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Article
QUANTIFICATION OF PAIN THRESHOLD IN PARKINSON’S DISEASE

Authors: Aqeel K Hatim عقيل كريم حاتم --- Munther T Hamzah منذر طاهر حمزة --- Hasan A Hasan حسن عزيز حسن --- Zaki N Hasan زكي نوح حسن
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 1 Pages: 83-86
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

BackgroundParkinson's disease (PD) is the second most common degenerative neurologic disorder after Alzheimer’s disease. Pain is one of the major clinical symptoms of Parkinson's disease, occurring in 50-83% of patients. Pathways mediating pain are complex and include basal ganglia and thalamocortical-basalganglia circuits.ObjectiveTo quantitatively assess pain perception in Parkinson disease patients, by determining pain threshold in patients with and without pain through using electrical stimulation.MethodsA cross sectional observational study recruiting 18 patients with a clinical diagnosis of Parkinson disease and healthy controls from the neurologic unit in Al-Kadhimiya Teaching Hospital in Baghdad; between May 2010 to Jan 2011. There were 13 men and 5 women with a mean age of (66.5 ± 10.2 years). The control group includes 18 healthy subjects, [12 males/ 8 females] with a mean age of 56.6±6.74 years. Quantitative sensory testing was carried at the neurophysiology laboratory in Al-Kadhimiya hospital; using bipolar stimulating electrodes on the forearm, index finger, mid leg, and big toe.ResultsFourteen Out of 18 patients (77.7%) reported pain, while 4 (22.3%) had no pain. There was a highly significant statistical difference in electrical perception between the affected and unaffected side, and between Parkinson disease patients and the controls. There was no statistically significant difference between males and females [p =0.8248], and between patients with and those without pain [p =0.3279]. And between upper and lower limbs on the affected side [p =0.1412], and body side involvement whether right or left in both the patients and controls.ConclusionChronic pain is present in 77.7% of Parkinson disease. Patients with Parkinson disease had lower pain threshold compared to controls. The affected side had lower pain threshold. The left or right body side and gender had no effect on pain threshold.Key worldsParkinson disease, Pain

Keywords

Parkinson disease --- Pain


Article
CLINICAL AND PARACLINICAL PREDICTORS OF MECHANICAL VENTILATION IN GUILLAIN BARRÉ SYNDROME

Authors: Zaki N. Hasan زكي نوح حسن --- Sajid I. Kadhim ساجد ابراهيم كاظم --- Ghufran K. Shamick --- Aqeel K. Hatim عقيل كريم حاتم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 3 Pages: 216-221
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Guillain Barré syndrome (GBS) is an acute post infective autoimmune polyradiculo-neuropathy; it is the commonest polyneuropathy causing respiratory failure. A lot of studies suggested certain GBS clinical and preclinical features anticipate and predicate the neuromuscular respiratory failure and can accurately assess the progression to mechanical ventilation; bulbar muscles involvement, severity of weakness of upper and lower limbs, bilateral facial muscles involvement and autonomic nervous system involvement were the main features associated with progression to mechanical ventilation.Objectives:To assess demographic, clinical and para clinical features and their relation with the progression of GBS to respiratory failure.Methods:Clinical and paraclinical predictors of impending respiratory involvement and requirement for mechanical ventilation were studied in 40 GBS patients aged 12-57 years (28 males and 12 females).Results:Ten (6 female/4 male) patients (25%) were admitted to the intensive care unit and received mechanical ventilation. Younger age, female gender and rapid disease progression in first 3 days were associated with respiratory involvement and subsequent ventilation. Bulbar weakness, bilateral facial palsy, poor digit counting (<10/1 breath) were the strongest indicators of impending respiratory failure. In combination they were found in 90% of ventilated patients. Dense weakness (power grade ≤2), weak neck flexion and axonal electromyography also showed significant risk for mechanical ventilation. Other parameters (autonomic dysfunction, antecedent gastrointestinal and respiratory illness, earlier upper limbs weakness and pain) showed no statistical significance in our studyConclusion:Respiratory failure in the course of GBS can to some extent, predicted depending on clinical information. Respiratory failure was associated with younger age, female gender, rapid progressive weakness, bulbar weakness. Facial weakness. Dense weakness, weak neck flexion, poor digit count and axonal neuropathy.Keywords:Guillain Barre syndrome, respiratory failure, bulbar weakness, mechanical ventilation.

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