scholarly journals Vascular decompression with videoendoscopy as a treatment for glossopharyngeal nerve neuralgia: clinical case and literature review

2021 ◽  
Vol 23 (2) ◽  
pp. 77-85
Author(s):  
A. G. Vinokurov ◽  
A. A. Kalinkin ◽  
A. A. Bocharov ◽  
O. N. Kalinkina ◽  
S. M. Chupalenkov
Keyword(s):  
Clinical Case ◽  
Correct Diagnosis ◽  
Pain Syndrome ◽  
Treatment Method ◽  
Glossopharyngeal Nerve ◽  
Vagus Nerves ◽  
Appropriate Treatment ◽  
Clinical Center ◽  
Low Incidence ◽  
Vascular Decompression

The objective is to demonstrate the effectiveness of the vascular decompression with videoendoscopy in the treatment of classical glossopharyngeal nerve neuralgia by a clinical case and to summarize the literature data on this subject. Clinical case. In February 2020, a 56-year-old patient with a clinical picture of glossopharyngeal nerve neuralgia was admitted to the Research Clinical Center of Specialized Medical Care and Medical Technologies. The pain syndrome bothered about 3 years, constantly took carbamazepine at a dose of 1200 mg per day, amitriptyline 75 mg per day, clonazepam 2 mg per day without effect. After further examination and differential diagnosis of causal neuralgia of the glossopharyngeal nerve, a neurovascular conflict appeared between the glossopharyngeal nerve, the posterior inferior cerebellar and vertebral arteries. A good postoperative clinical result was obtained. An analysis of the available scientific literature on this problem is carried out.Results. After performing vascular decompression of the root of the glossopharyngeal and vagus nerves, pain completely regressed (BNI - I, VAS - 0). 6 months after surgery, there is no pain, the patient does not receive drug therapy. In the course of the analysis of available literature, the effectiveness of vascular decompression in the treatment of patients with classical neuralgia reaches 98 %.Conclusion. Given the low incidence of glossopharyngeal neuralgia, the correct diagnosis and the choice of an appropriate treatment method determine the outcome of the disease. The performed operation in the volume of vascular decompression of the glossopharyngeal nerve root with the use of videoendoscopy allowed to completely stop the pain syndrome.

Clinical case of pyodermia ulcerosa serpiginosa(pyoderma gangrenosum)

2021 ◽  
pp. 32-38
Author(s):  
L.V. Verbytska ◽  
D.A. Kinash
Keyword(s):  
Pyoderma Gangrenosum ◽  
Clinical Case ◽  
Wound Care ◽  
Secondary Infection ◽  
Topical Therapy ◽  
Pain Syndrome ◽  
Treatment Method ◽  
Pathological Process ◽  
Social Adaptation ◽  
Aged People

Objective — to highlight the issue of difficulties in the diagnosis and treatment of patients with pyoderma gangrenosum (PG). Materials and methods. A literature review and analysis of the results of the clinical examination of patients with PG was performed. Pyoderma gangrenosum is most commonly observed in young and middle-aged people, more frequently in women. The pathogenesis of PG has not been fully studied. It is believed to be related to genetic mutations, neutrophil dysfunction and impaired immunity/inflammation regulation. Maverakis and others developed diagnostic criteria for PG. First-line treatment is aimed at optimizing the local wound care. For more severe diseases, systemic therapy is required. Oral corticosteroids (0.5—1 mg/kg/day) are the basis of treatment and used for control of PG. Cyclosporine can be used either alone or in combination with corticosteroids. At present, there is an increasing evidence of effectiveness of biological therapy as treatment method for a number of cytokines. Results and discussion. This article presents a clinical case of a patient diagnosed with PG. Based on recent guidelines, systemic corticosteroid therapy (Medrol starting at 48 mg/d), systemic anti-inflammatory and vascular drugs, topical therapy and treatment results were presented. Conclusions. Without treatment, the disease lasts for months and years. Ulcers sometimes grow very fast, reaching huge sizes in a matter of days. After the healing of some ulcers new ones often emerge. Pain syndrome, the addition of a secondary infection and the continuous progression of the pathological process lead to a decrease in the patient’s quality of life, as well as to a deterioration in his social adaptation. Therefore, timely adequate diagnosis, treatment and full compliance of the patient are the key to success.

Rare Clinical Case of Cryopyrin-Associated Periodic Syndrome Presented with Ankylosing Spondylitis: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Anna A. Zayaeva ◽  
Lyudmila V. Sokolova ◽  
Denis V. Shaduro ◽  
Andrey V. Petrov ◽  
Shanmugaraj Kulanthaivel ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Treatment Method ◽  
Genetically Engineered ◽  
Periodic Syndrome ◽  
Biological Drugs ◽  
Nlrp3 Gene ◽  
Long Time

Background: Cryopyrin-Associated Periodic Syndrome (CAPS) is a variety of clinical variants of autoinflammatory diseases. The pathology is based on a mutation in the NLRP3 gene encoding the cryopyrin protein, which leads to the uncontrolled production of interleukin-1β. Particular attention should be paid to the rarity of this disease and the lack of clinical knowledge about it in therapeutic and rheumatological practice, which leads to an erroneous diagnosis and the appointment of ineffective treatment for a long time, leading to the progression of the disease and disability of the patient. Case Presentation: This article describes a clinical case of this disease. The first manifestations of the disease in a woman appeared from the age of 2 years, in the form of a rash and fever. Since school age, there have been signs of arthritis. By the age of 24, sensorineural hearing loss and pain in the spine were evident. The disease occurred under the clinical manifestations of spondyloarthritis. Its treatment with anti-inflammatory therapy did not give a stable result. Conclusion: From the analysis, we can conclude that patient M. from early childhood suffers from a severe Neonatal-onset Multisystem Inflammatory Disease of a genetic nature. For a long time, the patient was diagnosed with ankylosing spondylitis, and appropriate treatment was carried out without significant success. The correct diagnosis of CAPS was made only in 2018. This patient has conditions of both CAPS and AS together, which is a very rare association in rheumatological practice. The only treatment method that could stop the manifestations of the disease and prevent life-threatening kidney damage (amyloidosis) is the use of genetically engineered biological drugs, i.e., IL-1β inhibitors. The only drug of this group registered in Russia is canakinumab (Ilaris ®). From the moment of diagnosis to the present day, the patient is treated with the genetically engineered drug canakinumab (Ilaris ®) at a dose of 150 mg once every 8 weeks. 6 months after taking the drug, the patient went into complete clinical and laboratory remission.

scholarly journals Endo-perio lesions: diagnosis and interdisciplinary treatment options

2020 ◽  
Vol 3 (1) ◽  
pp. 257-261
Author(s):  
Timea Dakó ◽  
Ana Petra Lazăr ◽  
Cristina Ioana Bică ◽  
Luminița Lazăr
Keyword(s):  
Tooth Loss ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Functional Relation ◽  
Interdisciplinary Approach ◽  
Treatment Method ◽  
Interdisciplinary Treatment ◽  
Periodontal Tissues ◽  
Endodontic Infection ◽  
Appropriate Treatment

AbstractAbout 50% of tooth loss is caused by either endodontic infection, periodontal disease or the combination of the two in the form on endo-perio lesions (EPL). Combined EPL develop due to the intimate anatomic and functional relation between endodontic and periodontal tissues. Both the pulp and periodontium share the same embryologic and anatomic origin. The various pathways connecting the two, added up to the extremely alike microorganisms in both illnesses’ etiology, create a complex condition in which interdisciplinary approach is required. Despite numerous decades of literature describing these lesions, they remain a continuous challenge for practitioners in both diagnosing and managing. The purpose of this article is to present a comprehensive review of various aspects of the combined EPL and to emphasize the importance of making a correct diagnosis and adopting the appropriate treatment method in the management of these challenging situations.

scholarly journals Glossopharyngeal neuralgia due to exposed glossopharyngeal nerve post tonsillectomy and transoral styloidectomy

2020 ◽  
Vol 6 (9) ◽  
pp. 1725
Author(s):  
Ajith Keragodi Mahalingappa ◽  
Richa Gupta ◽  
Sathi Ramakrishnan
Keyword(s):  
Rare Condition ◽  
Pain Syndrome ◽  
Styloid Process ◽  
Glossopharyngeal Nerve ◽  
Glossopharyngeal Neuralgia ◽  
Intractable Pain ◽  
Vagus Nerves ◽  
Inferior Aspect ◽  
Posterior Tongue

<p>Glossopharyngeal neuralgia (GN) is a rare facial pain syndrome, characterized by paroxysm of excruciating radiating pain in the sensory distribution of the auricular and pharyngeal branches of glossopharyngeal and vagus nerves. In relation to the tonsil, the glossopharyngeal nerve passes deep to the styloid process and related muscles attaching to styloid process. The lingual branch of the glossopharyngeal nerve provides sensation to the posterior tongue and enters the tongue base by traveling through the constrictor muscles in the area of the lingulotonsillar sulcus. Post tonsillectomy fossa with exposed nerve causing intractable pain is a rare entity. We report a case of 64 year male patient, post tonsillectomy and transoral styloidectomy, with complaint of severe throat pain on left side for 2 years, radiating upwards to the ipsilateral ear, face and eye. Glossopharyngeal nerve and its branches were found exposed in the posterior and inferior aspect of tonsillar bed. Surgical resection of exposed glossopharyngeal nerve and its branches was carried out in view of failure to respond to oral carbamazepine. Patient was symptom free during 10 months of follow up visit. GN is a rare condition following tonsillectomy and styloidectomy. Radical dissection of tonsillar bed during tonsillectomy and not suturing tonsillar bed properly after styloidectomy can lead to exposure of glossopharyngeal nerve and its branches, resulting in intractable GN.</p>

scholarly journals Ischemia of the glans penis after circumcision and blockade of the spinal nerve of the penis, a clinical case

2021 ◽  
Vol 14 (1) ◽  
pp. 140-143
Author(s):  
R.Yu. Valiev ◽  
◽  
S.G. Vrublevskiy ◽  
А.S. Vrublevskiy ◽  
E.N. Vrublevskaya ◽  
...  
Keyword(s):  
Clinical Case ◽  
Treatment Method ◽  
Endothelial Damage ◽  
Spinal Nerve ◽  
Glans Penis ◽  
Domestic Literature ◽  
Choice Of Treatment ◽  
Arterial Inflow ◽  
Exact Etiology ◽  
Low Incidence

Introduction. Circumcisio is a fairly simple, often performed surgical procedure in childhood, which is fraught with a small number of complications (1-5-5%). One of the most rare and dangerous is necrosis of the glans penis. The low incidence of complications determines the lack of a single standardized approach to the treatment of this pathology. The clinical case. In this article, we present a case of glans ischemia after circumcisio with pineal block, corrected with the help of therapy aimed at improving the rheological properties of the blood. A review of the literature and various treatment methods described by other authors was conducted. The exact etiology of ischemia and necrosis of the head in most cases remains unclear. However, numerous possible causes have been described, including spasm of the veins / arteries in the glans penis, thrombosis, hematoma at the injection site, burn during electrocoagulation, perforation of a vein or artery leading to endothelial damage and delayed necrosis. Results. After a course of conservative therapy, local signs of ischemia associated with surgery were stopped without side effects. Discussion.The standard of choice of treatment method for ischemia and necrosis of the glans penis after circumcisio has not yet been established. We have not found an analysis of such clinical cases in children in the domestic literature. A number of foreign colleagues have reported several therapies that have been used with successful results. The ultimate goal of all of these studies was vasodilation to increase arterial inflow and improve venous outflow, which allowed for revascularization of ischemic tissues. Conclusions. Despite the fact that ischemia or necrosis of the glans penis after circumcision is extremely rare, surgeons, urologists need to be wary if patients complain of acute pain or darkening of the color of the glans penis after circumcision of the foreskin.

Middle ear tuberculosis - clinical case

ORL ro ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
A. Sandul ◽  
M. Buracovschi ◽  
N. Buracovschi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Human Population ◽  
Clinical Case ◽  
Correct Diagnosis ◽  
Tuberculous Otitis Media ◽  
Type V

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.  

scholarly journals An intrasellar germinoma with normal tumor marker concentrations mimicking primary lymphocytic hypophysitis

2013 ◽  
Vol 57 (7) ◽  
pp. 566-570 ◽  
Author(s):  
Mariana F. Guzzo ◽  
Cristina B. Formiga Bueno ◽  
Thiago T. Amancio ◽  
Sergio Rosemberg ◽  
Cleonice Bueno ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Correct Diagnosis ◽  
Careful Analysis ◽  
Malignant Neoplasms ◽  
Pituitary Hormone ◽  
Appropriate Treatment ◽  
Suprasellar Region ◽  
Neoplastic Lesions ◽  
Posterior Pituitary Hormone ◽  
Pituitary Stalk Thickening

Intracranial germinomas (GE) are malignant neoplasms most commonly found in the suprasellar region, which may cause anterior and particularly posterior pituitary hormone deficits with central diabetes insipidus (DI). Differential diagnosis of pituitary stalk thickening includes granulomatous, inflammatory, infectious, and neoplastic lesions. Although careful analysis of clinical, laboratory, and imaging findings may facilitate the diagnosis, transsphenoidal biopsy is indicated to confirm the disease, as the correct diagnosis directs the appropriate treatment.

COVID-19-associated orthostatic hypotension syndrome: direct and indirect mechanisms of development

2021 ◽  
Vol LIII (3) ◽  
pp. 64-70
Author(s):  
Elena G. Mendelevich ◽  
Alsu A. Saifeeva ◽  
Artur I. Kurbanov
Keyword(s):  
Nervous System ◽  
Orthostatic Hypotension ◽  
Clinical Case ◽  
Clinical Observation ◽  
Thrombus Formation ◽  
Correct Diagnosis ◽  
Aim Analysis ◽  
Angiotensin Converting Enzyme 2 ◽  
Mechanisms Of Development ◽  
Near Future

Background. The article presents an observation of the clinical case of orthostatic hypotension that developed after an infection caused by the SARS-CoV-2 virus. The issues of etiology, pathogenesis, diagnosis are outlined. The complexity of diagnosis at the stage of clinical observation is due to the comorbidity of possible mechanisms and the difficulty of determining the primary factor. Taking into account the study of variants of direct and indirect action of this 2019-nCoV, the description of the clinical observation of orthostatic hypotension supplements the data on the spectrum of manifestations of this disease. Aim. Analysis of the clinical case of the development of orthostatic hypotension in the post-acute period of COVID-19. Material. When conducting a literature review on the selected topic, various sources were considered. The search depth was over 7 years. For the recruitment of literature, Internet platforms UpToDate, PubMed, Medscape were used. Russian and foreign sources were studied. Methods. Anamnesis collection, objective research, specialized tests, laboratory and instrumental research methods, study of disease history, literature sources on orthostatic hypotension and the effect of COVID-19 on the autonomic nervous system. Results. The analysis of this case with the determination of the leading mechanism of orthostatic hypotension is extremely difficult. Probably, there is a combination of factors: direct and indirect effects on the nervous system at COVID-19. The direct effect is associated with the interaction of the virus with the angiotensin converting enzyme 2 receptors in the nervous system, which causes a significant increase in the concentration of bradykinin and the development of hypotension. An indirect effect is due to both increased thrombus formation with the development of PE, and autonomic dysfunction, within the framework of secondary polyneuropathy of fine fibers. Conclusion. It is likely that in the near future the number of such patients in the practice of doctors will increase, therefore, timely and correct diagnosis of these conditions, with their careful management, will be the fundamental postulates in the recovery of patients. Drawing attention to this topic will possibly expand our understanding of the spectrum of complications of COVID-19 and will greatly complement the information available today.

scholarly journals Spinal Cord Electrical Stimulation for Refractory Angina Treatment

2017 ◽  
Vol 38 (04) ◽  
pp. 272-278
Author(s):  
Gustavo Veloso Lages ◽  
Jose Oswaldo Oliveira Júnior
Keyword(s):  
Cardiovascular Disease ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Electrical Stimulation ◽  
Visceral Pain ◽  
Pain Syndrome ◽  
Refractory Angina ◽  
Family Disruption ◽  
Appropriate Treatment ◽  
Absence From Work

AbstractCardiovascular disease (CVD) is the main cause of death worldwide, including in Brazil. Angina pectoris is a challenging disease because its clinical manifestation is not always related to the degree of obstruction. Visceral pain from any source can be totally disabling. It influences all aspects of the life of a patient and it can be one of the main causes of absence from work and of family disruption. Spinal cord electrical stimulation (SCES) has been traditionally applied for the treatment of neuropathic pain, with good to excellent results. Visceral pain syndrome can be as debilitating and disabling as somatic or neuropathic pain; however, there seems to be a lack of consensus on the appropriate treatment and strategies for these disorders. The major difference of SCES for visceral pain, compared to postlaminectomy syndrome or to regional complex syndrome, is the number of stimulated dermatomes. In most viscera, the somatotopic arrangement has two to four medullar levels, sometimes requiring laterality. After reviewing the literature, we have concluded that SCES is now a viable, low-risk option with satisfactory results for the treatment of neuropathic and visceral pain; therefore, it can be used in refractory angina after the failure of standard therapy. However, further studies are required to increase the application and efficacy of this procedure in the clinical practice.

Sign in / Sign up

Export Citation Format

Share Document