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Journal of Oral Rehabilitation May 2020The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients.
BACKGROUND
The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients.
OBJECTIVES
To present the results of a literature-based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients.
METHODS
In 2018, electronic literature searches were carried out in PubMed, Cochrane Library and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant papers. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus.
RESULTS
Based on the contents of the 77 articles identified in the search, the current knowledge about clinical characteristics, epidemiology, aetiology, diagnostic process, differential diagnosis and management of OD is summarised.
CONCLUSIONS
Occlusal dysesthesia exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counselling, defocusing, cognitive behavioural therapy, supportive drug therapy and certain non-specific measures. Irreversible, specifically an exclusively dental treatment approach must be avoided.
Topics: Dental Occlusion; Dentists; Humans; Malocclusion; Paresthesia; Professional Role
PubMed: 32080883
DOI: 10.1111/joor.12950 -
PloS One 2022Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile,...
INTRODUCTION/AIMS
Patients with diabetic polyneuropathy (DPN) may experience paresthesia, dysesthesia, and pain. We aimed to characterize the predictors, symptoms, somatosensory profile, neuropathy severity, and impact of painful DPN and dysesthetic DPN.
METHODS
This study was a cross-sectional study of type 2 diabetes patients with confirmed DPN, diagnosed using widely accepted methods including a clinical examination, skin biopsy, and nerve conduction studies.
FINDINGS
Of 126 patients with confirmed DPN, 52 had DPN without pain or dysesthesia, 21 had dysesthetic DPN, and 53 painful DPN. Patients with painful DPN were less physically active and suffered from more pain elsewhere than in the feet compared to patients with DPN without pain. Patients with painful DPN had the largest loss of small and large sensory fiber function, and there was a gradient of larger spatial distribution of sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. This could indicate that patients with dysesthesia had more severe neuropathy than patients without dysesthesia but less than patients with painful DPN. Patients with dysesthetic and painful DPN had higher symptom scores for depression and fatigue than those without dysesthesia/pain with no difference between dysesthetic and painful DPN.
CONCLUSIONS
There was a gradient of increasing sensory loss from DPN without dysesthesia/pain to dysesthetic DPN and to painful DPN. Pain and dysesthesia are common in DPN and both interfere with daily life. It is therefore important to consider dysesthesia when diagnosing and treating patients with neuropathy.
Topics: Aged; Case-Control Studies; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Diabetic Neuropathies; Female; Humans; Male; Neuralgia; Neurologic Examination; Paresthesia; Sensation; Surveys and Questionnaires
PubMed: 35176062
DOI: 10.1371/journal.pone.0263831 -
The Journal of Orthopaedic and Sports... Dec 2020A 45-year-old man presented to an emergency department reporting back pain, bilateral lower extremity weakness with paresthesia, and 1 episode of bladder incontinence....
A 45-year-old man presented to an emergency department reporting back pain, bilateral lower extremity weakness with paresthesia, and 1 episode of bladder incontinence. Radiographs and magnetic resonance imaging of the thoracolumbar spine were negative for cauda equina syndrome and positive for central canal stenosis and cord signal change from T2 to T4. The emergency department referred him to his primary care provider, who referred him to physical therapy. Following examination, due to the progressive neurological compromise correlated with magnetic resonance imaging findings, the physical therapist contacted neurosurgery for immediate referral. Two days later, the patient underwent emergency thoracic laminectomies, without fusion, for decompression of the spinal stenosis had resulted in thoracic myelopathy. .
Topics: Acute Disease; Emergency Service, Hospital; Humans; Laminectomy; Lower Extremity; Magnetic Resonance Imaging; Male; Middle Aged; Muscle Weakness; Paresthesia; Radiography; Recovery of Function; Spinal Cord Diseases; Spinal Stenosis; Thoracic Vertebrae; Time-to-Treatment; Urinary Incontinence
PubMed: 33256518
DOI: 10.2519/jospt.2020.9262 -
The Journal of Dermatological Treatment Jun 2020Notalgia paresthetica (NP) is a sensory neuropathy of the back characterized by a well demarcated, hyperpigmented macule or patch located medial or inferior to the... (Review)
Review
Notalgia paresthetica (NP) is a sensory neuropathy of the back characterized by a well demarcated, hyperpigmented macule or patch located medial or inferior to the scapulae. Symptoms include localized pruritus and pain, and the clinical course consists of remissions and relapses. It can be an underrecognized and difficult disease to treat since conventional treatments for pruritus in inflammatory dermatosis have variable efficacy. There are a variety of treatment modalities, but strong evidence to suggest the superiority of any one treatment is lacking. This review describes the treatments that have been used for NP in the literature and evaluates their level of evidence with respect to their efficacy. We also present a treatment algorithm based on our analysis. MEDLINE search was performed using the terms 'notalgia,' 'paresthetica,' and 'treatment.' All resulting articles have been included in this review. Treatment options include topical agents (capsaicin, tacrolimus, anesthetic cream, and amitriptyline/ketamine), systemic agents (gabapentin, oxcarbazepine, and amitriptyline), procedural modalities (botulinum toxin A and narrowband UVB), and physical therapy. Treatment should begin with topical agents or physical therapy, then systemic agents, and finally procedural modalities. We recommend combining treatment options with physical therapy for sustained treatment response.
Topics: Administration, Oral; Administration, Topical; Anticonvulsants; Botulinum Toxins, Type A; Capsaicin; Humans; Hyperpigmentation; Paresthesia; Physical Therapy Modalities; Pruritus; Sensory System Agents
PubMed: 30942103
DOI: 10.1080/09546634.2019.1603360 -
Dermatologic Clinics Oct 2020Adverse reactions to medications are common and may have a variety of clinical presentations in the oral cavity. Targeted therapies and new biologic agents have... (Review)
Review
Adverse reactions to medications are common and may have a variety of clinical presentations in the oral cavity. Targeted therapies and new biologic agents have revolutionized the treatment of cancers, autoimmune diseases, and inflammatory and rheumatologic diseases but have also been associated with adverse events in the oral cavity. This review describes the most common clinical presentations of oral mucosal reactions to medications, namely hyposalivation, lichenoid reactions, ulcers, bullous disorders, pigmentation, fibrovascular hyperplasia, reactive keratosis, dysesthesia, osteonecrosis, infection, angioedema, and malignancy.
Topics: Animals; Bisphosphonate-Associated Osteonecrosis of the Jaw; Drug-Related Side Effects and Adverse Reactions; Humans; Hyperpigmentation; Hyperplasia; Leukoplakia; Lichenoid Eruptions; Mouth; Mouth Diseases; Mouth Neoplasms; Oral Ulcer; Paresthesia; Skin Diseases, Vesiculobullous; Xerostomia
PubMed: 32892860
DOI: 10.1016/j.det.2020.05.012 -
Journal of the American Academy of... Feb 2022In distal upper extremity surgeries, there can be a choice to use an upper arm or forearm tourniquet. This study examines discomfort and tolerance in healthy volunteers... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In distal upper extremity surgeries, there can be a choice to use an upper arm or forearm tourniquet. This study examines discomfort and tolerance in healthy volunteers to determine whether one is more comfortable.
METHODS
Forty healthy, study participants were randomized to an upper extremity laterality and site. Tourniquets were inflated to 100 mm Hg over systolic blood pressure. Participants experienced an upper arm and a forearm tourniquet sequentially. Visual analog scores (VAS) were recorded at 2-minute intervals. Time until request and VAS at tourniquet deflation were recorded. Time until the complete resolution of paresthesias was also recorded. Participants subjectively stated which tourniquet felt more comfortable.
RESULTS
Tourniquets were inflated longer on the forearm than the upper arm (mean 16.1 minutes versus 12.2 minutes; P < 0.0001). VAS at tourniquet removal was not different between the sites (means 7.3 and 7.3) (P = 0.839). Time until paresthesia resolution after the tourniquet was deflated was not different (means 8.1 and 7.7 minutes) (P = 0.675). Time until paresthesia resolution was proportional to tourniquet inflation time for both sites (regression coefficient 0.41; P < 0.00001). Participants found the forearm more comfortable (95% confidence interval, 0.63 to 0.92).
CONCLUSION
Forearm placement allows the tourniquet to be inflated for an average of 4 minutes longer. Forearm tourniquet is subjectively more comfortable.
Topics: Arm; Forearm; Humans; Paresthesia; Tourniquets; Upper Extremity
PubMed: 35167505
DOI: 10.5435/JAAOSGlobal-D-21-00229 -
Yakugaku Zasshi : Journal of the... 2020Dysesthesia is an unpleasant abnormal sensation, often accompanied by pain, paresthesia (abnormal sensation), and numbness (decrease or loss of sensation). Dysesthesia... (Review)
Review
Dysesthesia is an unpleasant abnormal sensation, often accompanied by pain, paresthesia (abnormal sensation), and numbness (decrease or loss of sensation). Dysesthesia has been associated with various conditions, although its underlying mechanisms are largely unknown. This study assessed the roles of transient receptor potential ankyrin 1 (TRPA1) in dysesthesia by utilizing three animal models of dysesthesia characterized by reductions in blood flow to the skin: a transient hindlimb ischemia/reperfusion model, characterized by spontaneous licking and tactile hypoesthesia of the ischemic hindpaw; a streptozotocin-induced diabetic neuropathy model in mice, characterized by cold hypersensitivity, which is likely parallel to the reduced skin blood flow of the hindpaw; and a hindlimb ischemia model. TRPA1 inhibition or deficiency blocked spontaneous licking in the transient hindlimb ischemia/reperfusion model and cold hypersensitivity in the diabetic mouse model mice. Consistent with these results, the nocifensive behaviors induced by intraplantar injection of a TRPA1 agonist were enhanced in the diabetic neuropathy and hindlimb ischemia models. Hypoxia enhanced HO-induced TRPA1 responses in human TRPA1-expressing cells and cultured mouse dorsal root ganglion neurons, with this hypoxia-induced TRPA1 sensitization to HO being associated with hypoxia-induced inhibition of the hydroxylation of prolyl hydroxylases. These results suggest that dysesthesia following blood flow reduction is caused by the activation of TRPA1 sensitized by hypoxia and that hypoxia-induced TRPA1 sensitization plays a pivotal role in painful dysesthesia induced by peripheral blood flow reduction.
Topics: Animals; Diabetic Neuropathies; Disease Models, Animal; Humans; Hypoxia; Paresthesia; Regional Blood Flow; Skin; TRPA1 Cation Channel
PubMed: 31902877
DOI: 10.1248/yakushi.19-00175 -
The Veterinary Clinics of North... Jan 2024Pain is a subjective, aversive sensory and emotional experience and can cause or exacerbate problem behaviors. In this review, the biobehavioral model of pain is... (Review)
Review
Pain is a subjective, aversive sensory and emotional experience and can cause or exacerbate problem behaviors. In this review, the biobehavioral model of pain is introduced and used to improve understanding by veterinarians of pain mechanisms and their relationship with problem behaviors. A range of potential indicators of discomfort are presented, illustrated by selected cases from the authors' behavior and pain referral clinics. Various myths exist around pain resulting in barriers to reporting assessment and treatment. Veterinarians should always consider discomfort in any case presenting with a problem behavior.
Topics: Animals; Problem Behavior; Paresthesia; Pain
PubMed: 37743157
DOI: 10.1016/j.cvsm.2023.08.007 -
World Neurosurgery Oct 2023There are no systematic evidence-based medical data on the complications of endoscopic cervical spinal surgery. This narrative analysis compiled data from various... (Review)
Review
BACKGROUND
There are no systematic evidence-based medical data on the complications of endoscopic cervical spinal surgery. This narrative analysis compiled data from various studies that examined endoscopic complications, such as cervical disc herniation and foraminal stenosis. This study aimed to investigate the efficacy and safety of endoscopic surgery in cervical radiculopathy.
METHODS
We searched the PubMed/MEDLINE databases to identify articles on endoscopic spinal surgery, and keywords were set as "endoscopic cervical spinal surgery", "endoscopic cervical discectomy", "endoscopic cervical foraminotomy", and "percutaneous endoscopic cervical discectomy". We analyzed the evidence level and classified the prescribed complications according to the literature. Endoscopic cervical surgery was divided into three categories: full endoscopic anterior, endoscopic posterior, and unilateral biportal approaches. We excluded duplicate publications, studies without full text, studies without complications or incomplete information, and studies that did not provide the necessary data for extraction, animal experiments, or reviews.
RESULTS
Difficulties in swallowing, hematoma, and hoarseness are common complications associated with the anterior cervical approach. In contrast, complications of the posterior approach include nerve root injury, hematoma, and dysesthesia. However, endoscopic cervical spinal surgery, including the full endoscopic anterior, posterior, and unilateral biportal approaches, is a safe and effective treatment for cervical radiculopathy.
CONCLUSIONS
Complications of full endoscopic cervical spinal surgery differ significantly depending on the anterior and posterior approaches. In the anterior approach, swallowing difficulty, recurrent disc, hematoma, and dysphonia are the common complications. In contrast, transient dysesthesia, dural tears, upper limb motor deficits, and persistent arm pain are commonly reported with the posterior approach.
Topics: Humans; Radiculopathy; Paresthesia; Cervical Vertebrae; Endoscopy; Intervertebral Disc Displacement; Diskectomy; Hematoma; Treatment Outcome; Retrospective Studies
PubMed: 37479028
DOI: 10.1016/j.wneu.2023.07.058 -
Annales de Dermatologie Et de... Sep 2019Sensitive skin (or reactive skin) is defined as a syndrome involving the onset of unpleasant sensations (stinging sensation, burning sensation, pain, pruritus, tingling)... (Review)
Review
Sensitive skin (or reactive skin) is defined as a syndrome involving the onset of unpleasant sensations (stinging sensation, burning sensation, pain, pruritus, tingling) in response to stimuli that do not normally produce such sensations. These unpleasant sensations cannot be accounted for by lesions attributable to any specific skin disease. The skin may appear normal or erythema may be present. Sensitive skin can occur on any part of the skin but particularly affects the face. Sensitive skin is very common and affects around half of the population to different degrees. The diagnosis is based primarily on clinical examination. The physiopathology of the condition is becoming better known: it appears to be caused by hyperreactivity of the cutaneous nervous system and is associated in particular with activation of sensorial proteins present on keratinocytes and nerve endings. However, there is still no consensus regarding treatment.
Topics: Humans; Pain; Paresthesia; Pruritus; Skin Diseases
PubMed: 31320184
DOI: 10.1016/j.annder.2019.05.007