Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000322
J. Sarrafzadeh, Saemeh Khani, K. Ezzati, I. Takamjani
Background: Dry needling is one of the main therapeutic approaches in patients with Myofascial pain syndrome. Few studies have been compared the superficial and deep dry needling methods in these patients. Objective: To evaluate the effects of superficial and deep dry needling on pain and muscle thickness in subjects with upper trapezius myofascial pain syndrome. Design: A randomized quasi-experimental double-blinded trial. Methods: 50 subjects with upper trapezius myofascial pain syndrome (age=26/08 ± 4/62, weight=63/88 ± 8/71 kg, height=167/7 ± 4/82 cm, pain duration=9/75 ± 7/05 m) randomly assigned to the superficial (n=25) and deep (n=25) dry needling groups. The pain and maximum thickness of upper trapezius muscle in rest, fair and normal contractions were measured by visual analogue scale (VAS) and an ultrasound device respectively before and after the intervention as well as 7 and 15 days follow-up. Results: The mixed-model ANOVAs revealed a significant group-by-time interaction (F=44.03, p<0.001) for pain and muscle thickness in rest (F=67.00, p<0.001), fair (F=108.73, p<0.001) and normal contraction (F=17.73, p<0.001). The main effects of group and time were statistically significant for pain, rest, fair and normal muscle thickness (p<0.001). There were not any significant differences in rest, fair and normal muscle thickness after intervention as well as 7 and 15 days follow-up. Conclusion: Both superficial and deep dry needling techniques induced significant short-term changes in the VAS. Muscle thickness in rest, fair and normal contractions did not show any significant changes between the groups.
{"title":"Effects of Superficial and Deep Dry Needling on Pain and Muscle Thickness in Subject with Upper Trapezius Muscle Myofascial Pain Syndrome","authors":"J. Sarrafzadeh, Saemeh Khani, K. Ezzati, I. Takamjani","doi":"10.4172/2167-0846.1000322","DOIUrl":"https://doi.org/10.4172/2167-0846.1000322","url":null,"abstract":"Background: Dry needling is one of the main therapeutic approaches in patients with Myofascial pain syndrome. Few studies have been compared the superficial and deep dry needling methods in these patients. Objective: To evaluate the effects of superficial and deep dry needling on pain and muscle thickness in subjects with upper trapezius myofascial pain syndrome. Design: A randomized quasi-experimental double-blinded trial. Methods: 50 subjects with upper trapezius myofascial pain syndrome (age=26/08 ± 4/62, weight=63/88 ± 8/71 kg, height=167/7 ± 4/82 cm, pain duration=9/75 ± 7/05 m) randomly assigned to the superficial (n=25) and deep (n=25) dry needling groups. The pain and maximum thickness of upper trapezius muscle in rest, fair and normal contractions were measured by visual analogue scale (VAS) and an ultrasound device respectively before and after the intervention as well as 7 and 15 days follow-up. Results: The mixed-model ANOVAs revealed a significant group-by-time interaction (F=44.03, p<0.001) for pain and muscle thickness in rest (F=67.00, p<0.001), fair (F=108.73, p<0.001) and normal contraction (F=17.73, p<0.001). The main effects of group and time were statistically significant for pain, rest, fair and normal muscle thickness (p<0.001). There were not any significant differences in rest, fair and normal muscle thickness after intervention as well as 7 and 15 days follow-up. Conclusion: Both superficial and deep dry needling techniques induced significant short-term changes in the VAS. Muscle thickness in rest, fair and normal contractions did not show any significant changes between the groups.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"13 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74773176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000312
Bruno Vilas Boas Dias, Jhenifer Luana dos Santos Camara, Bruno Oliveira Prado, Jean Jhonys Beraldes Cesar
Objective: The objective of this study was to identify the view of nurses in the application of the pain scale in patients hospitalized in intensive care and medical clinic. Method: An exploratory-descriptive study was conducted with a qualitative approach in a private hospital in the interior of the State of Sao Paulo. The sample consisted of 20 nurses who answered 2 identical questionnaires, one demographic member with thirteen questions and the other with a dissertative question regarding the research objective. Results: Twenty nurses were interviewed, where 10 (50%) applied the scale at the time of patient admission, 4 (20%) applied the numerical scale more easily, while another 4 (20%) reported that they did not apply any pain scale. Among these, 20 (100%) consider the scale useful, 17 (85%) do not find difficulties in the application and 14 (70%) do not apply the scale in sedated patients. All of them recognized the importance of the scale and know pain as the 5th vital sign and it was clear that with the application of the scale it is possible to offer more comfort, evaluating the effectiveness of the medication and aiding in the clinical reasoning. Conclusion: All nurses consider it useful to use the pain scale, but lack of an institutional protocol often fails to apply the scale at important moments of patient admission.
{"title":"Nursing in the Attention of the Evaluation of Pain as a 5th Vital Sign","authors":"Bruno Vilas Boas Dias, Jhenifer Luana dos Santos Camara, Bruno Oliveira Prado, Jean Jhonys Beraldes Cesar","doi":"10.4172/2167-0846.1000312","DOIUrl":"https://doi.org/10.4172/2167-0846.1000312","url":null,"abstract":"Objective: The objective of this study was to identify the view of nurses in the application of the pain scale in patients hospitalized in intensive care and medical clinic. Method: An exploratory-descriptive study was conducted with a qualitative approach in a private hospital in the interior of the State of Sao Paulo. The sample consisted of 20 nurses who answered 2 identical questionnaires, one demographic member with thirteen questions and the other with a dissertative question regarding the research objective. Results: Twenty nurses were interviewed, where 10 (50%) applied the scale at the time of patient admission, 4 (20%) applied the numerical scale more easily, while another 4 (20%) reported that they did not apply any pain scale. Among these, 20 (100%) consider the scale useful, 17 (85%) do not find difficulties in the application and 14 (70%) do not apply the scale in sedated patients. All of them recognized the importance of the scale and know pain as the 5th vital sign and it was clear that with the application of the scale it is possible to offer more comfort, evaluating the effectiveness of the medication and aiding in the clinical reasoning. Conclusion: All nurses consider it useful to use the pain scale, but lack of an institutional protocol often fails to apply the scale at important moments of patient admission.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"187 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89007505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000332
Dalamagka Maria, Zervas Konstantinos
{"title":"Inhalation Burn, Crush-syndrome and Rhabdomyolysis Syndrome","authors":"Dalamagka Maria, Zervas Konstantinos","doi":"10.4172/2167-0846.1000332","DOIUrl":"https://doi.org/10.4172/2167-0846.1000332","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86995122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000329
S. Gozani, X. Kong
Purpose: Transcutaneous electrical nerve stimulation (TENS) produces pain relief by decreasing central excitability and increasing central inhibition. Fixed-site high-frequency TENS (FS-TENS) is a form of TENS in which the device is designed to stimulate a predetermined area rather than to overlap the patient’s pain. The objective of this study was to confirm that FS-TENS has widespread effects beyond the stimulation site in a real-world chronic pain population. Methods: A retrospective cohort study was conducted on users of a FS-TENS device. This device is placed on the upper calf. Study participants were stratified into two groups, those whose pain distribution did not include foot or leg pain (proximal pain group) and those whose pain distribution included foot or leg pain (distal pain group). The outcome measures were changes in pain intensity and pain interference with sleep, activity and mood from a baseline assessment to a 60-day follow-up. FS-TENS dose was characterized by utilization, which was defined as the percentage of days with at least 30 minutes of stimulation. Predictors of pain outcomes were examined by moderated multivariable regression. Results: 1676 FS-TENS users met the inclusion and exclusion criteria. There were 296 (17.7%) participants in the proximal pain group and 1380 (82.3%) participants in the distal pain group. There were no differences in FS-TENS usage between the groups. There were no differences between the two groups for any pain outcome. Age, baseline pain measures, number of painful health conditions, constant pain, weather sensitivity and utilization were predictive of pain outcomes. Distal pain moderated the associations between utilization and sleep/activity interference. The doseresponse associations between FS-TENS utilization and pain outcomes were comparable in participants with distal and proximal pain. Conclusion: These results are consistent with FS-TENS having widespread effects beyond the site of stimulation in real-world chronic pain.
{"title":"Real-World Evidence for the Widespread Effects of Fixed-Site High- Frequency Transcutaneous Electrical Nerve Stimulation in Chronic Pain","authors":"S. Gozani, X. Kong","doi":"10.4172/2167-0846.1000329","DOIUrl":"https://doi.org/10.4172/2167-0846.1000329","url":null,"abstract":"Purpose: Transcutaneous electrical nerve stimulation (TENS) produces pain relief by decreasing central excitability and increasing central inhibition. Fixed-site high-frequency TENS (FS-TENS) is a form of TENS in which the device is designed to stimulate a predetermined area rather than to overlap the patient’s pain. The objective of this study was to confirm that FS-TENS has widespread effects beyond the stimulation site in a real-world chronic pain population. Methods: A retrospective cohort study was conducted on users of a FS-TENS device. This device is placed on the upper calf. Study participants were stratified into two groups, those whose pain distribution did not include foot or leg pain (proximal pain group) and those whose pain distribution included foot or leg pain (distal pain group). The outcome measures were changes in pain intensity and pain interference with sleep, activity and mood from a baseline assessment to a 60-day follow-up. FS-TENS dose was characterized by utilization, which was defined as the percentage of days with at least 30 minutes of stimulation. Predictors of pain outcomes were examined by moderated multivariable regression. Results: 1676 FS-TENS users met the inclusion and exclusion criteria. There were 296 (17.7%) participants in the proximal pain group and 1380 (82.3%) participants in the distal pain group. There were no differences in FS-TENS usage between the groups. There were no differences between the two groups for any pain outcome. Age, baseline pain measures, number of painful health conditions, constant pain, weather sensitivity and utilization were predictive of pain outcomes. Distal pain moderated the associations between utilization and sleep/activity interference. The doseresponse associations between FS-TENS utilization and pain outcomes were comparable in participants with distal and proximal pain. Conclusion: These results are consistent with FS-TENS having widespread effects beyond the site of stimulation in real-world chronic pain.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79646325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000324
Bruno Vilas Boas Dias, Jose Paulo Muniz Junior, Silvia M R Oyama
The hospital scenario or home hospitalization brings feeling of insecurity to patients and families that accentuate when they depend on basic care such as hygiene, food, and physical mobility. The professional has the opportunity to focus his/her care actions making an integrated connection between the tasks normalized by the institution together with the possibilities to better assist the patient and the family to ensure comfort and safety [1]. However, caring is not limited to the execution of technical activities, but it evolves the patient as a whole, his/her history, expectations, and feelings, rescuing the importance of emotional, psychological and physical aspects welcoming and valuing them in all their dimensions [2].
{"title":"Proposal for Portable Shower for Comfort and Relief of Patients, Family, and Professionals","authors":"Bruno Vilas Boas Dias, Jose Paulo Muniz Junior, Silvia M R Oyama","doi":"10.4172/2167-0846.1000324","DOIUrl":"https://doi.org/10.4172/2167-0846.1000324","url":null,"abstract":"The hospital scenario or home hospitalization brings feeling of insecurity to patients and families that accentuate when they depend on basic care such as hygiene, food, and physical mobility. The professional has the opportunity to focus his/her care actions making an integrated connection between the tasks normalized by the institution together with the possibilities to better assist the patient and the family to ensure comfort and safety [1]. However, caring is not limited to the execution of technical activities, but it evolves the patient as a whole, his/her history, expectations, and feelings, rescuing the importance of emotional, psychological and physical aspects welcoming and valuing them in all their dimensions [2].","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"2015 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73297612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000325
N. Andjelkov, H. Riyadh, P. Wretenberg
Objective: Cartilage injuries are one of the most frequent causes of knee pain. Other causes such as meniscus tears, synovial plica, synovitis, partial and total ligament ruptures are rather easy to identify by standard diagnostic methods and diagnostic arthroscopy. In this study we are describing two other clinical states, which could be the cause of the knee pain and should be addressed before a decision for operative treatment of cartilage injury has been made by a surgeon. Materials and Methods: Two patients with isolated focal defects due to previous trauma to the knee were diagnosed both using magnetic resonance imaging preoperatively and intraoperatively during arthroscopy. These were operated arthroscopically with standard procedure for microfracture. Both patients had treatment failure without a sign of significant improvement after six and twelve months. Results: Second look arthroscopy was performed in both cases due to the treatment failure and close to normal cartilage was found in the patella in first case and both in trochlea and medial femoral condyle in other case. No other cause of pain could be identified both with second look arthroscopy and magnetic resonance imaging done 6-12 months postoperatively. The patients were diagnosed with neuralgic pain in one case, and nociceptive pain in other case. Conclusion: These states are rare, but have to be addressed by the surgeon before making the decision about the operative treatment. By doing so, one could avoid eventual treatment failure and exposition of the patient to an unnecessary risk of complications during the surgery.
{"title":"Neuralgic and Nociceptive Pain in the Knee as a Cause of the Treatment Failure after Cartilage Repair Surgery: Two Case Reports","authors":"N. Andjelkov, H. Riyadh, P. Wretenberg","doi":"10.4172/2167-0846.1000325","DOIUrl":"https://doi.org/10.4172/2167-0846.1000325","url":null,"abstract":"Objective: Cartilage injuries are one of the most frequent causes of knee pain. Other causes such as meniscus tears, synovial plica, synovitis, partial and total ligament ruptures are rather easy to identify by standard diagnostic methods and diagnostic arthroscopy. In this study we are describing two other clinical states, which could be the cause of the knee pain and should be addressed before a decision for operative treatment of cartilage injury has been made by a surgeon. Materials and Methods: Two patients with isolated focal defects due to previous trauma to the knee were diagnosed both using magnetic resonance imaging preoperatively and intraoperatively during arthroscopy. These were operated arthroscopically with standard procedure for microfracture. Both patients had treatment failure without a sign of significant improvement after six and twelve months. Results: Second look arthroscopy was performed in both cases due to the treatment failure and close to normal cartilage was found in the patella in first case and both in trochlea and medial femoral condyle in other case. No other cause of pain could be identified both with second look arthroscopy and magnetic resonance imaging done 6-12 months postoperatively. The patients were diagnosed with neuralgic pain in one case, and nociceptive pain in other case. Conclusion: These states are rare, but have to be addressed by the surgeon before making the decision about the operative treatment. By doing so, one could avoid eventual treatment failure and exposition of the patient to an unnecessary risk of complications during the surgery.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"3 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74948723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000333
Pedro Garcia-Quintero, N. Suraci, J. D. Mello
{"title":"TAP Blocks: A Recent Review of Anesthetic Combinations","authors":"Pedro Garcia-Quintero, N. Suraci, J. D. Mello","doi":"10.4172/2167-0846.1000333","DOIUrl":"https://doi.org/10.4172/2167-0846.1000333","url":null,"abstract":"","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89836596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000313
J. Hesselink, D. Kopsky
Pain management should be individualized for each patient as much as possible, and the use of a placebo in the clinical practice can help. The treatment with compounded topical analgesics holds a great promise for such individualized therapy, due to the fast response of patients after applying cream containing adequate concentrations of an active pharmaceutical ingredient. We present and discuss a new single-blinded placebo-controlled test paradigm, enabling the physician to quickly differentiate between responders and non-responders, and to further explore the concentration-effect response. This way the placebo assists in selecting the optimal pain treatment, and such use should be regarded as beneficial for patients and ethical correct.
{"title":"The Value of Placebos to Individualize Pain Therapy via A New Singleblind Test Paradigm Identifying Responders on Topical Analgesic Interventions","authors":"J. Hesselink, D. Kopsky","doi":"10.4172/2167-0846.1000313","DOIUrl":"https://doi.org/10.4172/2167-0846.1000313","url":null,"abstract":"Pain management should be individualized for each patient as much as possible, and the use of a placebo in the clinical practice can help. The treatment with compounded topical analgesics holds a great promise for such individualized therapy, due to the fast response of patients after applying cream containing adequate concentrations of an active pharmaceutical ingredient. We present and discuss a new single-blinded placebo-controlled test paradigm, enabling the physician to quickly differentiate between responders and non-responders, and to further explore the concentration-effect response. This way the placebo assists in selecting the optimal pain treatment, and such use should be regarded as beneficial for patients and ethical correct.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"337 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80677193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000334
D. G. Vilar, G. García-Fadrique, J. BeltranPersiva, M. Perez-Mestre
Patients with BPS persistent and unacceptable symptoms despite oral and/or intravesical therapy are candidates for more aggressive modalities. Many of these are best administered within the context of a clinical trial if possible. These may include: neuromodulation, intradetrusor botulinum toxin, oral cyclosporine and other anesthesic techniques. The last step in treatment is usually some type of surgical intervention aimed at increasing the functional capacities of the bladder or diverting the urinary stream. In this paper a review of interventional treatment ́s clinical evidence is made and shows how to improve symptoms in refractory BPS.
{"title":"Interventional Treatments for Bladder Pain Syndrome","authors":"D. G. Vilar, G. García-Fadrique, J. BeltranPersiva, M. Perez-Mestre","doi":"10.4172/2167-0846.1000334","DOIUrl":"https://doi.org/10.4172/2167-0846.1000334","url":null,"abstract":"Patients with BPS persistent and unacceptable symptoms despite oral and/or intravesical therapy are candidates for more aggressive modalities. Many of these are best administered within the context of a clinical trial if possible. These may include: neuromodulation, intradetrusor botulinum toxin, oral cyclosporine and other anesthesic techniques. The last step in treatment is usually some type of surgical intervention aimed at increasing the functional capacities of the bladder or diverting the urinary stream. In this paper a review of interventional treatment ́s clinical evidence is made and shows how to improve symptoms in refractory BPS.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82536661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-0846.1000314
Takuya Naganawa, Jumpei Uchida, T. Okamoto, T. Ando, Abhishek Kumar
Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is considered to be an immunemediated, acquired disease of the peripheral nerves. CIDP patients infrequently develop neuropathy with various clinical forms, such as blink reflex and trigeminal neuropathy. However, to our knowledge, there is no information about intraoral somatosensory changes associated with CIDP. Here, we report the case of a patient with CIDP who exhibited somatosensory changes investigated by quantitative sensory testing (QST). Case Report: A 77-year-old Japanese man was referred to our institution with symptoms of intraoral pain and swollen gingiva. The patient had been diagnosed with CIDP 8 years earlier. The second premolar of the right mandible was diagnosed with apical periodontitis, and tooth extraction was performed to control his pain and inflammation. Following the tooth extraction, local inflammation and pain subsided, however, the patient reported spontaneous dysesthesia on the adjacent gingiva of the extracted tooth. Intraoral qualitative sensory testing of the gingiva showed gingival mechanical allodynia and cold hypoalgesia at the extraction site. We diagnosed the patient with painful post-traumatic trigeminal neuropathy related to tooth extraction. Conclusion: Because of the lack of evidence for peripheral, organic changes in the oral mucosa, the sensory changes may be best explained by peripheral disturbance, an association may exist between these reported somatosensory changes and CIDP.
{"title":"Intraoral Sensory Abnormalities Caused by Tooth Extraction in a Patient with Chronic Inflammatory Demyelinating Polyneuropathy","authors":"Takuya Naganawa, Jumpei Uchida, T. Okamoto, T. Ando, Abhishek Kumar","doi":"10.4172/2167-0846.1000314","DOIUrl":"https://doi.org/10.4172/2167-0846.1000314","url":null,"abstract":"Background: Chronic inflammatory demyelinating polyneuropathy (CIDP) is considered to be an immunemediated, acquired disease of the peripheral nerves. CIDP patients infrequently develop neuropathy with various clinical forms, such as blink reflex and trigeminal neuropathy. However, to our knowledge, there is no information about intraoral somatosensory changes associated with CIDP. Here, we report the case of a patient with CIDP who exhibited somatosensory changes investigated by quantitative sensory testing (QST). Case Report: A 77-year-old Japanese man was referred to our institution with symptoms of intraoral pain and swollen gingiva. The patient had been diagnosed with CIDP 8 years earlier. The second premolar of the right mandible was diagnosed with apical periodontitis, and tooth extraction was performed to control his pain and inflammation. Following the tooth extraction, local inflammation and pain subsided, however, the patient reported spontaneous dysesthesia on the adjacent gingiva of the extracted tooth. Intraoral qualitative sensory testing of the gingiva showed gingival mechanical allodynia and cold hypoalgesia at the extraction site. We diagnosed the patient with painful post-traumatic trigeminal neuropathy related to tooth extraction. Conclusion: Because of the lack of evidence for peripheral, organic changes in the oral mucosa, the sensory changes may be best explained by peripheral disturbance, an association may exist between these reported somatosensory changes and CIDP.","PeriodicalId":16641,"journal":{"name":"Journal of Pain and Relief","volume":"39 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81308836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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