Could it be possible that the meningioma could be affecting the thalamus? Patients with thalamic pain present with these symptoms and the pain can be really severe, not touched by too many medications. I had one patient who was placed on Elavil and this seemed to help her some. Sympathetic block is another option I have heard has works.
Charlotte Chatto
Instructor
Medical College of Georgia
>>> "Sood" <[log in to unmask]> 06/29 12:14 AM >>>
Dear friends,
probably practice of medicine began when one person asked another for help in relief of his pain.To erase pain I think it is important to find cause or origin of pain.It is in one of rare case of this kind I seek opinion of the house.
Two months back A forty five year old lady,developed hemiplegia on left side,with the involvement of face,as she was having hypertension,and diabetes no one was surprised,but not until she went in for CT brain where a huge meningioma was found.Face has recovered not the limbs.She is having flaccid paralysis of left arm.But for her that is not the problem ,Problem is SEVERE PAIN in left hand ,not responding to any conventional Analgesic,even opium derivatives.
X-ray,cervical Spine Shows,Decreased intervertibral space in C5/C6 ,C6/C7 in
addition to osteoarthritis changes.
Xray shoulder shows attempt at new bone formation in the inferior surface of glnohumral joint,no past h/o any trauma or infection
Xray left hand is normal exept few osteoporotic areas.
WHAT COULD BE CAUSE OF PAIN OF SUCH SEVERITY
IS IT HER TUMOUR,CERVICAL SPINE,SHOULDER,OR HAND
Her higher functions are normal,memory,is normal.Blood sugar level was raised
at the time if examination which is now under control.She is being given carbamazapine Tegritol 400 mg tds for diabetic neuropathy.in addition to tramadol
analgesic,TENS.Cockup Splint, passive exercise and message after infrared,cervical traction for cervical spine.
Thanks
Dr.Sarveshwar Chander Sood
Orthopaedic Surgeon & Head
Department of Physical Medicine & Rehabilitation
S.B.L.S Civil Hospital
812/1,Housing Board Colony,Model Town
Jalandhar City,Punjab State,India
E-mail [log in to unmask]; [log in to unmask]
Phone 0181-273653,0181-463980
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