An osteopathic approach to occipital neuralgia and tinnitus

2021 ◽  
pp. 37-41
Author(s):  
Alexis Aiman ◽  
Joy Skaug ◽  
Regina K. Fleming
Keyword(s):  
Primary Care ◽  
Differential Diagnosis ◽  
Conservative Management ◽  
Primary Care Physicians ◽  
Careful Consideration ◽  
Osteopathic Manipulative Treatment ◽  
Occipital Neuralgia ◽  
Eye Pain ◽  
Life Threatening ◽  
Specific Symptoms

Eye pain and ringing in the ear are non-specific symptoms commonly evaluated by primary care physicians and specialists alike. The differential diagnosis for these symptoms is broad and includes musculoskeletal, ophthalmologic and neurologic considerations. Careful consideration of the differential diagnosis should include acute, potentially life-threatening pathologies such as glaucoma or intracranial masses, as well as common pathologies, including cervicalgia, headache variants (migraine, tension) and acoustic neuroma. This report describes a patient with eye pain caused by occipital neuralgia and tinnitus. Correcting the somatic dysfunctions found in the head, cervical, thoracic and rib regions with osteopathic manipulative treatment resolved the occipital neuralgia and the tinnitus for this patient. Thus, osteopathic manipulative treatment should be considered for conservative management of occipital neuralgia and tinnitus.

Teaching Normal and Abnormal Behavior to Primary Care Physicians

1994 ◽  
Vol 24 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Uriel Halbreich
Keyword(s):  
Primary Care ◽  
Differential Diagnosis ◽  
Human Behavior ◽  
Primary Care Physicians ◽  
Family Physicians ◽  
Abnormal Behavior ◽  
General Internists ◽  
Education Committee ◽  
Personal Skills

Objective: This article delineates the framework for a curriculum on psychiatry, normal and abnormal human behavior for primary care physicians (PCPs). Methods: Curricula have been surveyed. Members of the Education Committee of the Association of Medicine and Psychiatry, as well as Family Physicians and General Internists involved in education have been consulted. Their recommendations are integrated. Results and Conclusions: The curriculum should be developed according to the needs of PCPs and from their perspective. Patient and problem-oriented, its content can be divided into: a) personal skills that should be developed; and b) knowledge of symptoms, their differential diagnosis (DDX) and management within the PCP's, facilities and abilities.

scholarly journals Cough variant asthma and atopic cough

2010 ◽  
Vol 5 ◽  
Author(s):  
Chiara Magni ◽  
Elisa Chellini ◽  
Alessandro Zanasi
Keyword(s):  
Primary Care ◽  
Differential Diagnosis ◽  
Chronic Cough ◽  
Primary Care Physicians ◽  
Ace Inhibitor ◽  
Cough Variant Asthma ◽  
The Third ◽  
The World ◽  
Normal Chest ◽  
Atopic Cough

Chronic cough has been reported to be the fifth most com- mon complaint seen by primary care physicians in the world, the third in Italy. Chronic cough in non-smoking, non-treated with ACE-inhibitor adults with normal chest radiogram could be a symptom of asthma and can be sub-classified into: cough-variant asthma, atopic cough, and eosinophilic bron- chitis. This review discusses the differential diagnosis of these three disorders.

scholarly journals Differentiating occipital neuralgia from migraine and tension-type headache

2014 ◽  
Vol 22 (3) ◽  
pp. 425-431
Author(s):  
Omar Franklin Molina ◽  
Zeila Coelho Santos ◽  
Laura Martins ◽  
Bruno Ricardo Simião ◽  
Douglas Oliveira Andrade ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Migraine With Aura ◽  
Severe Pain ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Type Headache ◽  
Specific Symptoms

Objective. To establish differential diagnosis in patients presenting occipital neuralgia, tension-type headache, and migraine with aura. Method. We analyzed 32 patients with Occipital neuralgia (mean age=38.0; females=75%), 102 with tension-type headache (mean age=33.0; females=92.2%), and 16 with migraine without aura (mean age=37.0; females=56.3%). The specific symptoms of headaches were used in according to International Classification of Headache Dis­orders (ICHD) in patients with for craniomandibular disorders and bruxing behavior. Results. Occipital neuralgia group presented more nausea (78.1%; p=0.0001), vomiting (62.5%; p=0.0001), photopho­bia (71.8%; p=0.0001), throbbing (53.1%; p=0.0001), stabbing pain (78.1%; p=0.0001), severe pain (93.7%; p=0.0001), burning (68.8%; p=0.0001), and occipital nerve tenderness (100%; p=0.0001) than tension-type headache group. Occipital neuralgia group showed more stabbing (78.1%; p=0.0001), burning (68.8%; p=0.0005), and oc­cipital nerve tenderness (100%; p=0.0001) than migraine without aura group. Migraine without aura group showed more vomiting (94%; p=0.03) and photophobia (100%; p=0.02) than occipital neu­ralgia group. Conclusions. Nausea, vomiting, photophobia, throb­bing, stabbing, severer pain, a burning description and occipital nerve tenderness, better differentiated occipital neuralgia from tension-type headache. Stabbing pain, burning and occipital nerve tenderness, bet­ter differentiated occipital neuralgia from migraine without aura.

scholarly journals Conservative Management of a Splenic Artery Aneurysm in Pregnancy: A Case Report

2020 ◽  
Vol 3 ◽  
Author(s):  
Raleene Gatmaitan ◽  
Keagan Werner-Gibbings ◽  
Morad Sallam ◽  
Rachel Bell ◽  
Panos Gkoutzios
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Conservative Management ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Careful Consideration ◽  
Splenic Artery Aneurysm ◽  
Life Threatening ◽  
In Pregnancy ◽  
Viable Treatment

Splenic artery aneurysms (SAA) are a rare and life-threatening pathology. Ruptured SAA has a mortality rate of up to 25%, with increased rates of rupture in pregnancy, pseudoaneurysm, liver transplantation, portal hypertension, symptomatic SAA and diameter >2 cm. Management of SAA in pregnant women is poorly described in the literature, making treatment of these patients difficult. Furthermore, careful consideration of complications for both the mother and the foetus need to be taken into account. This case report demonstrates that conservative management with monthly surveillance MRI can be used as viable treatment option of an asymptomatic 17 mm splenic artery aneurysm in a pregnant woman.

AM:STARs: Acute Emergencies in Adolescents, Vol. 26, No. 3

2016 ◽  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Physicians ◽  
Health Problems ◽  
Health Concerns ◽  
Life Threatening

Adolescents frequently present to the emergency department or to primary care physicians for acute health concerns that range from minor to life-threatening. This issue of AM:STARs focuses on many of the more urgent and emergent health problems and concerns that bring adolescents to clinics, private offices, and emergency department settings.

scholarly journals Malignant Hyperthermia and Idiopathic HyperCKemia

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Pashtoon Murtaza Kasi
Keyword(s):  
Primary Care ◽  
Creatine Kinase ◽  
Malignant Hyperthermia ◽  
Genetic Susceptibility ◽  
Primary Care Physicians ◽  
Susceptibility Testing ◽  
Clinical Implications ◽  
Threatening Condition ◽  
Life Threatening ◽  
Genetic Susceptibility Testing

Malignant hyperthermia (MH) is a rare but life-threatening condition that is more frequently encountered and discussed within the anesthesia literature. Here we through a case specifically discuss the susceptibility of individuals and/or families with asymptomatic unexplained elevations of creatine kinase (CK), also frequently referred to as hyperCKemia or idiopathic hyperCKemia (IHCK) in recent reports. The clinical implications would be to underscore the importance of this as a susceptibility to developing MH and highlight the importance of genetic susceptibility testing in such cases. Anesthesiologists and critical care intensivists as well as primary care physicians should keep this in mind when seeing patients with asymptomatic hyperCKemia and potentially inform them about the possibility of developing MH if exposed to triggering agents. Genetic susceptibility testing should be considered if available and family members should also receive nontriggering agents when undergoing anesthesia and wear Medic Alert tags.

Sudden Airway Obstruction Due to Pedunculated Laryngeal Polyps

1983 ◽  
Vol 92 (4) ◽  
pp. 340-343 ◽  
Author(s):  
Jeffrey N. Hausfeld ◽  
Eiji Yanagisawa ◽  
Myles L. Pensak
Keyword(s):  
Primary Care ◽  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Airway Obstruction ◽  
Primary Care Physicians ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Diagnosis And Treatment ◽  
Respiratory Obstruction

Acute upper airway obstruction from laryngeal polyps is uncommon. However, a large pedunculated laryngeal polyp, when unrecognized, may produce sudden airway obstruction. The importance of an early diagnosis and treatment is stressed. Primary care physicians, endoscopists, anesthesiologists, and otolaryngologists should be aware of this condition and add it to their differential diagnosis of sudden respiratory obstruction.

scholarly journals Human Granulocytic Anaplasmosis as a COVID-19 Mimicker

2021 ◽  
Author(s):  
Deeksha Ramanujam ◽  
Adeel Nasrullah ◽  
Obaid Ashraf ◽  
Marshall Bahr ◽  
Khalid Malik
Keyword(s):  
Differential Diagnosis ◽  
Altered Mental Status ◽  
Cytokine Storm ◽  
Human Granulocytic Anaplasmosis ◽  
Granulocytic Anaplasmosis ◽  
Downstream Effects ◽  
Inflammatory State ◽  
Life Threatening ◽  
Novel Coronavirus ◽  
Specific Symptoms

Introduction: Human granulocytic anaplasmosis (HGA) is a tick-borne illness caused by the bacterium Anaplasma phagocytophilum. HGA has a widely variable clinical presentation and can be life-threatening. Case description: A 77-year-old man was transferred from an outside facility with altered mental status, a fever of up to 40.5°C, and shortness of breath. Laboratory analysis revealed a progressively worsening pro-inflammatory state and abnormalities in the patient’s coagulation studies. With clinical and laboratory evidence concerning for potential COVID-19 infection, the patient was placed in isolation as a precaution. The results of two COVID-19 tests, given approximately 24 hours apart, were negative. The patient’s spouse confirmed a bug bite to his upper extremity while working outdoors. His symptoms resolved completely after a 10-day course of empiric doxycycline. Discussion: The diverse clinical presentations of HGA necessitate a broad differential diagnosis, including viral, bacterial and non-infectious aetiologies. In severe cases, a cytokine-mediated immune cascade can occur (namely, cytokine storm) leading to devastating downstream effects. This cytokine storm can be seen in many other diseases, but most recently it has been demonstrated in the novel coronavirus disease 2019 (COVID-19). Conclusion: Here we present a case of HGA in which diagnosis was delayed due to mimicry of COVID-19 infection. This case highlights the importance of taking clinical and social histories, seasonality and geography into account during diagnosis, and maintaining a broad differential with non-specific symptoms. Despite the current COVID-19 pandemic, we recommend that HGA remains in the differential diagnosis of a pro-inflammatory state with an atypical respiratory presentation.

Pediatric Cardiac Conditions

Asthma ◽  
2014 ◽  
pp. 204-214
Author(s):  
Louis I. Bezold
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Differential Diagnosis ◽  
Side Effects ◽  
Cardiac Disease ◽  
Cardiac Dysfunction ◽  
Primary Care Physicians ◽  
Public Health Issue ◽  
Medical Issues ◽  
Common Association

Many cardiac conditions presenting in childhood belong on the differential diagnosis list of bronchial asthma, and vice versa. Asthma, through either direct disease action or undesired side effects of therapy, is associated with subclinical cardiac dysfunction and ischemia. Obesity, a tremendous public health issue, shares a common association with both cardiac disease and asthma. Considering these facts, close collaboration between pediatric subspecialists and primary care physicians is absolutely necessary to effectively manage children with the multiple comorbidities associated with asthma. More research is needed to optimize asthma therapies while reducing complications, with the goal of the best possible outcomes for all children struggling with these medical issues.

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