We have recently managed a case of syringomyelia associated with Chiari I Type malformation. The syrinx was found at C2 level to T10 level. And the patient complained left forearm pain and paresthesia in left shoulder, arm with segmental dissociated sensory loss. The cranio-vertebral decompression(suboccipital craniectomy, cervical laminectomy) and the shunting procedures were performed. Postoperative course was not uneven, the clinical and neurological improvement was observed. M.R.I. permitted rapid, exact diagnosis including localization of syrinx and information of associated anomaly.
Arm ; Diagnosis ; Forearm ; Humans ; Paresthesia ; Shoulder ; Syringomyelia*

OBJECTIVE: Surgical treatment of focal plantar hyperhidrosis is often unsatisfactory compared to palmar hyperhidrosis. The purpose of this study is to evaluate the effect of lumbar sympathetic radiofrequency neurotomy on plantar hyperhidrosis. METHODS: From February 2004 to December 2005, 10 patients (mean age 24.3 male 1, female 9) with the clinical diagnosis of plantar hyperhidrosis were treated by bilateral lumbar sympathetic radiofrequency neurotomy of L3 and L4. Patients' symptom relief, satisfactory rate and side effects related to the procedure were analyzed. RESULTS: Radiofrequency neurotomy was effective in the treatment of focal plantar hyperhidrosis showing excellent (more than 75% improved) outcome in 70% of the patients and good (more than 50% improved) in 30%. Complications related to the surgical procedure, such as sensory dysesthesia and compensatory hyperhidrosis were not detected in any case. CONCLUSION: The use of radiofrequency neurotomy to ablate the lumbar sympathetic ganglion is a safe and effective treatment option for patients with plantar hyperhidrosis.
Diagnosis ; Female ; Ganglia, Sympathetic ; Humans ; Hyperhidrosis* ; Male ; Paresthesia

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the "state of the art" today.
Burning Mouth Syndrome ; diagnosis ; drug therapy ; etiology ; Candidiasis, Oral ; diagnosis ; Diagnosis, Differential ; Glossalgia ; diagnosis ; Humans ; Paresthesia ; diagnosis ; Xerostomia ; diagnosis

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of epidermoid cyst in the spinal canal. SUMMARY OF LITERATURE REVIEW: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer. MATERIAL AND METHODS: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6-T8 level. The cystic mass was excised after durotomy using a posterior approach. RESULTS: We confirmed the presence of an epidermoid cyst for histopathology. CONCLUSION: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
Diagnosis ; Diagnosis, Differential ; Epidermal Cyst* ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Paresthesia ; Spinal Canal ; Spine

Several clinical variants of Guillain-Barre syndrome(GBS) merit separate description because they simulate other diseases and because they may illuminate the pathophysioloy of the typical illness. Some limited regional forrns of the GBS and unusual focal signs or symptoms that resemble other illnesses are described. A number of patients will have prominent pharyngeal, facial, and neck-flexion weakness at the onset of GBS, which descends to involve the arms, and soon after. The legs. The unusual of distribution of weakness, presenation of leg reflexes, and unusual absence of paresthesias directs diagnostic attention toward myasthenia, botulism, or diphtheria. In a few such patients the illness halts when it has caused severe oropharyngeal. Neck. Shoulder, and proximal arm wealiness. Completely sparing power and reflexes in the legs. We report two cases of unusual clinical variant of GBS, so called pharyngeal-cervical-brachial variants who had bilateral ptosis. Marked oropharyngeal, neck, and shoulder weakness, and with areflexia in the arrns only. And normal sensation. Botulism or diphtheria and, less so, myasthenia, were initially considered diagnoses. The illness progressed to generalized typical GBS with respiratory failure in one patient. In the other patient. The illness halted without affecting power or reflexes in the legs, and electrophysiologic abnormalities were isolated to the face and the arms.
Arm ; Botulism ; Diagnosis ; Diphtheria ; Guillain-Barre Syndrome* ; Humans ; Leg ; Neck ; Paresthesia ; Reflex ; Respiratory Insufficiency ; Sensation ; Shoulder

Guillain-Barre syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy. In typical cases, the first symptoms of GBS are pain, numbness, paresthesia, weakness in the limbs. Autonomic involvement is common and causes urinary retention and ileus. Much of these symptoms overlap with those of lumbar spinal stenosis. Therefore, correct diagnosis of GBS in a patient with symptomatic lumbar spinal stenosis or in a patient with atypical manifestations of GBS can be difficult, especially early in the course of GBS. Here, we report on a case of atypical GBS in a 74-year-old previously healthy patient with lumbar spinal stenosis and discuss the differential diagnosis of the GBS and lumbar spinal stenosis.
Diagnosis, Differential ; Extremities ; Guillain-Barre Syndrome ; Humans ; Hypesthesia ; Ileus ; Paresthesia ; Polyradiculopathy ; Spinal Stenosis ; Urinary Retention

BACKGROUND: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thighis produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. MATERIALS AND METHODS: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old(mean+/-SD:42.06+/-15.74) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. RESULTS: The mean values(msec+/-SD) of LPo, SPdegree, LN, and SN1 of all subjects were 35.10(+/-2.42), 33.80(+/-2.4), 43.68(+/-1.88) and 42.16(+/-2.12) and the mean values(msec+/- SD) of DPo, DNl and DA(tw+/-SD) were 1.3O(fi1.14), 1.52(+/-1.38) and 0.32(+/-0.33). CONCLUSION: For the diagnosis of MP, comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results, the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.
Adult* ; Diagnosis ; Evoked Potentials, Somatosensory ; Humans ; Individuality ; Male ; Paresthesia ; Reference Values ; Somatotypes ; Thigh

BACKGROUND: Meralgia paresthetica(MP) is clinically benign entrapment neuropathy which is characterized by paresthesias and sensory impairment in the cutaneous distribution of the lateral femoral cutaneous nerve(LFCN). The diagnosis of MP is mostly based on clinical symptoms. Sensory nerve conduction study of the LFCN have been of limited value because frequently they could not be recorded in able-bodied persons and also because lesions of the nerve may be localized proximally from the segment that is accessible to nerve conduction study. For these reasons, I studied simple bilateral somatosensory evoked potentials(SSEP) of LFCN to evaluate this clinical symptoms objectively. METHODS: 16 MP patients (mean age+/-SE : 50+/-3.21yrs) and 15 disease free adults(49+/-4.47yrs) were studied bilateral SSEP of LFCN. The stimulation site was anterolateral aspect of thigh and the recording site was Cz'. RESULTS: The mean latencies of P0 and N1 were prolonged on the affected side(P<0.05), The mean latency differences of P0 and N1 between two sides were increased in the patients with MP compare with those of controls.(P<0.001) The mean amplitude difference between two sides were increased in the patients with MP compare with that of controls(P<0.05). CONCLUSION: SSEP of LFCN can be used as a objective test to support the diagnosis of MP. I suggest more than 2.4msec difference for P0 latency between affected and unaffected side could be abnormal.
Diagnosis ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Humans ; Neural Conduction ; Paresthesia ; Thigh

A 33-year-old woman presented with tingling and paresthesia on left extremity for 2 months. Magnetic resonance imaging revealed that the tumor was iso- and hypo-intensity on T1-weighted image, mixed iso- and high-signal intensity on T2-weighted images and heterogeneously enhanced with rim enhancement. Neither arachnoid cleft nor dural tail was certain but mass was located extra-axially so meningioma was suspected. During operation, tumor wasn't attached to dura at all but arachnoid attachment was seen. Pathologically, clear cell type ependymoma was confirmed. Details of diagnosis and treatment of this tumor is described.
Adult ; Arachnoid ; Diagnosis ; Ependymoma* ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Paresthesia ; Tail

Lipoma is the most common, benign, soft tissue, mesenchymal tumour and is composed of mature adipose tissue. It is infrequent in the oral cavity (approximately 0.3% of all tongue neoplasias). We describe the case of a 68-year-old man with a swelling at the tongue edge and tongue dysesthesia. Medical history, clinical assessment, radiographic images, and cytological analysis enabled specialists to classify this neoplasia as a lipoma. The patient recovered fully after surgical excision of the affected area, and the neuralgic symptoms regressed. Surgical excision is an elective treatment; however, accurate differential diagnosis, histological examination, and follow-up are required.
Adipose Tissue ; Aged ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Hypesthesia ; Lipoma* ; Macroglossia ; Mouth ; Paresthesia ; Specialization ; Tongue*