We report two cases of numbness and pain of neuropathy due to ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis successfully treated with Ogikeishigomotsuto. The first case was a 57-year-old female who complained of high fever, painful skin eruptions of the lower limbs, and proteinuria. Although the severe pain was reduced with steroid therapy, neuropathy-related numbness and pain remained widespread in her lower limbs. After we prescribed Ogikeishigomotsuto, most of her pain disappeared while her degree of numbness diminished by almost half in two weeks. In addition, her steroid therapy could be tapered off without adverse effect. The second case was an 82-year-old female with fever and myalgia. Although myalgia of the upper arm disappeared with steroid treatment, walking became difficult due to numbness from the lower legs, to the soles of her feet. With Ogikeishigomotsuto administration, she became better able to walk because her legs had warmed up, and the range of her numbness had decreased. These cases suggest that Ogikeishigomotsuto may be effective against numbness and neuropathic pain due to ANCA-associated vasculitis.
Numbness ; Pain ; Peripheral neuropathy ; Antineutrophil cytoplasmic antibody measurement ; Vasculitis

The level of vitamin B1 in 20 patients with the mild and typical the "numb-unsteady" syndrome and 20 healthy persons with ages of 20-50 was quantified during 10-12/1999. The participants did use the vitamin B1 within the previous 3 weeks. The level of vitamin B1 was quantified by the high performance liquid chromatography (HPLC). The results have shown that the level of blood vitamin B1 in 100% of participants was lower than normal level. Although patients used continuously the vitamin B1 at high dose, the blood vitamin B1 has still lower than normal range and control. The level of vitamin B1, B2 and PP in the diet of both patients and control groups did not meet the wanted level
Thiamine ; Hypesthesia

Morton's neuroma has been treated with resection of the enlarged interdigital nerve by most of surgeons, but the numbness after resection could bother the patients. We reported the experiences of the good results after treatment of Morton's neuroma with the decompression of the interdigital nerve. Three patients, 4 feet were diagnosed to Morton's neuroma and taken the surgery, decompression of the interdigital nerve after the conservative treatments. The decompression can be considered first as another choice of treatment for interdigital neuroma before resection of the nerve.
Decompression ; Foot ; Humans ; Hypesthesia ; Neuroma

Excluding cases of maxillary sinus mucoceles developing 1-2 decades after Caldwell-Luc's operation, the primary mucoceles of the maxillary sinus are very rare and believed to result from chronic obstruction of sinus ostium. Organized hematoma represents a rare benign lesion with locally destructive behavior. After the first case reported in 1996, there have been only a few reports for organized hematoma of the maxillary sinus. To our knowledge, this is the first article describing a maxillary sinus mucocele resulting from obstruction of natural ostium by organized hematoma presenting with unilateral cheek hypesthesia and retro-orbital pain. We present this first case with a review of literature.
Cheek ; Hematoma* ; Hypesthesia ; Maxillary Sinus* ; Mucocele*

Twenty eight year-old male with 3 year history of radiating pain to both thighs and thirty six year-old female with one year history of perineal hypesthesia and constipation were presented. The clinical features, radiologic features, surgical techniques and complications are described. In both cases, postoperative cerebrospinal fluid leakage was developed and managed successfully with lumbar drainage and rest respectively. The preoperatively presented symptoms were completely disappeared after surgery.
Cerebrospinal Fluid ; Constipation ; Drainage ; Female ; Humans ; Hypesthesia ; Male ; Thigh

The sublabial approach for transseptal transsphenoidal surgery of pituitary tumors has been the most popular procedure since Cushing first introduced this technique in early 1900's. In recent years, various modifications for transseptal route and their obvious advantages over the sublabial approach have been reported. Currently, in our institute, the preferred method is the external rhinoplasty approach, suggested by Braint and descried by McCurdy. After experiencing 54 cases since 1995 DEC, we found this technique simple, providing good exposure and short distance for instrumentation, preserving nasal tip projection, avoding postoperative numbness of upper teeth and especially beneficial to revision surgery when septal cartilage has been removed by a previous sublabial approach and to surgery for acromegaly patients.
Acromegaly ; Cartilage ; Humans ; Hypesthesia ; Pituitary Neoplasms* ; Rhinoplasty* ; Tooth

Diaschisis is classically defined as a sudden inhibition of function, produced by an acute focal disturbance in a remote area which is anatomically connected through fiber tracts. Transhemispheric diaschisis can underlie some diffuse symptoms of acute supratentorial stroke such as agitation, confusion, and coma. We experienced a patient with right middle cerebral artery infarction, presenting a quadriparesis and hypoesthesia at sensory level. This case suggests the diaschisis exacerbate the initial focal deficit such as weakness and sensory loss.
Coma ; Dihydroergotamine ; Humans ; Hypesthesia ; Infarction, Middle Cerebral Artery* ; Quadriplegia* ; Stroke

BACKGROUND: Musculoskeletal symptoms, such as pain, numbness, and ganglions on involved joints were common problems in repetitive job workers, who exposed to prolonged, repetitive use of the wrist in factory. This study was performed to compare the degree of musculoskeletal symptoms and prevalence of soft tissue mass (esp. ganglion on wrist) in repetitive job group with those of non-repetitive job group and to evaluate the association of development of ganglion and the duration of wrist use. METHODS: Study subjects were 253 workers who work on a brick manufacturing factory and they were composed of 153 non-repetitive job workers and 100 repetitive job workers. Authors conducted a questionnaire survey among workers in the factory and examined their lesions. RESULTS: There were no significant difference statistically in age, level of education and work duration in both groups. It was statistically significant that the degree of wrist use was more frequent in repetitive job group than in non-repetitive job group(P<0.01). Musculoskeletal symptoms, such as pain and numbness on affected joints were more common in repetitive job group than in non-repetitive job group. Affected side was bilateral in three joints and right only in two joints(P<0.01, P<0.05). The prevalence of ganglions in repetitive job group(6 subjects, 6.0%) was much higher statistically than that in the non-repetitive job group(2 subjects, 1.3%). In a comparison of two groups according to the existence of ganglions, no stasistically significant differences were found in age, level of education and work duration. However, duration of wrist use was statistically significant relation with development of wrist ganglions(P<0.05). The 8 subjects with ganglion on wrist all worked on manufacturing part in the factory. The duration of work ranged from two to fourteen years. The affected sides of ganglions on wrist were right in 3 cases and left in 5 cases. Size of ganglions ranged from 0.5 to 3 cm in diameter. Painful symptom in the ganglion was complained by two cases(25%) among 8 cases. CONCLUSIONS: We suggest that prolonged, repetitive activities such as carrying a brick, have a tendency to develop musculoskeletal symptoms and ganglions in the workers. Because high prevalence of ganglions in this factory seems to be an important occupational problem among repetitive job workers, further studies on the factors contributing to development of ganglions in this factory are needed.
Education ; Ganglion Cysts* ; Hypesthesia ; Joints ; Prevalence ; Wrist ; Surveys and Questionnaires

Symptomatic Tarlov (perineural cysts) are uncommon. In the following hemodialysis case, cauda equina syndrome was not detected after combined spinal-epidural anesthesia untilthe patient reported a lack of sensation in the perianal area 14 days postoperatively. She had normal motor function of her extremities. A laminectomy and cyst irrigation was performed. After the operation, her sphincter disturbance subsided gradually and her symptoms had disappeared.
Anesthesia ; Delayed Diagnosis ; Humans ; Hypesthesia ; Laminectomy ; Renal Dialysis ; Tarlov Cysts

After rhinoplasty, numbness of the nasal tip has been reported by many surgeons. The nasal tip receives its main sensory nerve supply from the external nasal nerve. However, investigations of the external nasal nerve have not been previously studied. Therefore, anatomic study of the external nasal nerve was performed. Twenty external nasal nerves were dissected in 10 fresh cadaver noses. On dissection, the exit of the nerve between nasal bone and upper lateral cartilage was identified, and the distance from the point of exit to the midline of the nose was measured. The course and the running plane of the nerve were investigated. The nerve branching was also classified into type I; having only 1 nerve without any branch, type II; having 1 nerve proximally, then splitting into 2 main branches, and type III; having 2 main branches from the point of exit. The point of exit of external nasal nerve from distal nasal bone was located 6.5 to 8.5 mm lateral to nasal midline. Nineteen nerves(95%) run in the same deep fatty layer all the way down to the alar cartilages, but one nerve coursed medially between both medial crura. Regarding the branching type of the nerves, type I was found to be the most common, in 10 of 20 nerves. Type II was observed in 6 and type III was seen in 4. Based on our results, the followings are suggested during a rhinoplasty. First, it is best to avoid deep inter- or intracartiaginous incisions. Instead, the dissection should be maintained directly on the surface of the cartilage. Second, dissection at the junction of nasal bone and upper lateral cartilage area of one side should be limited within 6.5mm from midline. Lastly, when the nasal dorsum is augmented by onlay graft, implants or grafts less than 13 mm wide at rhinion level should be used.
Cadaver ; Cartilage ; Hypesthesia ; Inlays ; Nasal Bone ; Nose ; Rhinoplasty ; Running ; Transplants