Clinical manifestations, diagnostics and treatment of persistent idiopathic facial pain

Medical alphabet ◽

10.33667/2078-5631-2021-36-30-36 ◽

2021 ◽

pp. 30-36

Author(s):

N. M. Voevodina ◽

A. N. Barinov

Keyword(s):

Poor Prognosis ◽

Facial Pain ◽

Clinical Manifestations ◽

Persistent Idiopathic Facial Pain ◽

Effective Treatments

Persistent idiopathic facial pain (PIFP) is often regarded as an undiagnosed condition with a poor prognosis. Extensive research on this topic is limited, and there are few effective treatments. Even with an established diagnosis of PIFP, due to poor awareness of the etiology and pathogenesis of the development of the disease, patients struggle with the acceptance of the ‘all-encompassing’ disorder in search of the causes that led to the disease and often undergo unnecessary tests and procedures in search of alternative diagnoses.

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Small cell carcinoma of the cervix complicated by syndrome of inappropriate antidiuretic hormone secretion: a case report

Journal of International Medical Research ◽

10.1177/0300060520985657 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098565

Author(s):

Cai-Fu Zhao ◽

Su-Fen Zhao ◽

Ze-Qing Du

Keyword(s):

Cell Carcinoma ◽

Antidiuretic Hormone ◽

Small Cell Carcinoma ◽

Poor Prognosis ◽

Hormone Secretion ◽

Clinical Manifestations ◽

Small Cell ◽

Laboratory Examination ◽

Inappropriate Antidiuretic Hormone Secretion ◽

Antidiuretic Hormone Secretion

Small cell carcinoma of the cervix is a rare malignant tumor in the clinical setting. Clinical manifestations of this tumor are mostly similar to those of normal types of cervical cancer. Small cell carcinoma of the cervix only shows symptoms of neuroendocrine tumors, such as syndrome of inappropriate antidiuretic hormone secretion (SIADH). Most of the hyponatremia caused by SIADH can be managed after removal of the cause. Hyponatremia is a predictor of poor prognosis and can be used as an indicator of partial recurrence. We report a case of small cell carcinoma of the cervix complicated by SIADH. Our patient presented with irregular vaginal bleeding after menopause. After one cycle of chemotherapy, there was trembling of the limbs, and a laboratory examination showed low Na+ and low Cl− levels. After limited water intake, intravenous hypertonic saline, and intermittent diuretic treatment, the patient’s blood Na+ levels returned to normal. After a radical operation, the above-mentioned symptoms disappeared.

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Evaluation of patients suffered from burning mouth syndrome and persistent idiopathic facial pain using Japanese version PainDETECT questionnaire and depression scales

Journal of Dental Sciences ◽

10.1016/j.jds.2020.06.008 ◽

2021 ◽

Vol 16 (1) ◽

pp. 131-136

Author(s):

Aiji Sato (Boku) ◽

Hiroyuki Kimura ◽

Tatsuya Tokura ◽

Eri Umemura ◽

Tomoya Miyauchi ◽

...

Keyword(s):

Facial Pain ◽

Japanese Version ◽

Burning Mouth Syndrome ◽

Persistent Idiopathic Facial Pain ◽

Paindetect Questionnaire ◽

Burning Mouth ◽

Depression Scales

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Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

10.21203/rs.3.rs-107199/v1 ◽

2020 ◽

Author(s):

Wenzhi ZHANG ◽

Hui LI ◽

Jingzhen LIU ◽

Jiawei XU ◽

Jinjin HAO ◽

...

Keyword(s):

Trisomy 21 ◽

Poor Prognosis ◽

Clinical Characteristics ◽

Pediatric Patients ◽

Laboratory Data ◽

Clinical Manifestations ◽

The Other ◽

Hematopoietic Stem ◽

Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

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Characteristics and Prognosis of Autoimmune Encephalitis in the East of China: A Multi-Center Study

Frontiers in Neurology ◽

10.3389/fneur.2021.642078 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shan Qiao ◽

Huai-kuan Wu ◽

Ling-ling Liu ◽

Ran-ran Zhang ◽

Mei-ling Wang ◽

...

Keyword(s):

Poor Prognosis ◽

Disease Onset ◽

Clinical Manifestations ◽

Brain Magnetic Resonance Imaging ◽

Autoimmune Encephalitis ◽

Post Discharge ◽

Disturbance Of Consciousness ◽

Imaging Results ◽

Epidemiological Characteristics

Objective: This study aimed to investigate epidemiological characteristics, clinical manifestations, and long-term outcomes of patients with autoimmune encephalitis (AE) in the east of China.Methods: From January 2015 to December 2019, 226 potential AE patients were recruited from five clinical centers, and a total of 185 patients who met the diagnostic criteria were included in the study. We retrospectively reviewed clinical features, auxiliary examinations, details of treatments, and outcomes of AE, and identified risk factors of poor prognosis. Modified Rankin Scale scores were used to evaluate neurological function, and scores of 3–6 indicated a poor-prognosis.Results: Patients with five main subtypes of AE were enrolled in the study, as follows: anti-NMDAR (79), anti-LGI1 (55), anti-CASPR2 (30), anti-GABABR (16), and anti-AMPAR (5). Among 185 patients, 58.38% (108/185) were male and 41.62% (77/185) were female. The median age at disease onset was 41 years (interquartile range, 17–62). The most common clinical manifestations of AE were seizures (146, 78.92%) and memory deficit (123, 66.49%). A total of 95 (51.35%) patients had abnormal brain magnetic resonance imaging results. Electroencephalographic findings were abnormal in 131 (70.81%) patients, and 168 (90.81%) and 26 (14.05%) patients were treated with first- and second-line immunotherapies, respectively. All surviving patients were followed-up for at least 1 year (range 12–36 months). Good clinical outcomes were achieved in 117 (63.24%), while 68 (36.76%) patients had a poor prognosis. Further, 33 (17.84%) patients relapsed and 10 (5.41%) died within 1 year post-discharge. Older patients tended to have a poorer prognosis, and the occurrence of mental behavioral disorders, movement disorders, disturbance of consciousness, central hypoventilation, and tumors were overrepresented in the poor-prognosis group.Conclusions: AE is a treatable disease, and most patients have a good prognosis. There are differences in the clinical manifestations of patients with different AE subtypes. Some with AE will relapse, and long-term follow-up is of great significance for further research.

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Comparison of Clinical Symptoms and Magnetic Resonance Angiographic (MRA) Results in Patients with Trigeminal Neuralgia and Persistent Idiopathic Facial Pain. Medium-Term Outcome after Microvascular Decompression of Cases with Positive MRA Findings

Cephalalgia ◽

10.1111/j.1468-2982.2005.01030.x ◽

2006 ◽

Vol 26 (3) ◽

pp. 266-276 ◽

Cited By ~ 41

Author(s):

A Kuncz ◽

E Vörös ◽

P Barzó ◽

J Tajti ◽

P Milassin ◽

...

Keyword(s):

Magnetic Resonance ◽

Trigeminal Neuralgia ◽

Microvascular Decompression ◽

Facial Pain ◽

Clinical Symptoms ◽

Vascular Compression ◽

Term Outcome ◽

Persistent Idiopathic Facial Pain ◽

Venous Compression ◽

Imaging Results

To evaluate whether NC could be demonstrated preoperatively, high-resolution magnetic resonance angiography (MRA) was performed in 287 consecutive patients with TN and persistent idiopathic facial pain (PIFP) on a 0.5-T and a 1-T MR unit. Depending on the clinical symptoms, the TN cases were divided into typical TN and trigeminal neuralgia with non-neuralgic interparoxysmal pain (TNWIP) groups. Microvascular decompression (MVD) was performed in 103 of the MRA-positive cases. The patients were followed up postoperatively for from 1 to 10 years. The clinical symptoms were compared with the imaging results. The value of MRA was assessed on the basis of the clinical symptoms and surgical findings. The outcome of MVD was graded as excellent, good or poor. The clinical symptoms were compared with the type of vascular compression and the outcome of MVD. The MRA image was positive in 161 (56%) of the 287 cases. There were significant differences between the clinical groups: 66.5% of the typical TN group, 47.5% of the TNWIP group and 3.4% of the PIFP group were positive. The quality of the MR unit significantly determined the ratio of positive/negative MRA results. The surgical findings corresponded with the MRA images. Six patients from the MRA-negative group were operated on for selective rhizotomy and no NC was found. Venous compression of the trigeminal nerve was observed in a significantly higher proportion in the background of TNWIP than in that of typical TN on MRA imaging (24.1% and 0.8%, respectively) and also during MVD (31.2% and 1.2%, respectively). Four years following the MVD, 69% of the patients gave an excellent, 23% a good and 8% a poor result. The rate of some kind of recurrence of pain was 20% in the typical TN and 44% in TNWIP group. The rate of recurrence was 57% when pure venous compression was present. The only patient who was operated on from the PIFP group did not react to the MVD. The clinical symptoms and preoperative MRA performed by at least a 1-T MR unit furnish considerable information, which can play a role in the planning of the treatment of TN.

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Cranial neuralgias and persistent idiopathic facial pain

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0027 ◽

2020 ◽

pp. 237-247

Author(s):

Aydin Gozalov ◽

Messoud Ashina ◽

Joanna M. Zakrzewska

Keyword(s):

Neuropathic Pain ◽

Trigeminal Neuralgia ◽

Facial Pain ◽

Orofacial Pain ◽

Treatment Modalities ◽

Management Approach ◽

Trigeminal Neuropathy ◽

Facial Region ◽

Persistent Idiopathic Facial Pain ◽

Chronic Orofacial Pain

Orofacial pain is a complex problem and affects up to 7% of the population. Although trigeminal neuralgia has been considered the prime neuralgic condition in the facial region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. Many patients with chronic orofacial pain report numerous comorbidities, such as psychiatric or personality disorders, which significantly affect management. Various pain conditions present in the facial region. Some of them rarely present extra-orally (unless as radiating pain) such as atypical odontalgia or persistent dento-alveolar pain disorder and burning mouth syndrome, whereas others will present in both areas such as classical trigeminal neuralgia, post-traumatic trigeminal neuropathy, trigeminal neuropathy attributed to multiple sclerosis, and persistent idiopathic facial pain. Myofascial pain syndrome related to the muscles of mastication is very common and may also be associated with temporomandibular joint problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are similar in quality and characteristics with specific treatment modalities, but differ in pain location. Trigeminal neuropathic pain is caused most frequently by trauma. If no other diagnostic criteria are fulfilled, a diagnosis of persistent idiopathic facial pain is made. It is crucial for these patients to be managed by multidisciplinary teams.

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