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

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

Neurologists are occasionally confronted with patients who have unique symptoms of bilateral but regional weaknesses that do not conform to the typical case with Guillain-Barre syndrome (GBS). Acute facial diplegia is a very uncommon neurologic manifestation that can be the presenting symptom in a wide range of diseases. We describe a 32-year-old male patient with acute facial diplegia and distal limb paresthesias without diminished reflexes. His neurophysiologic studies, CSF albuminocytologic dissociation and the clinical course are in keeping with a regional variant of GBS. The absence of hyporeflexia does not necessarily exclude the diagnosis of a GBS variant.
Adult ; Diagnosis ; Extremities ; Guillain-Barre Syndrome* ; Humans ; Male ; Neurologic Manifestations ; Paresthesia ; Reflex ; Reflex, Abnormal

Odontogenic myxoma is one of rare tumors in oral and maxillofacial region and it is thought to be mesenchymal or ectomesenchymal origin. Its characteristics are benign and non-metastatic but it has the potential of local invasion and high recurrence rate. It originally occurs in atrium of heart and in central case, my xoma is located mainly in the maxilla and mandible. Most odontogenic myxoma develops in 2nd or 3rd decades of life and rarely occurs in child or older persons over fifty. The distribution of reported cases between the sexes is similar and the maxilla and mandible are equally affected or slightly higher in mandible. Clinically it is usually asymptomatic, however it can cause pain and paresthesia is complained in the advanced stages. Displacement and mobility of teeth have also been reported Odontogenic myxoma is not a frequent tumor, but in case of slow and painless growing tumor it must be considered as a differential diagnosis.
Child ; Diagnosis, Differential ; Heart ; Humans ; Jaw ; Mandible ; Maxilla ; Myxoma* ; Paresthesia ; Recurrence ; Tooth

BACKGROUND: The purpose of this study was to report the ultrasonographic findings and clinical features of schwannoma of the hand. METHODS: We enrolled 8 patients who were initially diagnosed with ganglion by ultrasonography but finally with schwannoma by a tissue biopsy. We retrospectively analyzed the ultrasonographic findings of eight patients including echogenicity, internal homogeneity, posterior enhancement, internal vascularity, and clinical manifestations such as the occurrence site, tenderness, Tinel's sign, and paresthesia before the surgery. RESULTS: The occurrence sites were as follows: two cases on the thenar area, one case on the second web space, three cases on the third web space, one case on the radiovolar aspect of the proximal phalanx of the index finger, and one case on the radiovolar aspect of the proximal phalanx of the middle finger. Four patients suffered from tenderness and pain on presentation, and all patients had pain around the mass before presentation. Tinel's sign was present without paresthesia in one case. Ultrasonography revealed cystic lesions showing clear margins in all cases, and two of them had acoustic enhancement without internal flow. CONCLUSIONS: It may not be easy to diagnosis schwannoma of the hand with ultrasonography alone when the lesion is small because of the similarity to the ultrasonographic findings of ganglion. Therefore, it is necessary to consider the possibility of schwannoma if a mass near the digital nerve or cutaneous nerve branch is accompanied by dull pain and tenderness.
Acoustics ; Biopsy ; Diagnosis ; Fingers ; Ganglion Cysts ; Hand* ; Humans ; Neurilemmoma* ; Paresthesia ; Retrospective Studies ; Ultrasonography

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