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Tongue paraesthesia and dysgeusia post suspension laryngoscopy

Mohamad H, Mohamad I

Kobe J Med Sci, 2012;58(2):E60-2.
PMID: 22972170

Suspension laryngoscopy is a common laryngeal procedure in Endolaryngeal microsurgery (ELMS). Oral mucosa and dental injuries are the known complications of the procedure. Nerve injury however is an infrequent encounter. We report a rare complication of lingual nerve injury which manifested as tongue numbness and altered taste following Endolaryngeal microsurgery procedure. The condition improved completely after few months of conservative management.

Matched MeSH terms: Paresthesia/etiology*
Fulltext Haemodialysis associated amyloidosis of the tongue: a case report

Sathasivam, Hans Prakash, Lau, Shin Hin

Archives of Orofacial Sciences, 2013;8(2):65-68.
MyJurnal

Haemodialysis associated amyloidosis (HAA) is a complication of long-term haemodialysis caused by deposition of β2-microglobulin in tissues that most often presents clinically at osteoarticular sites. However, in very rarecircumstances, patients do present initially with oral manifestations of HAA. In a normally functioning kidney, β2-microglobulin is cleared by glomerular filtration and is catabolized in the proximal tubules. This article describes a patient with oral manifestation of haemodialysis associated amyloidosis with an unusual presenting complaint of lingual dysaesthesia.

Matched MeSH terms: Paresthesia
Is there a "safety zone" in the mandibular premolar region where damage to the mental nerve can be avoided if periapical extrusion occurs?

Ngeow WC

J Can Dent Assoc, 2010;76:a61.
PMID: 20579448
Matched MeSH terms: Paresthesia/chemically induced; Paresthesia/prevention & control*
Median nerve compression by gouty tophi: a case report

Raffael, I., Rajesh, S.

International Medical Journal Malaysia, 2015;14(1):87-91.
MyJurnal

We describe a case of median nerve compression by gouty tophi. This is a rare condition and presented with loss of function with paraesthesia of both hands in addition to multiple tophis. Surgery was chosen for immediate relief, where a debulking of left flexor digitorum superficialis with decompression of carpal tunnel was done and resulted in improvement of symptoms but became complicated due to inadequate physiotherapy.

Matched MeSH terms: Paresthesia
Fulltext The Clinikal Conundrum Of A Numb Chin

Ghazali, N., Ismail, S.M., Abdul Rahman, Z.A.

Ann Dent, 2001;8(1):-.
MyJurnal

Mental nerve neuropathy is an important presenting complaint that may be encountered by dental surgeons in their daily practise. There are various pathological processes that could bring about this symptom, ranging. from simple dental cause to vague, life threatening diseases. We present three cases of mental paraesthesia of different aetiologies. A literature review on mental nerve neuropathy related to malignancies and infection is discussed. The importance of a thorough chair side history taking, clinical examination and relevant investigations are emphasised in a suggested clinical approach to obtaining the diagnosis of a numb chin.

Matched MeSH terms: Paresthesia
Restless legs syndrome: pathophysiology and modern management

Nagandla K, De S

Postgrad Med J, 2013 Jul;89(1053):402-10.
PMID: 23524988 DOI: 10.1136/postgradmedj-2012-131634

Restless legs syndrome (RLS) is a common sensory motor neurological disorder that is characterised by an irresistible urge to move the legs that significantly affects the quality of life of the patient. Prevalence in the general population is 5-25% and it is twice as prevalent in women as in men. RLS is the most common movement disorder in pregnancy with a fourfold increased risk of developing this disorder later in life. The pathophysiology of RLS is centred on dopaminergic dysfunction, reduced central nervous system iron, genetic linkages, or alteration in neurotransmitters such as hypocretins, endorphins levels and immune dysfunction and inflammatory mechanisms. With the emergence of new evidence, there are changes to the previous treatment recommendations for RLS. There is sufficient evidence to conclude that dopamine agonists such as rotigotine transdermal patch, pramipexole, ropinirole, gabapentin enacarbil, pregabalin and gabapentin are effective in the short-term treatment of RLS and rotigotine, followed by gabapentin enacarbil, ropinirole, pramipexole and gabapentin for long-term treatment. Based on expert consensus, the recommendation for daily RLS is dopamine agonists or gabapentin or low-potency opioids. Levodopa is less preferred for treating daily RLS due to its high risk of augmentation. For intermittent RLS, it is levodopa or dopamine agonists or low-potency opioids or benzodiazepines. For refractory RLS, the choice is to change to gabapentin or a different dopamine agonist, addition of a second agent like gabapentin or benzodiazepine to the existing drug or changing to a high-potency opioid or tramadol. Medications with safety record in pregnancy include opioids and antiepileptics such as carbamazepine and gabapentin. There are concerns that patients with RLS are at risk for metabolic deregulation, autonomic dysfunction and cardiovascular morbidity. However, a recent study concluded that RLS is not associated with increased risk of cardiovascular complications.

Matched MeSH terms: Paresthesia/diagnosis; Paresthesia/drug therapy; Paresthesia/physiopathology*; Paresthesia/psychology
Fulltext Impact of carpal tunnel syndrome on the expectant woman's life

Rozali ZI, Noorman FM, De Cruz PK, Feng YK, Razab HW, Sapuan J, et al.

Asia Pac Fam Med, 2012 Jan 30;11(1):1.
PMID: 22283968 DOI: 10.1186/1447-056X-11-1

INTRODUCTION: Carpal Tunnel Syndrome is known to be a common complication during pregnancy especially during the third trimester.

AIM: This article focuses on its impact to the third trimester pregnant mothers with CTS.

METHODS: Third trimester pregnant mothers with no other known risk factors for CTS, were interviewed and examined for a clinical diagnosis of CTS. The severity of CTS was assessed by means of symptoms severity and functionality using the Boston Carpal Tunnel Questionnaire.

RESULTS: Out of 333 third trimester pregnant mothers, 82 (24.6%) were clinically diagnosed with CTS. Malay race was found to have significant correlation with the diagnosis of CTS (p = 0.024) and are two times more likely to get CTS during pregnancy (OR = 2.26) compare to the non-Malays. Bilateral CTS was two times higher (n = 58, 63.4%) than unilateral cases (n = 30, 36.6%), however no significant correlation between the two was found with severity (p = 0.284) or functional (p = 0.906). The commonest complaint was numbness/tingling during day time (n = 63, 76.8%). Majority of the CTS cases were mild (n = 66, 80.5%) and approximately one third (n = 28, 34.1%) had affected hand functions. All symptoms related to pain was found to have significant correlation with severity (p = 0.00, OR = 12.23) and function (p = 0.005, OR = 5.01), whereas numbness and tingling does not (Severity, p = 0.843, function, p = 0.632).

CONCLUSION: This study shows that even though CTS in third trimester pregnancy is prevalent, generally it would be mild. However, function can still be affected especially if patients complain of pain.

Matched MeSH terms: Paresthesia
Fulltext Vasovagal reaction among whole blood donors in Hospital Pulau Pinang. A statistical-epidemiological study

Hasan I, Arshad A, Rahim NA, Soo PY

Asian J Transfus Sci, 2020 07 24;14(1):28-32.
PMID: 33162702 DOI: 10.4103/ajts.AJTS_111_17

CONTEXT: Whole blood donation is generally considered a safe procedure; however, a small percentage of donors could develop vasovagal reactions (VVRs) during or after completion of blood donation.
AIMS: This study was undertaken to establish the prevalence of VVR among whole blood donors in Hospital Pulau Pinang and to investigate factors that lead to its occurrence.
SETTINGS AND DESIGN: A cross-sectional study was conducted involving 27,890 whole blood donations in 2016.
SUBJECTS AND METHODS: For each donation, donor's demographic and blood donation-related information was extracted from the blood bank database.
STATISTICAL ANALYSIS USED: Qualitative data including age group, sex, race, frequency, and location of donation were analyzed using Chi-square tests, while blood pressure was analyzed using t-test.
RESULTS: Overall, 425 cases of VVRs were reported, resulting in a VVR rate of 1.5% (one event in every 65 donations). We found a statistically significant association (P < 0.05) between the occurrence of VVRs with the young age group, female gender, Indian race, first-time donor, lower predonation blood pressure, and donation performed in a mobile donation campaign. The most common vasovagal symptoms are lightheadedness (88%), followed by nausea (5.4%), muscle twitching (3.5%), vomiting (1.4%), loss of consciousness <30 s (1.4%), and paresthesia (0.2%).
CONCLUSIONS: The prevalence of VVRs among whole blood donors in Hospital Pulau Pinang appeared to be low. Our study reaffirms that blood donation is a relatively safe process, and the incidence of VVR can be further reduced by ensuring strict screening procedure before blood donation.

Matched MeSH terms: Paresthesia
Fulltext The Aetiology And Management Of ChronicIdiopathic Facial Pain: A Review

Abdul Rahman, Z.A.

Ann Dent, 1998;5(1):-.
MyJurnal

Chronic idiopathic facial pain is the diagnosis given to a group of orofacial pain of psychogenic origin which includes atypical facial pain, facial-arthromyalgia, atypical odontalgia and oral dysaesthesia. Despite various biochemical findings, the condition remains poorly understood, but we have begun to understand the nature of these patients. This review discusses the possible aetiology of the disease through various biochemical and clinical findings. The contribution of behavioural and psychological factors to the clinical course of the disease are described. The type of adverse life events that predispose people to the disease and their potency are briefly mentioned. The current diagnostic approach for the disease is also mentioned. Treatment includes antidepressant medication, physiotherapy, bite-guards and analgesics. The problems encountered in the long-term management and outcome studies of these patients include drop-outs, non-compliance and denial.

Matched MeSH terms: Paresthesia
Fulltext Remission of recalcitrant dermatomyositis following a chiropractic adjustment

Chu ECP, Lo FS, Bhaumik A

J Family Med Prim Care, 2019 Nov;8(11):3742-3744.
PMID: 31803683 DOI: 10.4103/jfmpc.jfmpc_839_19

Dermatomyositis (DM) is an idiopathic inflammatory myopathy characterized by progressive muscle weakness and pathognomonic skin eruptions. Systemic corticosteroid with or without an immunosuppressive agent is the current treatment of choice in most cases. Cutaneous disease in DM is often refractory and can become the most challenging component to manage effectively. Here, we report a case of recalcitrant DM in a 66-year-old female who sought chiropractic attention for recent episodes of pain and paresthesia in the neck and exacerbation of joint pain. As expected, the musculoskeletal complaints including neck pain, peripheral arthralgia, and muscle weakness that resolved within 1 month after starting treatment. Unexpectedly, dramatic remission of the characteristic skin rashes occurred concurrently. The underlying therapeutic mechanisms of chiropractic remain elusive. This case highlights the importance of family physicians becoming familiar with diagnosing the condition and using a multidisciplinary team approach to treat recalcitrant DM.

Matched MeSH terms: Paresthesia
Feasibility analysis of treating breast cancer patients with breast-conserving surgery via a periareolar incision combined with non-lipolytic suspension-type mastoscopy

Liu J, He G, Zhang Y, Wong MP, Chu J, Kong L, et al.

Sci Rep, 2023 Jul 26;13(1):12129.
PMID: 37495629 DOI: 10.1038/s41598-023-39199-y

The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary Lymph Node Dissection (SMALND) and traditional inflated Mastoscopic Axillary Lymph Node Dissection (MALND). This was a randomized trial conducted from June 1, 2020, to April 30, 2022, in the Department of Second Breast Surgery, Shengjing Hospital of China Medical University, and the Department of Thyroid and Breast Surgery, Zibo Central Hospital, in accordance with the criteria of inclusion and exclusion. Overall, 126 patients diagnosed and treated for early-stage breast cancer were selected to undergo periareolar-incision breast-conserving surgery. Those patients who underwent periareolar-incision surgery combined with SMALND formed the observation group (SMALND Group), while those who underwent periareolar-incision surgery combined with traditional inflation became MALND Group. In the two groups, paired data "t" was used to examine, analyze, and compare the postoperative daily drainage volume and drain removal time, while paired data "χ2" was used to examine, analyze, and compare the incidences of postoperative upper limb edema and paresthesia. There were 64 cases in the SMALND Group and 62 cases in the MALND Group. Between the two clusters, no differences were found in age, clinical staging, BMI, and breast cancer classification (P > 0.05). The intraoperative surgery time of the SMALND Group was 43.37 ± 6.27 min while that of the MALND Group was longer: 45.72 ± 4.25 min (P paresthesia incidence rate of the SMALND Group was 18.75% (12/64), while that of the MALND Group was 17.7% (11/62), without an obvious difference (P = 0.88). For axillary lymph node dissection, the use of non-lipolytic suspension-type mastoscopy has reduced the intraoperative hemorrhage volume of patients, shortened surgery time and postoperative recovery time, saved treatment expenses for patients, and avoided complications such as hypercapnia and subcutaneous emphysema caused by traditional inflated mastoscopic surgery. Moreover, it has not increased the incidence of postoperative upper limb edema and paresthesia, supporting its safety and effectiveness.

Matched MeSH terms: Paresthesia
Fulltext Haemorrhagic lumbar synovial cyst

Soon CK, Razak M

Med J Malaysia, 2001 Dec;56 Suppl D:57-60.
PMID: 14569769

Hemorrhagic lumbar synovial cysts are not commonly reported in English literature. Post-resection recurrence of synovial cyst is unusual and therefore recurrence symptoms required repeat MRI or CT scan. We reported a case of hemorrhagic lumbar synovial cyst presented with neurological deficit that recovered initially after surgery but subsequently developed recurrent of symptoms at a higher level due to fibrous tissue.

Matched MeSH terms: Paresthesia/etiology
The effect of melatonin on delirium in hospitalised patients: A systematic review and meta-analyses with trial sequential analysis

Ng KT, Teoh WY, Khor AJ

J Clin Anesth, 2020 Feb;59:74-81.
PMID: 31279283 DOI: 10.1016/j.jclinane.2019.06.027

OBJECTIVES: Melatonin is an endogenous hormone, which regulates circadian rhythms and promotes sleep. In recent years, several randomised controlled trials examining the prophylactic use of melatonin to prevent delirium were published with conflicting findings. The primary aim of this review was to determine the effect of melatonin on the incidence of delirium in hospitalised patients.
DATA SOURCES: MEDLINE, EMBASE and CENTRAL were systematically searched from their inception until December 2018.
REVIEW METHODS: All randomised clinical trials were included.
RESULTS: Sixteen trials (1634 patients) were included in this meta-analysis. Incidence of delirium was not significantly lower in patients who received melatonin, with an odd ratio, OR (95%Cl) of 0.55 (0.24-1.26); ρ = 0.16, certainty of evidence = low, trial sequential analysis = inconclusive. However, patients who randomised to melatonin had a significantly shorter length of stay in intensive care units, with a mean difference, MD (95%CI) of -1.84 days (-2.46, -1.21); ρ 

Matched MeSH terms: Paresthesia/chemically induced; Paresthesia/epidemiology
Fulltext Anaphylactic shock following the bite of a wild Kayan slow loris (Nycticebus kayan): implications for slow loris conservation

Madani G, Nekaris KA

J Venom Anim Toxins Incl Trop Dis, 2014;20(1):43.
PMID: 25309586 DOI: 10.1186/1678-9199-20-43

BACKGROUND: Asian slow lorises (Nycticebus spp.) are one of few known venomous mammals, yet until now only one published case report has documented the impact of their venomous bite on humans. We describe the reaction of a patient to the bite of a subadult Nycticebus kayan, which occurred in the Mulu District of Sarawak in 2012.

FINDINGS: Within minutes of the bite, the patient experienced paraesthesia in the right side of the jaw, ear and right foot. By 40 minutes, swelling of the face was pronounced. The patient was admitted to Mulu National Park Health Clinic/Klinik Kesihatan Taman Mulu Tarikh, at which time he was experiencing: swollen mouth, chest pain, mild abdominal pain, nausea, numbness of the lips and mouth, shortness of breath, weakness, agitation and the sensation of pressure in the ears due to swelling. The blood pressure was 110/76, the heart ratio was 116 and oxygen saturation was 96%. The patient was treated intramuscularly with adrenaline (0.5 mL), followed by intravenous injection of hydrocortisone (400 mg) and then intravenous fluid therapy of normal saline (500 mg). By 8 h10 the next day, the patient's condition had significantly improved with no nausea, and with blood pressure and pulse rate stable.

CONCLUSIONS: A handful of anecdotes further support the real danger that slow loris bites pose to humans. As the illegal pet trade is a major factor in the decline of these threatened species, we hope that by reporting on the danger of handling these animals it may help to reduce their desirability as a pet.

Matched MeSH terms: Paresthesia

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