patients when seen on review. The association of paraesthesia, anaesthesia and pain with acromegaly is well documented. However, there appear to be few reports linking acromegaly with orofacial pain or dysaesthesia. This paper describes two such cases.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
2/13. 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) |
3/13. MRI findings in cobalamin deficiency.A 55 year old male presented 2 years after a jejuno-iliectomy with weakness of all limbs, paraesthesiae, and difficulty in walking. Clinical examination revealed loss of posterior column sensations. Investigations were suggestive of a deficiency of vitamin B12 and folate. MRI showed a band of hyperintensity on T2 image, in the dorsal portion of the spinal cord.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
4/13. Enigmatic trigeminal sensory neuropathy diagnosed by facial skin biopsy.Facial paraesthesia due to perineural malignant infiltration is a well recognised complication of basal and squamous cell carcinomas of the head and neck. Perineural involvement was originally attributed to involvement of the perineural lymphatics; however subsequent studies have demonstrated conclusively that these lymphatics do not exist and that the invasion occurs along the line of least resistance. Previous studies on perineural spread of carcinomas of the head and neck have emphasised diagnostic biopsy of an involved nerve (e.g. the infraorbital, mental or major branches of the trigeminal nerve), or at times craniectomy with exploration of the gasserian ganglion. We suggest that in many cases the diagnosis can be obtained by biopsy of the anaesthetic skin alone, without recourse to more involved biopsy techniques. The following case report illustrates this point.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
5/13. "A girdle-like tightening sensation" misapprehended as abdominal splanchnopathy in a sarcoidosis patient.We describe a 53-year-old man with the isolated manifestation of girdle-like tightening sensation of the trunk due to polyradiculopathy at the beginning of sarcoidosis which was first misapprehended as abdominal splanchnopathy. Late development of other neurological and systemic symptoms led to the final diagnosis of sarcoidosis. Segmental dysesthesia at the trunk in neurosarcoidosis is unique and may mimic a splanchnic pain. Such a dysesthesia may be solely manifested at the beginning of sarcoidosis and may continue for days without other symptoms. When patients complain of a girdle-like tightening with unknown etiology, sarcoidosis should be suspected as the possible cause.- - - - - - - - - - ranking = 22.331515423685keywords = dysesthesia (Clic here for more details about this article) |
6/13. Delayed oxaliplatin-associated neurotoxicity following adjuvant chemotherapy for stage III colon cancer.Oxaliplatin-containing chemotherapy regimens are utilized commonly for metastatic colorectal cancer and increasingly in the adjuvant setting following surgical resection. The dose-limiting toxicity is neurotoxicity. Acute neurotoxicity is cold induced and transient. Chronic neurotoxicity usually has a predictable clinical course. It is manifested by paresthesias and dysesthesias of gradually prolonged duration that occur between treatment cycles, and increase in intensity and duration with the cumulative dose. We report here a case of a patient who developed significant grade 3 chronic neuropathy following completion of 6 months of adjuvant oxaliplatin-containing chemotherapy for stage III colon cancer. The neurotoxicity was not preceded by any transient symptoms characteristic of chronic oxaliplatin neuropathy and its onset was unpredictable. Delayed neurotoxicity is a complication which must be considered for patients receiving adjuvant therapy and attempts to utilize the minimum effective cumulative dose of oxaliplatin are warranted.- - - - - - - - - - ranking = 11.165757711843keywords = dysesthesia (Clic here for more details about this article) |
7/13. Idiopathic spinal cord herniation causing progressive brown-sequard syndrome.We report a 59-year-old woman with a 2.5 year history of progressive loss of temperature sensation and dysesthesia in the right and weakness in the contralateral lower limb. magnetic resonance imaging (MRI) and computed tomography myelography of the spinal cord demonstrated transdural herniation and deformation of the spinal cord in the upper thoracic spine. The herniated part of the spinal cord was untethered and replaced, and the anterior dural defect was closed. At a clinical follow-up 3 months later, the motor and sensory functions were almost restored. MRI at this time showed disentanglement of spinal cord adherence.- - - - - - - - - - ranking = 11.165757711843keywords = dysesthesia (Clic here for more details about this article) |
8/13. Chronic cutaneous dysesthesia syndrome: a psychotic phenomenon or a depressive symptom?A 54-year-old woman had a 4-month history of sensitivity to all forms of light. Evaluation revealed no detectable abnormalities. A diagnosis of chronic cutaneous dysesthesia syndrome was made, and the patient experienced slow, steady resolution with oral pimozide. We discuss the classification, diagnostic categories, treatment principles, and prognosis of this disorder and summarize our experience with 13 other patients.- - - - - - - - - - ranking = 55.828788559213keywords = dysesthesia (Clic here for more details about this article) |
9/13. Low-grade non-Hodgkin B-cell lymphoma presenting as sensory neuropathy.Low-grade non-Hodgkin B-cell lymphoma was found during the evaluation of 3 aged patients with predominantly sensory neuropathy of mild to moderate severity. Presenting manifestations were sensory ataxia and right ulnar mononeuropathy in a 75-year-old man, and painful dysesthesias of the legs in two 78-year-old women. A neurophysiological study showed mainly axonopathic alterations. M-protein was present in all cases (Ig-kappa in two, triclonal gammopathy IgG(kappa)/IgM(kappa)/IgM-gamma in one). The male patient had IgM antisulfatide antibody in high titer, whereas the other 2 patients had cryoglobulinemia (type II and type III, respectively). Our report emphasizes the occurrence of mild polyneuropathy as presenting manifestation of low-grade non-Hodgkin lymphoma, different from the clinicopathological entity of neurolymphomatosis, in which severe nerve damage occurs in association with manifest lymphoma, related to nerve infiltration by lymphomatous cells. Alternative pathogenetic mechanisms, such as antibody-mediated nerve damage, or vasa nervorum changes caused by cryoglobulin, may be implicated in our cases. Non-Hodgkin lymphoma should be considered in the diagnostic evaluation of polyneuropathy of unknown cause, especially in patients with paraproteinemia and/or cryoglobulinemia.- - - - - - - - - - ranking = 11.165757711843keywords = dysesthesia (Clic here for more details about this article) |
10/13. Mental nerve dysfunction: a symptom of diverse mandibular disease.Paraesthesia and anaesthesia of the mental nerve may result from a variety of pathological conditions, and in persistent cases of orofacial sensory disturbance thorough clinical assessment, including CT scanning, is vital to exclude underlying systemic or neoplastic disease. This paper presents three patients with right mental nerve dysfunction, and reviews the aetiology of mental nerve paraesthesia and anaesthesia.- - - - - - - - - - ranking = 1keywords = paraesthesia (Clic here for more details about this article) |
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