Post-COVID-19 unilateral upper lip numbness: A case report

@#This is a case of a 63-year-old female with post-COVID-19 unilateral upper lip pain and numbness. Neurologic examination did not reveal any deficits other than deficits on pinprick in the maxillary division (V2) of the left trigeminal nerve. Brain neuroimaging showed signs of acute inflammation of the left maxillary sinus. Neuropraxia of the infraorbital nerve, a branch of the trigeminal nerve, was the diagnosis considered. Reports on trigeminal neurosensory changes following acute sinusitis are few, and isolated trigeminal neuropathy is rare except in cases of dental disorders. Up to this writing, there have been no reports on post-COVID-19 unilateral upper lip numbness and pain. This study will also serve as a concise review on the correlative neuroanatomy of the trigeminal nerve.

Application of improved 3D digital guide plate-assisted guided puncture in microballoon compression for primary trigeminal neuralgia / 口腔疾病防治

Objective @#To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). @*Methods @# This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P<0.05 indicating a statistically significant difference. @*Results @#The experimental group was significantly better than the control group in terms of the success rate of the first puncture (χ2 = 21.51, P<0.001), puncture time (Z = -5.51, P<0.001), operative time (t = 9.37, P<0.001), and the number of C-arm scans (Z = -4.59, P<0.001). Postoperative BNI scores of the experimental group included 21 cases of grade Ⅰ (91.5%) and 1 case of grade Ⅱ, while the control group included 17 cases of grade Ⅰ (85.0%), 2 cases of grade Ⅱ (10.0%) and 1 case of grade Ⅲ (5.0%), with no statistical significance (P>0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. @* Conclusions @#3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.

Forty-Five Cases of Chronic Testicular Pain and Groin Pain Treated with Kampo Medicine / 日本東洋医学雑誌

We examined Kampo treatment given to 45 patients with chronic testicular pain and groin pain. Thirty-three of 45 cases were healed with anti-percussive agents including keishibukuryogan, tokishakuyakusan. In addition to testicular pain, when the pain and numbness in the femoral lesion appeared, hachimijiogan and goshajinkigan were effective. If coldness in the lower body is an aggravating factor, tokishakuyakusan is considered appropriate as the first choice. We should notice the sign of qi-blood-fluid, especially, static blood, to select medicine for chronic testicular pain and groin pain.

Finding a Mass Within the Oral Cavity: What Are the Common Causes and How Should A GP Manage them?

@#A 24-year-old male presented with worsening right buccal pain and numbness of the anterior right tip of the tongue. A fixed, hard, non-tender mass was found on the right floor of the mouth. Subsequently, maxillofacial surgery evaluation, MRI scan of the head and neck, and biopsy confirmed a low-grade hyalinising clear cellcarcinoma, likely of salivary gland origin. This clinical encounter led to a review for the variety of masses that can occur in each site in the oral cavity and the commonmasses that may present to a GP. A suggested management approach is presented. In addition,common salivary gland pathologies are highlighted, andsalivary gland tumours as was present in this patient are further discussed.

Task-state fMRI observation on impact of electrical stimulation numbness to central nervous system in normal people / 中国医学影像技术

Objective: To investigate the impact of electrical stimulation numbness to central nervous system in normal people. Methods: Electric stimulator was used to establish low-frequency, high-frequency numbness models with 22 healthy subjects. Scores for numbness and emotional valence for different electrical stimulations were recorded, and data of functional MRI (fMRI) in task state were also collected. The differences of numbness and emotional valence score of subjects under low frequency and high frequency electrical stimulation were compared, respectively. Then brain regions with significant differences in brain activation intensity under different frequencies of electrical stimulation were obtained, and the differences of activation effect values of activated brain regions under different electrical stimulations intensity were compared, respectively. The relationship of numbness and emotional valence scores under high frequency electrical stimulation were analyzed. Results: There were statistical differences of numbness (t=13.18) and valence score (t=10.77) under different electrical stimulations (both P<0.05). There was negative correlation between numbness and valence scores under high-frequency electrical stimulation (r=-0.53, P=0.01). The brain areas with significant differences of activation intensity under different electrical stimulation included left parietal operculum, left middle cingulate gyrus, left temporal gyrus, right parietal operculum, left postcentral gyrus, right central operculum, right posterior insula and left thalamus (all P<0.05). Conclusion: The activated brain regions under different electrical stimulations caused numbness include left parietal operculum, left middle cingulate gyrus, left temporal gyrus, right parietal operculum, left postcentral gyrus, right central operculum, right posterior insula and left thalamus in normal people. Block-designed BOLD-fMRI can be used to detect activity of brain areas associated with numbness.

Effect of "Buqi Yixue" needling on neurological function and nerve conduction velocity in patients with diabetic peripheral neuropathy / 针刺研究

OBJECTIVE: To observe the efficacy of "Buqi Yixue "needling on clinical symptoms, neurological function and nerve conduction velocity in patients with diabetic peripheral neuropathy. METHODS: Eighty-six patients with diabetic peripheral neuropathy numbness and pain were equally randomized into control group and treatment group. The patients of the control group received basic treatment and oral administration of Cilostazol (50 mg/time, 2 times/d) and Epalrestat (50 mg/time, 3 times/d). The patients of the treatment group received acupuncture stimulation of Danzhong (CV17), Qihai (CV6), Pishu (BL20), Quchi (LI11), etc., for 30 min, once every day, on the basic treatment. The treatment was conducted for 8 successive weeks. The scores of Traditional Chinese Medicine (TCM) symptoms, Toronto clinical scoring system (TCSS) and nerve conduction velocity (NCV) were detected before and after the treatment. RESULTS: After the treatment, the scores of TCM symptoms and TCSS were considerably decreased (P<0.05), and the NCV was significantly increased (P<0.05) in both groups compared with those of their own pre-treatment. The the-rapeutic effect of the treatment group was significantly superior to that of the control group in lowering the scores of TCM symptoms and TCSS, and in up-regulating the NCV (P<0.01). CONCLUSION: "Buqi Yixue" needling is effective in improving clinical symptoms and increasing NCV in patients with diabetic peripheral neuropathy.

Effect of Bloodletting Therapy on Pain and Numbness, and Blood Viscosity in Cervical Spondylotic Radiculopathy / 上海针灸杂志

Objective To investigate the therapeutic effect of point Shixuan(Ex-UE11) bloodletting on blood viscosity, and pain and numbness in patients with cervical spondylotic radiculopathy. Method One hundred patients with cervical spondylotic radiculopathy were randomized to treatment and control groups. Both groups received conventional acupuncture at Huatuo jiaji(Ex-B2) points. The treatment group received bloodletting therapy in addition. Pain and numbness severity and blood viscosity were recorded before and after treatment. The data were analyzed statistically. Result The pain and numbness, and blood viscosity were improved in both groups of patients with cervical spondylotic radiculopathy, but there were statistically significant differences between the two groups (P<0.01). Conclusion Bloodletting therapy can improve not only the pain and numbness but also blood viscosity in cervical spondylotic radiculopathy. There is a certain correlation between the two.

Effects of modified finger exercise on limb pain and numbness after transradial per-cutaneous coronary intervention / 中华护理杂志

Objective To explore the effects of modified finger exercise on limb pain and numbness in patients after transradial percutaneous coronary intervention (PCI). Methods From March to June 2017,patients underwent PCI in a tertiary hospital in Beijing were enrolled,and divided into the experimental group(37 cases) and the con-trol group (38 cases). The experimental group was treated with modified finger exercise together with routine care, while the control group was provided with routine care. Palm circumference,numbness and pain of the limb were observed and analyzed. Results The pain of the experimental group was lower than the control group(Z=-3.935,-2.986,-2.854,P<0.05) at 0.5 h,2 h and 4h after PCI. The numbness of the experimental group was lower than the control group (Z=-2.756,-4.876,-3.310,P<0.05) at 2h and 4h after PCI and 1h after removal of the hemostasis equipment. However,there was no significant difference in swelling between two groups (F=1.627,P>0.05). Conclusion The modified finger exercise can ease limb discomfort and reduce pain and numbness of the affected limb after PCI.

A Retrospective Study Assessing Kampo Medicine for the Treatment of Lower Extremity Symptoms Caused by Lumbar Spinal Diseases / 日本東洋医学雑誌

We assessed the efficacy of Kampo medicine for lower extremity symptoms caused by lumbar spinal diseases, such as lumbar spondylosis, spinal canal stenosis, and post-spinal surgery syndrome. In particular, we evaluated its usefulness for lower extremity pain, coldness, and numbness. In addition, the efficacy of antecedent drug selection and pain treatment was also assessed. In accordance with Japanese traditional herbal medical practice, keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto were prescribed primarily for lower extremity symptoms caused by lumbar disease. Thirty-two of 60 (53%) cases with lower extremity pain, 17 of 34 (50%) cases of pain with coldness, and 4 of 19 cases (21%) of pain with numbness were improved by these drugs. We conclude that the addition of keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto after antecedent pain therapy was effective in treating lower extremity symptoms caused by lumbar disease.

Migraine And Its Related Symptoms In Female Dominating Drug.

Background: Migraine is periodic attack of headache, usually on one side of head. Severe throbbing pain is sometimes accompanied by nausea and vomiting. Some migraine patients have warning symptoms before headache, including visual disturbances, weakness, numbness or dizziness.

Can bedside patient-reported numbness predict postoperative ambulation ability for total knee arthroplasty patients with nerve block catheters? / 대한마취과학회지

BACKGROUND: Adductor canal catheters offer advantages over femoral nerve catheters for knee replacement patients because they produce less quadriceps muscle weakness; however, applying adductor canal catheters in bedside clinical practice remains challenging. There is currently no patient-reported outcome that accurately predicts patients' physical function after knee replacement. The present study evaluates the validity of a relatively new patient-reported outcome, i.e., a numbness score obtained using a numeric rating scale, and assesses its predictive value on postoperative ambulation. METHODS: We conducted a retrospective cohort study pooling data from two previously-published clinical trials using identical research methodologies. Both studies recruited patients undergoing knee replacement; one studied adductor canal catheters while the other studied femoral nerve catheters. Our primary outcome was patient-reported numbness scores on postoperative day 1. We also examined postoperative day 1 ambulation distance and its association with postoperative numbness using linear regression, adjusting for age, body mass index, and physical status. RESULTS: Data from 94 subjects were included (femoral subjects, n = 46; adductor canal subjects, n = 48). Adductor canal patients reported decreased numbness (median [10th-90th percentiles]) compared to femoral patients (0 [0-5] vs. 4 [0-10], P = 0.001). Adductor canal patients also ambulated seven times further on postoperative day 1 relative to femoral patients. There was a significant association between postoperative day 1 total ambulation distance and numbness (Beta = -2.6; 95% CI: -4.5, -0.8, P = 0.01) with R2 = 0.1. CONCLUSIONS: Adductor canal catheters facilitate improved early ambulation and produce less patient-reported numbness after knee replacement, but the correlation between these two variables is weak.

Numbness after Transradial Cardiac Catheterization: the Results from a Nerve Conduction Study of the Superficial Radial Nerve

BACKGROUND AND OBJECTIVES: Numbness on the hand occurs infrequently after a transradial cardiac catheterization (TRC). The symptom resembles that of neuropathy. We, therefore, investigated the prevalence, the predicting factors and the presence of neurological abnormalities of numbness, using a nerve conduction study (NCS). SUBJECTS AND METHODS: From April to December 2013, all patients who underwent a TRC were prospectively enrolled. From among these, the patients who experienced numbness on the ipsilateral hand were instructed to describe their symptoms using a visual analogue scale; subsequently, NCSs were performed on these patients. RESULTS: Of the total 479 patients in the study sample, numbness occurred in nine (1.8%) following the procedure. The NCS was performed for eight out of the nine patients, four (50%) of which had an abnormal NCS result at the superficial radial nerve. A larger sheath and history of myocardial infarction (p=0.14 and 0.08 respectively) tended towards the occurrence of numbness; however, only the use of size 7 French sheaths was an independent predictor for the occurrence of numbness (odds ratio: 5.50, 95% confidence interval: 1.06-28.58, p=0.042). The symptoms disappeared for all patients but one, within four months. CONCLUSION: A transient injury of the superficial radial nerve could be one reason for numbness after a TRC. A large sheath size was an independent predictor of numbness; therefore, large sized sheaths should be used with caution when performing a TRC.

Clinical Study onXing Nao Kai Qiao Needling plus Mountain-burning Fire Manipulation for Post-stroke Limb Numbness / 上海针灸杂志

Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain awakening and orifice opening) Needling plus mountain-burning fire manipulation in treating post-stroke limb numbness.Method Eighty patients with post-stroke limb numbness were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened byXing Nao Kai Qiao needling plus mountain-burning fire manipulation, while the control group was byXing Nao Kai Qiao needling alone. The sensory function and motor function (Fugl-Meyer Assessment, FMA), National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) were observed before and after intervention.Result The component scores of FMA (motor function, sensory function, range of motion, and joint pain intensity), NIHSS scores, and BI scores were significantly changed respectively after 1 and 2 treatment courses in both groups (P<0.05). The component scores of FMA, NIHSS scores, and BI scores after 2 treatment course were significantly different from that after 1 treatment course in both groups (P<0.05). After 2 treatment courses, the sensory function score, joint pain intensity in the treatment group were significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiaoneedling plus mountain-burning fire manipulation is an effective method in treating post-stroke limb numbness.

The anti-inflammatory and analgesic effects of Shuangwu numbness-relief decoction / 实用医学杂志

Objective To explore the anti-inflammatory and analgesic effects of Shuangwu numbness-relief decoction. Methods The anti-inflammatory effect was assessed by xylene-induced mouse auricular swelling and peritoneal capillary permeability;and the analgesic effect was assessed by hot plate method and acetic acid-induced twisting method. Results Shuangwu numbness-relief decoction at moderate or high dose had a significant inhibitory effect on mouse auricular swelling, with a significant difference as compared with the control group (P<0.01);the decoction at low , moderate , or high dose group played a marked inhibitory role in the increase in mouse peritoneal capillary permeability (P<0.01). Shuangwu numbness-relief decoction at moderate or high dose effectively reduced the writhing frequency in mice (P < 0.01). The decoction at high dose increased the pain threshold in mice one hour after intragastric administration (P < 0.05), and the decoction at moderate or high dose increased the pain threshold two hours after administration (P < 0.05). Conclusions Shuangwu numbness-relief decoction has an obvious anti-inflammatory and analgesic effect.

A toxicomania como paradigma do entorpecimento pulsional / Drug addiction as a paradigm of the numbness by drive / La toxicomanie comme paradigme de l’engourdissement pulsionnel

No trabalho clínico com pacientes toxicômanos, somos colocados constantemente diante de impasses que comprometem o progresso do tratamento, como, por exemplo, a indiferença frente aos riscos de morte, pouquíssima aderência ao tratamento e a prevalência do ato em detrimento às palavras. Para além de tais manifestações, escolhemos, como objeto deste artigo, a relação autoerótica do sujeito toxicômano com o corpo, tomando-a como paradigma da estrutura viciante própria da pulsão. Assim, o crescente número de casos de adições compulsivas, especificamente as toxicomanias, apresenta-se em nossa contemporaneidade marcado pela permissividade ao gozo desmedido como um paradigma do caráter entorpecente e extasiante próprio da pulsão.

In clinical work with addicted patients, many impasses arise that might compromise the progress of treatment, for example, the indifference to the risk of death, very little treatment compliance and preference for act instead of the words. Beyond these manifestations, we chose as the subject of this article, the autoerotic relation of the junkie subject with its body, taking it as a paradigm of the addictive structure which is characteristic of drive itself. Thus, the growing number of cases of compulsive addictions, specifically to drugs presents itself in our contemporary world marked by excessive permissiveness to enjoyment as a paradigm of the numbing and exhilarating character of drive.

Dans le travail clinique avec les patients toxicomanes, nous sommes placés en permanence devant les impasses qui compromettent les progrès du traitement, par exemple, l'indifférence au risque de la mort, très peu d’observance du traitement et la prévalence de l’acte en detriment des mots. Au delà de ces manifestations, nous avons choisi comme sujet de cet article, la relation de l'auto-érotique du junkie sujet avec le corps, en le prenant comme un paradigme de la structure addictive de la pulsion elle même. Ainsi, le nombre croissant de cas d'additions compulsives, toxicomanies spécifiquement, présent dans notre monde contemporain marqué par la permissivité excessive à la jouissance démesurée comme un paradigme Du charactère engourdissant et extasiant propre de la pulsion.

Preventing Lateral Skin Numbness after Medial Unicompartmental Knee Arthroplasty

BACKGROUND: The authors report the results of preserving the infrapatellar branch of the saphenous nerve during unicompartmental knee arthroplasty to prevent lateral skin numbness. METHODS: All 100 cases had medial compartmental osteoarthritis and a minimally invasive technique had been used. The mean follow-up duration was two years and eight months (range, 24 to 42 months). RESULTS: The classification according to the location of this nerve was observed as either Mochida Type I with 76 cases (76%), Type II with 16 cases (16%), and unclassified type with 8 cases (8%). In Type I, the nerve was saved in 62 cases (82%), but could not be preserved in Type II because of the surgical procedure. These results showed that the mean distance from the joint line to the nerve of Type I was 9.13 mm (range, 4 to 15 mm) and the nerve passed inferiorly. CONCLUSIONS: This study showed the location of this nerve can be predicted ahead of the procedure, which will help preserve it during the surgery.

Quebra de dormência em diásporos de teca (Tectona grandis L.f.)

Tectona grandis L.f. it is an exotic forest essence of economical and social importance to Brazil. The seedlings of that species are produced through diaspores constituted by the fruits with rigid endocarp and mesocarp. The objective of the present work was to analyze the effect of methods of numbness break in the germination of the seeds of this species. To overcome the numbness of the endocarp and mesocarp, the teak fruits were submitted to the immersion in hot water, immersion in sulfuric acid (33,5%) and immersion in running water. The diaspores were distributed in substratum constituted of sand, and the germination test was accomplished in germination camera with temperature of 30 ºC, under white light for eight hours a day. The evaluations were made daily, for 60 days. The method of immersion of the diaspores in sulfuric acid for three minutes was the most efficient treatment, presenting 73% of germinated seeds.

Tectona grandis L.f. é uma essência florestal exótica de importância econômica e social para o Brasil. As mudas dessa espécie são produzidas através de diásporos constituídos dos frutos com endocarpo e mesocarpo rígidos. O objetivo do presente trabalho foi avaliar o efeito de métodos de quebra de dormência na germinação das sementes desta espécie. Para superar a dormência do endocarpo e mesocarpo, os diásporos de teca foram submetidos à imersão em água quente, imersão em ácido sulfúrico (33,5%) e imersão em água corrente. Os diásporos foram distribuídos em substrato constituído de areia, e o teste de germinação foi realizado em câmara de germinação com temperatura de 30 ºC, sob luz branca durante oito horas por dia. As avaliações foram feitas diariamente, durante 60 dias. O método de imersão dos diásporos em ácido sulfúrico por três minutos, foi o tratamento mais eficiente, apresentando 73% das sementes germinadas.

Unrecognized intraneural injection as a possible cause of nerve injury associated with axillary block : A case report

A 71-year-old man who had a laceration on his right fifth finger underwent an emergency explorative operation under brachial plexus block that was performed by using transaxillary artery technique.During axillary block, no elicitation of paresthesia was presented.Postoperatively he complained numbness on his right arm along the dermatome of 7th cervical nerve distribution.Two weeks later the evidence of nerve injury was found on EMG and NCV carried by the department of neurology. Observing closely for another two weeks, the symptoms and signs were gradually improved.On 42nd postoperative day, the patient complained no neurologic problems and the findings of EMG and NCV returned to normal.Considering the method of anesthesia, operation time, tourniquet time and patient position, we conclude that the direct needle injury and intraneural injection during axillary block are the highly suggestive causes of nerve injury.

Unrecognized intraneural injection as a possible cause of nerve injury associated with axillary block : A case report

A 71-year-old man who had a laceration on his right fifth finger underwent an emergency explorative operation under brachial plexus block that was performed by using transaxillary artery technique.During axillary block, no elicitation of paresthesia was presented.Postoperatively he complained numbness on his right arm along the dermatome of 7th cervical nerve distribution.Two weeks later the evidence of nerve injury was found on EMG and NCV carried by the department of neurology. Observing closely for another two weeks, the symptoms and signs were gradually improved.On 42nd postoperative day, the patient complained no neurologic problems and the findings of EMG and NCV returned to normal.Considering the method of anesthesia, operation time, tourniquet time and patient position, we conclude that the direct needle injury and intraneural injection during axillary block are the highly suggestive causes of nerve injury.

Two Cases of Numbness and Pain of Neuropathy due to ANCA-associated Vasculitis Successfully Treated with Ogikeishigomotsuto / 日本東洋医学雑誌

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.