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LEPROSY NEUROPATHY 麻风病神经病变
Pub Date : 2023-03-01 DOI: 10.21776/ub.jphv.2023.004.01.3
Fahrani Yossa Prachika, S. Kurniawan
Leprosy is a major cause of peripheral neuropathy in developing countries, affecting sensory, motor, and autonomic nerve function. Neuropathy complications can include sensory loss and muscle weakness. Impaired sensory nerve function is often the first symptom encountered in leprosy neuropathy. Early detection and treatment of neuropathy in leprosy are important to prevent disability.
麻风病是发展中国家周围神经病变的主要原因,影响感觉、运动和自主神经功能。神经病变并发症包括感觉丧失和肌肉无力。感觉神经功能受损通常是麻风神经病的第一个症状。麻风病神经病变的早期发现和治疗对于预防残疾非常重要。
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引用次数: 0
POST HERPETIC NEURALGIA 疱疹后神经痛
Pub Date : 2023-03-01 DOI: 10.21776/ub.jphv.2023.004.01.1
Irsyah Dwi Rohmayanti, S. Kurniawan
Postherpetic neuralgia (PHN) is a chronic neuropathic pain condition that lasts 3 months or more after an outbreak of shingles. Herpes zoster, especially acute herpes zoster, is associated with the reactivation of the inactivated varicella zoster virus in individuals who have had chickenpox. PHN is associated with persistent and often refractory neuropathic pain. Patients may experience several types of pain, including deep pain, intolerable pain, burning, paroxysmal pain, stabbing pain, hyperalgesia, and allodynia. Pharmacological treatment of PHN may include a variety of drugs, including alpha-2 delta ligands (gabapentin and pregabalin), other anticonvulsants (carbamazepine), tricyclic antidepressants (amitriptyline, nortriptyline, doxepin), topical analgesics (5% lidocaine patch, capsaicin) tramadol, or other opioids. The sizeable side effect profile of commonly used oral drugs often limits their practical use, and a combination of topical and systemic agents may be required for optimal results. Doctors and other care providers must adapt treatment based on individual patient responses.
带状疱疹后神经痛(PHN)是带状疱疹爆发后持续3个月或更长时间的慢性神经性疼痛。带状疱疹,特别是急性带状疱疹,与水痘患者体内灭活的水痘带状疱疹病毒的再激活有关。PHN与持续性且常常难治性神经性疼痛有关。患者可能会经历几种类型的疼痛,包括深度疼痛、无法忍受的疼痛、灼痛、阵发性疼痛、刺痛、痛觉过敏和异常性疼痛。PHN的药物治疗可包括多种药物,包括α -2 δ配体(加巴喷丁和普瑞巴林)、其他抗痉挛药(卡马西平)、三环抗抑郁药(阿米替林、去甲替林、多虑平)、局部镇痛药(5%利多卡因贴片、辣椒素)、曲马多或其他阿片类药物。常用口服药物的巨大副作用通常限制了它们的实际使用,局部和全身药物的组合可能需要达到最佳效果。医生和其他护理提供者必须根据患者的个体反应调整治疗。
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引用次数: 0
MYASTHENIA GRAVIS 重症肌无力
Pub Date : 2023-03-01 DOI: 10.21776/ub.jphv.2022.004.01.4
Dewi Permata Sari, S. Kurniawan
Myasthenia gravis is an autoimmune disease of the postsynaptic membrane, especially acetylcholine receptors in the neuromuscular link of skeletal muscle. Patients with myasthenia gravis have a high number globally. The disease occurs due to a disorder that impairs the impulse connection between chemicals traveling from nerve endings and receptors. Clinical symptoms include weakness of the eye muscles (ptosis and diplopia), difficulty swallowing, and difficulty speaking. The diagnosis of myasthenia gravis is based on the patient's complaints obtained in the history, physical and neurological examination, and supporting examinations. The management that can be given is intravenous immunoglobulin (IVIg) therapy, plasma exchange (PE), corticosteroids given together with IVIg and PE, or acetylcholinesterase inhibitors. These treatments can determine the patient's prognosis. If the patient with myasthenia gravis is left to involve the respiratory muscles, then the patient's prognosis becomes worse. In addition, myasthenic crisis and cholinergic crisis may occur, which is a medical emergency.
重症肌无力是一种以骨骼肌神经肌肉环节乙酰胆碱受体为主的突触后膜自身免疫性疾病。在全球范围内,重症肌无力患者的数量很高。这种疾病的发生是由于一种疾病,这种疾病损害了从神经末梢和受体传递的化学物质之间的冲动联系。临床症状包括眼肌无力(上睑下垂和复视)、吞咽困难和说话困难。诊断重症肌无力的依据是患者的病史、体格和神经学检查以及辅助检查。可给予的管理是静脉注射免疫球蛋白(IVIg)治疗,血浆置换(PE),皮质类固醇与IVIg和PE一起给予,或乙酰胆碱酯酶抑制剂。这些治疗可以决定病人的预后。如果让重症肌无力患者累及呼吸肌,那么患者的预后就会变差。此外,可能发生肌无力危机和胆碱能危机,这是一种医疗紧急情况。
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引用次数: 0
HNP LUMBALIS LUMBALIS HNP
Pub Date : 2023-03-01 DOI: 10.21776/ub.jphv.2023.004.01.2
Mega Yulia Rusmayanti, S. Kurniawan
Lumbar herniated nucleus pulposus (HNP) is a disorder characterized by local displacement of the disc beyond the anatomical boundaries of the intervertebral space causing pain, weakness or numbness, and/or tingling in myotomal or dermatomal distribution. HNP is the most common cause of low back pain. Lumbar HNP itself has several underlying etiologies, such as old age, excessive axial load, connective tissue disorders, and congenital abnormalities. Management of HNP can be carried out non-operatively or operatively, depending on the severity, the symptoms that arise, and the response to non-operative treatment.
腰椎间盘突出症(HNP)是一种以椎间盘局部移位超出椎间隙解剖边界为特征的疾病,引起肌层或皮层分布的疼痛、无力或麻木和/或刺痛。HNP是腰痛最常见的原因。腰椎HNP本身有几个潜在的病因,如老年、过度轴向负荷、结缔组织疾病和先天性异常。根据病情的严重程度、出现的症状和对非手术治疗的反应,可采用非手术或手术治疗HNP。
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引用次数: 0
PATHOPHYSIOLOGY IN CLUSTER HEADACHE: AN UPDATE 丛集性头痛的病理生理学:最新进展
Pub Date : 2023-03-01 DOI: 10.21776/ub.jphv.2022.004.01.5
Wa Ode Intan Nur Octina, S. Kurniawan
Cluster headache (CH) is a rare and very painful primary headache syndrome, with an estimated population prevalence of 0.12%. This condition can be episodic (ECH), lasting from 7 days to a year. A consensus statement from the European Headache Federation defines refractory CCH as a CCH with at least three severe attacks per week, even though at least three consecutive trials of adequate preventive care have been tested and managed with both acute and preventive treatment. Inhaled oxygen and subcutaneous sumatriptan are the two most effective acute treatment options for people with CH. Several preventive medications are also available, and the most effective is verapamil. However, most of these agents are not supported by strong clinical evidence. In some patients, this option may be ineffective, particularly in those with chronic CH. Surgical procedures for chronic refractory forms of disorder should then be considered.
丛集性头痛(CH)是一种罕见且非常痛苦的原发性头痛综合征,估计人群患病率为0.12%。这种情况可以是发作性的(ECH),持续7天到一年。欧洲头痛联合会的一项共识声明将难治性CCH定义为每周至少有三次严重发作的CCH,即使至少连续三次充分的预防保健试验已经通过急性和预防性治疗进行了测试和管理。吸入氧气和皮下舒马匹坦是慢性阻塞性肺病患者两种最有效的急性治疗选择。也有几种预防药物可用,其中最有效的是维拉帕米。然而,这些药物大多没有强有力的临床证据支持。在一些患者中,这种选择可能无效,特别是那些慢性CH患者。对于慢性难治性疾病,应考虑手术治疗。
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引用次数: 0
CLUSTER HEADACHE 丛集性头痛
Pub Date : 2022-09-01 DOI: 10.21776/ub.jphv.2022.003.02.1
Michelle Anisa, Shahdevi Nandar Kurniawan
Cluster headache (CH) is a trigeminal autonomic cephalgia characterized by attacks of severe unilateral headache accompanied by ipsilateral autonomic symptoms. The prevalence of cluster headache in the overall population is 1 in every 1000 people. The exact etiology of cluster headache remains unclear. However, it is thought that there is a connection between the trigeminovascular system, parasympathetic nerve fibers involved in trigeminal autonomic reflexes, and the hypothalamus. Treatment of CH has three stages, namely: abortive, transitional, and preventive. Cluster headaches tend to subside with age with less frequent attacks and longer periods of remission between attacks.
丛集性头痛(CH)是一种三叉神经自主神经性头痛,其特征是严重的单侧头痛发作并伴有同侧自主神经症状。丛集性头痛在总人口中的流行率为每1000人中有1人。丛集性头痛的确切病因尚不清楚。然而,人们认为三叉神经血管系统、参与三叉神经自主反射的副交感神经纤维和下丘脑之间存在联系。CH的治疗有三个阶段,即流产、过渡和预防。丛集性头痛往往随着年龄的增长而消退,发作频率降低,发作之间的缓解期延长。
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引用次数: 0
TENSION TYPE HEADACHE (TTH) 紧张性头痛(th)
Pub Date : 2022-09-01 DOI: 10.21776/ub.jphv.2022.003.02.3
Auliya Nur Muthmainnina, S. Kurniawan
Tension Type Headache (TTH) is the most common type of headache in all age groups worldwide. Because of its high prevalence and possible association with medical and psychiatric comorbidities, TTH has a large socioeconomic impact. TTH is the type of headache that most patients suffer from, ranging from mild to severe pain that reduces their ability to carry out daily activities. TTH can be classified into an episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH). The lifetime prevalence of TTH is high (78%). Approximately 24% to 37% experience TTH several times a month, 10% experience weekly and 2% to 3% of the population have chronic TTH disease. TTH treatment is carried out with pharmacological and non-pharmacological approaches
紧张性头痛(TTH)是全世界所有年龄组中最常见的头痛类型。由于其高患病率和可能与医学和精神合并症有关,TTH具有很大的社会经济影响。TTH是大多数患者所遭受的头痛类型,从轻微到严重的疼痛,降低了他们进行日常活动的能力。TTH可分为发作性紧张性头痛(ETTH)和慢性紧张性头痛(CTTH)。TTH的终生患病率很高(78%)。大约24%到37%的人每月经历几次TTH, 10%的人每周经历一次,2%到3%的人患有慢性TTH疾病。TTH治疗通过药物和非药物方法进行
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引用次数: 0
CLASSICAL MIGRAINE 经典偏头痛
Pub Date : 2022-09-01 DOI: 10.1007/978-3-540-29805-2_739
Shahdevi Nandar Kurniawan, Dyah Kusuma Wardhani
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引用次数: 0
COMPARISON OF HYDRODISSECTION INJECTION THERAPY USING ULTRASONOGRAPHIC AS GUIDES BETWEEN TRIAMCINOLONE ACETONIDE AND 5% DEXTROSE IN CARPAL TUNNEL SYNDROME 曲安奈德与5%葡萄糖超声引导下注射水解剖治疗腕管综合征的比较
Pub Date : 2022-09-01 DOI: 10.21776/ub.jphv.2022.003.02.5
Widodo Mardi Santoso, Ika Sedar Wasis Sasono, Catur Ari Setianto, Nuretha Hevy
Background: Carpal Tunnel Syndrome (CTS) is a symptomatic compression neuropathy of the median nerve characterized by increased pressure in the carpal tunnel and decreased nerve function due to compression of the median nerve in the carpal tunnel. The purpose of the hydrodissection injection method in CTS is to separate the soft tissue adhesions that cause nerve compression and this method are known for being minimally invasive, fast healing, and easy to apply. Local injection of triamcinolone acetonide (TCA) is often used as therapy for CTS because it stabilizes the sodium channels and reduces abnormal stimulatio, thus it relieved the pain. 5% dextrose injection (D5W) is also widely used as therapy of CTS because it is harmless to nerves and may reduce neurogenic inflammation through inhibition of capsaicin-sensitive receptors. Aim: To compare the effectivity of hydrodissection injection therapy using ultrasound guidance with triamcinolone acetonide and 5% dextrose in CTS. Methods: This study recruited 30 participants who diagnosed with CTS and met the inclusion criteria. Participants were divided into two treatment groups, the first group (n=15) was given 1ml TCA injection and 1 ml lidocaine 2%, while the second group (n=15) was given 5% 5 ml Dextrose injection. The parameters measured in this study were NRS, FSS, and SSS value before injection and 4 weeks after injection of the agent. We compared these parameters at week four after injection between the TCA group and the D5W group. Results: NRS values before and 4 weeks after TCA injection (sig 0.001; p <0.05), FSS values (sig 0.020; p <0.05), and SSS values (sig 0.001; p <0.05). NRS before and 4 weeks after injection of D5W (sig 0.002; p <0.05), FSS (sig 0.001; p <0.05), and SSS (sig 0.000; p <0.05). Comparison between TCA injection and D5W injection at 4 weeks after the injection showed that the results was significantly different on NRS (sig 0.806; p> 0.05) for FSS (sig 0.512; p> 0.05) and SSS (sig 0.293; p> 0.05). Conclusion: There is a significant difference in NRS, FSS and SSS values at 4 weeks after hydrodissection injection, using either TCA or D5W. TCA hydrodissection injection compared to D5W hydrodissection injection was equally effective in improving NRS, FSS and SSS after 4 weeks of injection.
背景:腕管综合征(Carpal Tunnel Syndrome, CTS)是一种有症状的正中神经压迫神经病,其特征是由于腕管正中神经受到压迫,导致腕管压力增加和神经功能下降。CTS的水解剖注射方法的目的是分离引起神经压迫的软组织粘连,该方法具有微创、愈合快、易于应用等优点。局部注射曲安奈德(triamcinolone acetonide, TCA)可稳定钠离子通道,减少异常刺激,减轻疼痛,常用于CTS的治疗。5%葡萄糖注射液(D5W)也被广泛应用于CTS的治疗,因为它对神经无害,并且可以通过抑制辣椒素敏感受体减少神经源性炎症。目的:比较超声引导下曲安奈德加5%葡萄糖注射治疗CTS的疗效。方法:本研究招募了30名诊断为CTS并符合纳入标准的参与者。将患者分为两组,第一组(n=15)给予TCA注射液1ml + 2%利多卡因1ml,第二组(n=15)给予葡萄糖注射液5ml + 5%。本研究测量的参数为注射前和注射后4周的NRS、FSS和SSS值。我们在注射后第4周比较TCA组和D5W组的这些参数。结果:TCA注射前和注射后4周的NRS值(sig 0.001;FSS的p 0.05) (sig 0.512;p> 0.05)和SSS (sig 0.293;p > 0.05)。结论:注射氢化解剖后4周,TCA与D5W治疗组NRS、FSS、SSS值均有显著差异。注射4周后,TCA加氢解剖与D5W加氢解剖在改善NRS、FSS和SSS方面效果相同。
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引用次数: 0
TENSION TYPE HEADACHE (TTH) 紧张性头痛(th)
Pub Date : 2022-09-01 DOI: 10.21776/ub.jphv.2022.003.02.4
Auliya Nur Muthmainnina, Shahdevi Nandar Kurniawan
Cerebrovascular disease is the number one cause of epilepsy in the elderly population. Headaches are relatively common in patients with cerebrovascular disorders. The frequency of stroke-related headaches ranges from 7% to 65% with different types of headaches. The prevalence of persistent post-stroke headaches from 7-23%, with follow-up times ranging from 3 months to 3 years after stroke. Persistent headache in the population was associated with high depression and fatigue scores and significantly impacted returning to work. Most headaches at stroke onset will resolve, persistent headaches are a real entity even years after the stroke. The mechanism that might explain the relationship between headache and hemorrhagic stroke is still unclear, including changes in blood vessel walls supported by endothelial dysfunction in migraine sufferers as well as comorbid vascular risk factors such as arterial hypertension or platelet dysfunction. Headache after stroke intracerebral hemorrhage is believed to be the result of vasoconstriction that causes ischemia of the vessel wall.
脑血管疾病是老年人癫痫的头号病因。头痛在脑血管疾病患者中比较常见。不同类型的头痛,中风相关头痛的发生率从7%到65%不等。卒中后持续性头痛的患病率为7-23%,随访时间为卒中后3个月至3年。人群中持续性头痛与高抑郁和疲劳评分相关,并显著影响重返工作岗位。大多数头痛在中风发作时就会消退,持续的头痛是一个真实的实体,甚至在中风后几年。可能解释头痛和出血性中风之间关系的机制尚不清楚,包括偏头痛患者由内皮功能障碍引起的血管壁改变,以及动脉高血压或血小板功能障碍等共病血管危险因素。脑卒中脑出血后头痛被认为是血管收缩引起血管壁缺血的结果。
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引用次数: 0
期刊
JPHV (Journal of Pain, Vertigo and Headache)
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