Spasm
Spasms, Infantile
Hemifacial Spasm
Esophageal Spasm, Diffuse
Ergonovine
Angina Pectoris, Variant
Facial Muscles
Vigabatrin
Facial Nerve Diseases
Neuromuscular Agents
Muscle Spasticity
Facial Nerve
Stiff-Person Syndrome
Angina Pectoris
Coronary Angiography
Botulinum Toxins, Type A
Oxytocics
Acetylcholine
Nerve Compression Syndromes
Microvascular Decompression Surgery
Nitroglycerin
Trigeminal Neuralgia
Adrenocorticotropic Hormone
Encyclopedias as Topic
MedlinePlus
Esophageal Motility Disorders
Consent Forms
Informed Consent
Myocardial Ischemia
Blepharospasm-oromandibular dystonia syndrome (Brueghel's syndrome). A variant of adult-onset torsion dystonia? (1/261)
Thirty-nine patients with the idiopathic blepharospasm-oromandibular dystonia syndrome are described. All presented in adult life, usually in the sixth decade; women were more commonly affected than men. Thirteen had blepharospasm alone, nine had oromandibular dystonia alone, and 17 had both. Torticollis or dystonic writer's camp preceded the syndrome in two patients. Eight other patients developed toritocollis, dystonic posturing of the arms, or involvement of respiratory muscles. No cause or hereditary basis for the illness were discovered. The evidence to indicate that this syndrome is due to an abnormality of extrapyramidal function, and that it is another example of adult-onset focal dystonia akin to spasmodic torticollis and dystonic writer's cramp, is discussed. (+info)Occurrence of familial spastic paraplegia in only one of monozygous twins. (2/261)
Three patients who suffer from spastic paraplegia are described who belong to two generations in one family. One of the patients, who has had symptoms and signs for at least 10 years, has a monozygous twin who is unaffected. Using blood groups and chromosomal polymorphisms, the probability of monozygosity is estimated to be 0.99986. The observation of nonpenetrance in familial spastic paraplegia suggests that environmental factors may be involved in provocation and emphasises the need for careful genetic counselling in this and related diseases. (+info)A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure. (3/261)
BACKGROUND AND METHODS: Lateral internal sphincterotomy, the most common treatment for chronic anal fissure, may cause permanent injury to the anal sphincter, which can lead to fecal incontinence. We compared two nonsurgical treatments that avert the risk of fecal incontinence. We randomly assigned 50 adults with symptomatic chronic posterior anal fissures to receive treatment with either a total of 20 U of botulinum toxin injected into the internal anal sphincter on each side of the anterior midline or 0.2 percent nitroglycerin ointment applied twice daily for six weeks. RESULTS: After two months, the fissures were healed in 24 of the 25 patients (96 percent) in the botulinum-toxin group and in 15 of the 25 (60 percent) in the nitroglycerin group (P=0.005). No patient in either group had fecal incontinence. At some time during treatment, five patients in the nitroglycerin group had transient, moderate-to-severe headaches that were related to treatment. None of the patients in the botulinum-toxin group reported adverse effects. Ten patients who did not have a response to the assigned treatment - 1 in the botulinum-toxin group and 9 in the nitroglycerin group - crossed over to the other treatment; the fissures subsequently healed in all 10 patients. There were no relapses during an average of about 15 months of follow-up. CONCLUSIONS: Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective nonsurgical treatment. (+info)Pseudoxanthoma elasticum with dipyridamole-induced coronary artery spasm: a case report. (4/261)
In patients with pseudoxanthoma elasticum, severe organic coronary artery stenosis often occurs without coronary risk factors. However, this report presents the case of a 49-year-old woman with pseudoxanthoma elasticum who had coronary artery spasm with an angiographically normal coronary artery. In addition, coronary artery spasm was provoked with dipyridamole thallium-201 cardiac imaging. (+info)Urinary catheter management. (5/261)
The use of urinary catheters should be avoided whenever possible. Clean intermittent catheterization, when practical, is preferable to long-term catheterization. Suprapubic catheters offer some advantages, and condom catheters may be appropriate for some men. While clean handling of catheters is important, routine perineal cleaning and catheter irrigation or changing are ineffective in eliminating bacteriuria. Bacteriuria is inevitable in patients requiring long-term catheterization, but only symptomatic infections should be treated. Infections are usually polymicrobial, and seriously ill patients require therapy with two antibiotics. Patients with spinal cord injuries and those using catheters for more than 10 years are at greater risk of bladder cancer and renal complications; periodic renal scans, urine cytology and cystoscopy may be indicated in these patients. (+info)An imbalance in plasma prostanoids in patients with Raynaud's phenomenon and pulmonary vasospasm. (6/261)
Raynaud's phenomenon has been suggested as a predisposing factor for pulmonary vasospasm which may lead to pulmonary hypertension, but the occurrence of cold stimulus-induced pulmonary vasospasm has been inconsistent. Such inconsistent pulmonary vascular responses may be caused by differences in the production of endogenous vasodilators and vasoconstrictors among patients. Fourteen patients with Raynaud's phenomenon associated with mixed connective tissue disease (n=10) or systemic sclerosis (n=4) participated in the study. Right heart catheterization was performed before and after a cold pressor test, immersing a hand in cold water (15 degrees C) for 5 min. Plasma levels of 6-keto prostaglandin (PG)F1alpha, thromboxane (TX)B2 and endothelin (ET)-1 in the mixed venous blood were measured. Mean pulmonary artery pressure increased after the cold pressor test in five of 14 patients, and the patients were divided into those with pulmonary vasospasm (responders) and those without vasospasm (nonresponders). After the cold pressor test, levels of 6-keto PGF1alpha increased significantly in nonresponders (p<0.01) and decreased significantly in responders (p<0.05). The ratios of 6-keto PGF1alpha to TXB2 significantly increased in nonresponders (p<0.01) but not in responders and the difference between responders and nonresponders after the cold pressor test was also statistically significant (p<0.05). No significant change in plasma ET-1 levels occurred in either responders or nonresponders. The results suggest that an impaired production of prostaglandin I2 and an imbalance between prostaglandin I2 and thromboxane A2 are associated with the occurrence of pulmonary vasospasm induced by Raynaud's phenomenon. (+info)Fogarty balloon dilatation for intraoperative arterial spasm. (7/261)
OBJECTIVE: to describe an intraoperative technique using a Fogarty balloon to treat arterial spasm following vascular bypass and endarterectomy. DESIGN: prospective case control study. SUBJECTS AND TREATMENT: twenty-two patients following femorodistal bypass surgery and one patient following carotid endarterectomy, with arterial spasm in the distal run-off on completion angiography, were treated with Fogarty balloon dilatation. MATERIALS: Fogarty balloon catheter (Baxtertrade mark). RESULTS: twenty-three patients (100%) with arterial spasm were successfully treated by Fogarty balloon as demonstrated on completion angiography. No complications were seen. CONCLUSION: this simple technique removes vascular spasm rapidly and produces an excellent angiographic result. (+info)A phenothiazine derivative in the treatment of spasticity. (8/261)
The efficacy of a selective fusimotor suppressant, the phenothiazine (+/-)-10-3-dimethylamino-2-methylpropyl)-2-valeroylphenothiazine, has been assessed in a double-blind crossover trail in eight patients suffering from cerebral spasticity and one patient suffering from spinal spasticity. Dosage was 40 mg daily. Independent clinical and electromyographic methods of assessment were used. The active agent produced a small but significant reduction in spasticity, although this was of clinical value in only a few patients. There were few side-effects. It is recommended that further studies using higher dosages be undertaken. (+info)A spasm is a sudden, involuntary contraction or tightening of a muscle, group of muscles, or a hollow organ such as the ureter or bronchi. Spasms can occur as a result of various factors including muscle fatigue, injury, irritation, or abnormal nerve activity. They can cause pain and discomfort, and in some cases, interfere with normal bodily functions. For example, a spasm in the bronchi can cause difficulty breathing, while a spasm in the ureter can cause severe pain and may lead to a kidney stone blockage. The treatment for spasms depends on the underlying cause and may include medication, physical therapy, or lifestyle changes.
Infantile spasms, also known as West syndrome, is a rare but serious type of epilepsy that affects infants typically between 4-8 months of age. The spasms are characterized by sudden, brief, and frequent muscle jerks or contractions, often involving the neck, trunk, and arms. These spasms usually occur in clusters and may cause the infant to bend forward or stretch out. Infantile spasms can be a symptom of various underlying neurological conditions and are often associated with developmental delays and regression. Early recognition and treatment are crucial for improving outcomes.
Hemifacial spasm is a neuromuscular disorder characterized by involuntary, irregular contractions or twitching of the muscles on one side of the face. These spasms typically begin around the eye and may progress to involve the muscles of the lower face, including those around the mouth.
The primary cause of hemifacial spasm is pressure on or irritation of the facial nerve (cranial nerve VII) as it exits the brainstem, often due to a blood vessel or tumor. This pressure can lead to abnormal electrical signals in the facial nerve, resulting in uncontrolled muscle contractions.
In some cases, hemifacial spasm may be associated with other conditions such as multiple sclerosis or Bell's palsy. Treatment options for hemifacial spasm include medications to help relax the muscles, botulinum toxin (Botox) injections to paralyze the affected muscles temporarily, and, in rare cases, surgical intervention to relieve pressure on the facial nerve.
Coronary vasospasm refers to a sudden constriction (narrowing) of the coronary arteries, which supply oxygenated blood to the heart muscle. This constriction can reduce or block blood flow, leading to symptoms such as chest pain (angina) or, in severe cases, a heart attack (myocardial infarction). Coronary vasospasm can occur spontaneously or be triggered by various factors, including stress, smoking, and certain medications. It is also associated with conditions such as coronary artery disease and variant angina. Prolonged or recurrent vasospasms can cause damage to the heart muscle and increase the risk of cardiovascular events.
Diffuse Esophageal Spasm (DES) is a motility disorder of the esophagus, which is the muscular tube that connects the throat to the stomach. In DES, the esophagus involuntarily and uncoordinately contracts, causing difficulty swallowing (dysphagia), chest pain, and sometimes regurgitation of food or liquids.
The term "diffuse" refers to the fact that these spasms can occur throughout the entire length of the esophagus, rather than being localized to a specific area. The exact cause of diffuse esophageal spasm is not known, but it may be associated with abnormalities in the nerve cells that control muscle contractions in the esophagus.
Diagnosis of DES typically involves a combination of medical history, physical examination, and specialized tests such as esophageal manometry or ambulatory 24-hour pH monitoring. Treatment options may include medications to relax the esophageal muscles, lifestyle modifications such as avoiding trigger foods, and in some cases, surgery.
Ergonovine is a medication that belongs to a class of drugs called ergot alkaloids. It is derived from the ergot fungus and is used in medical settings as a uterotonic agent, which means it causes the uterus to contract. Ergonovine is often used after childbirth to help the uterus return to its normal size and reduce bleeding.
Ergonovine works by binding to specific receptors in the smooth muscle of the uterus, causing it to contract. It has a potent effect on the uterus and can also cause vasoconstriction (narrowing of blood vessels) in other parts of the body. This is why ergonovine is sometimes used to treat severe bleeding caused by conditions such as uterine fibroids or ectopic pregnancy.
Like other ergot alkaloids, ergonovine can have serious side effects if not used carefully. It should be administered under the close supervision of a healthcare provider and should not be used in women with certain medical conditions, such as high blood pressure or heart disease. Ergonovine can also interact with other medications, so it's important to inform your healthcare provider of all medications you are taking before receiving this drug.
Angina pectoris, variant (also known as Prinzmetal's angina or vasospastic angina) is a type of chest pain that results from reduced blood flow to the heart muscle due to spasms in the coronary arteries. These spasms cause the arteries to narrow, temporarily reducing the supply of oxygen-rich blood to the heart. This can lead to symptoms such as chest pain, shortness of breath, and fatigue.
Variant angina is typically more severe than other forms of angina and can occur at rest or with minimal physical exertion. It is often treated with medications that help relax the coronary arteries and prevent spasms, such as calcium channel blockers and nitrates. In some cases, additional treatments such as angioplasty or bypass surgery may be necessary to improve blood flow to the heart.
It's important to note that chest pain can have many different causes, so it is essential to seek medical attention if you experience any symptoms of angina or other types of chest pain. A healthcare professional can help determine the cause of your symptoms and develop an appropriate treatment plan.
Facial muscles, also known as facial nerves or cranial nerve VII, are a group of muscles responsible for various expressions and movements of the face. These muscles include:
1. Orbicularis oculi: muscle that closes the eyelid and raises the upper eyelid
2. Corrugator supercilii: muscle that pulls the eyebrows down and inward, forming wrinkles on the forehead
3. Frontalis: muscle that raises the eyebrows and forms horizontal wrinkles on the forehead
4. Procerus: muscle that pulls the medial ends of the eyebrows downward, forming vertical wrinkles between the eyebrows
5. Nasalis: muscle that compresses or dilates the nostrils
6. Depressor septi: muscle that pulls down the tip of the nose
7. Levator labii superioris alaeque nasi: muscle that raises the upper lip and flares the nostrils
8. Levator labii superioris: muscle that raises the upper lip
9. Zygomaticus major: muscle that raises the corner of the mouth, producing a smile
10. Zygomaticus minor: muscle that raises the nasolabial fold and corner of the mouth
11. Risorius: muscle that pulls the angle of the mouth laterally, producing a smile
12. Depressor anguli oris: muscle that pulls down the angle of the mouth
13. Mentalis: muscle that raises the lower lip and forms wrinkles on the chin
14. Buccinator: muscle that retracts the cheek and helps with chewing
15. Platysma: muscle that depresses the corner of the mouth and wrinkles the skin of the neck.
These muscles are innervated by the facial nerve, which arises from the brainstem and exits the skull through the stylomastoid foramen. Damage to the facial nerve can result in facial paralysis or weakness on one or both sides of the face.
Blepharospasm is a medical condition characterized by involuntary spasms and contractions of the muscles around the eyelids. These spasms can cause frequent blinkings, eye closure, and even difficulty in keeping the eyes open. In some cases, the spasms may be severe enough to interfere with vision, daily activities, and quality of life.
The exact cause of blepharospasm is not fully understood, but it is believed to involve abnormal functioning of the basal ganglia, a part of the brain that controls movement. It can occur as an isolated condition (known as essential blepharospasm) or as a symptom of other neurological disorders such as Parkinson's disease or dystonia.
Treatment options for blepharospasm may include medication, botulinum toxin injections, surgery, or a combination of these approaches. The goal of treatment is to reduce the frequency and severity of the spasms, improve symptoms, and enhance the patient's quality of life.
Vigabatrin is an anticonvulsant medication used to treat certain types of seizures in adults and children. It works by reducing the abnormal excitement in the brain. The medical definition of Vigabatrin is: a irreversible inhibitor of GABA transaminase, which results in increased levels of gamma-aminobutyric acid (GABA) in the central nervous system. This medication is used as an adjunctive treatment for complex partial seizures and is available in oral form for administration.
It's important to note that Vigabatrin can cause serious side effects, including permanent vision loss, and its use should be closely monitored by a healthcare professional. It is also classified as a pregnancy category C medication, which means it may harm an unborn baby and should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.
Facial nerve diseases refer to a group of medical conditions that affect the function of the facial nerve, also known as the seventh cranial nerve. This nerve is responsible for controlling the muscles of facial expression, and it also carries sensory information from the taste buds in the front two-thirds of the tongue, and regulates saliva flow and tear production.
Facial nerve diseases can cause a variety of symptoms, depending on the specific location and extent of the nerve damage. Common symptoms include:
* Facial weakness or paralysis on one or both sides of the face
* Drooping of the eyelid and corner of the mouth
* Difficulty closing the eye or keeping it closed
* Changes in taste sensation or dryness of the mouth and eyes
* Abnormal sensitivity to sound (hyperacusis)
* Twitching or spasms of the facial muscles
Facial nerve diseases can be caused by a variety of factors, including:
* Infections such as Bell's palsy, Ramsay Hunt syndrome, and Lyme disease
* Trauma or injury to the face or skull
* Tumors that compress or invade the facial nerve
* Neurological conditions such as multiple sclerosis or Guillain-Barre syndrome
* Genetic disorders such as Moebius syndrome or hemifacial microsomia
Treatment for facial nerve diseases depends on the underlying cause and severity of the symptoms. In some cases, medication, physical therapy, or surgery may be necessary to restore function and relieve symptoms.
Neuromuscular agents are drugs or substances that affect the function of the neuromuscular junction, which is the site where nerve impulses are transmitted to muscles. These agents can either enhance or inhibit the transmission of signals across the neuromuscular junction, leading to a variety of effects on muscle tone and activity.
Neuromuscular blocking agents (NMBAs) are a type of neuromuscular agent that is commonly used in anesthesia and critical care settings to induce paralysis during intubation or mechanical ventilation. NMBAs can be classified into two main categories: depolarizing and non-depolarizing agents.
Depolarizing NMBAs, such as succinylcholine, work by activating the nicotinic acetylcholine receptors at the neuromuscular junction, causing muscle contraction followed by paralysis. Non-depolarizing NMBAs, such as rocuronium and vecuronium, block the activation of these receptors, preventing muscle contraction and leading to paralysis.
Other types of neuromuscular agents include cholinesterase inhibitors, which increase the levels of acetylcholine at the neuromuscular junction and can be used to reverse the effects of NMBAs, and botulinum toxin, which is a potent neurotoxin that inhibits the release of acetylcholine from nerve terminals and is used in the treatment of various neurological disorders.
Muscle spasticity is a motor disorder characterized by an involuntary increase in muscle tone, leading to stiffness and difficulty in moving muscles. It is often seen in people with damage to the brain or spinal cord, such as those with cerebral palsy, multiple sclerosis, or spinal cord injuries.
In muscle spasticity, the muscles may contract excessively, causing rigid limbs, awkward movements, and abnormal postures. The severity of muscle spasticity can vary from mild stiffness to severe contractures that limit mobility and function.
Muscle spasticity is caused by an imbalance between excitatory and inhibitory signals in the central nervous system, leading to overactivity of the alpha motor neurons that control muscle contraction. This can result in hyperreflexia (overactive reflexes), clonus (rapid, rhythmic muscle contractions), and flexor or extensor spasms.
Effective management of muscle spasticity may involve a combination of physical therapy, medication, surgery, or other interventions to improve function, reduce pain, and prevent complications such as contractures and pressure sores.
The facial nerve, also known as the seventh cranial nerve (CN VII), is a mixed nerve that carries both sensory and motor fibers. Its functions include controlling the muscles involved in facial expressions, taste sensation from the anterior two-thirds of the tongue, and secretomotor function to the lacrimal and salivary glands.
The facial nerve originates from the brainstem and exits the skull through the internal acoustic meatus. It then passes through the facial canal in the temporal bone before branching out to innervate various structures of the face. The main branches of the facial nerve include:
1. Temporal branch: Innervates the frontalis, corrugator supercilii, and orbicularis oculi muscles responsible for eyebrow movements and eyelid closure.
2. Zygomatic branch: Supplies the muscles that elevate the upper lip and wrinkle the nose.
3. Buccal branch: Innervates the muscles of the cheek and lips, allowing for facial expressions such as smiling and puckering.
4. Mandibular branch: Controls the muscles responsible for lower lip movement and depressing the angle of the mouth.
5. Cervical branch: Innervates the platysma muscle in the neck, which helps to depress the lower jaw and wrinkle the skin of the neck.
Damage to the facial nerve can result in various symptoms, such as facial weakness or paralysis, loss of taste sensation, and dry eyes or mouth due to impaired secretion.
Stiff-Person Syndrome (SPS) is a rare neurological disorder characterized by fluctuating muscle rigidity in the trunk and limbs and a heightened sensitivity to stimuli such as touch, sound, and emotional distress, which can trigger muscle spasms. The symptoms can significantly affect a person's ability to perform daily activities and can lead to frequent falls and injuries. SPS is often associated with antibodies against glutamic acid decarboxylase (GAD), an enzyme involved in the production of a neurotransmitter called gamma-aminobutyric acid (GABA) that helps regulate muscle movement. The exact cause of SPS remains unknown, but it is thought to involve both autoimmune and genetic factors.
Angina pectoris is a medical term that describes chest pain or discomfort caused by an inadequate supply of oxygen-rich blood to the heart muscle. This condition often occurs due to coronary artery disease, where the coronary arteries become narrowed or blocked by the buildup of cholesterol, fatty deposits, and other substances, known as plaques. These blockages can reduce blood flow to the heart, causing ischemia (lack of oxygen) and leading to angina symptoms.
There are two primary types of angina: stable and unstable. Stable angina is predictable and usually occurs during physical exertion or emotional stress when the heart needs more oxygen-rich blood. The pain typically subsides with rest or after taking prescribed nitroglycerin medication, which helps widen the blood vessels and improve blood flow to the heart.
Unstable angina, on the other hand, is more severe and unpredictable. It can occur at rest, during sleep, or with minimal physical activity and may not be relieved by rest or nitroglycerin. Unstable angina is considered a medical emergency, as it could indicate an imminent heart attack.
Symptoms of angina pectoris include chest pain, pressure, tightness, or heaviness that typically radiates to the left arm, neck, jaw, or back. Shortness of breath, nausea, sweating, and fatigue may also accompany angina symptoms. Immediate medical attention is necessary if you experience chest pain or discomfort, especially if it's new, severe, or persistent, as it could be a sign of a more serious condition like a heart attack.
Coronary angiography is a medical procedure that uses X-ray imaging to visualize the coronary arteries, which supply blood to the heart muscle. During the procedure, a thin, flexible catheter is inserted into an artery in the arm or groin and threaded through the blood vessels to the heart. A contrast dye is then injected through the catheter, and X-ray images are taken as the dye flows through the coronary arteries. These images can help doctors diagnose and treat various heart conditions, such as blockages or narrowing of the arteries, that can lead to chest pain or heart attacks. It is also known as coronary arteriography or cardiac catheterization.
Botulinum toxins type A are neurotoxins produced by the bacterium Clostridium botulinum and related species. These toxins act by blocking the release of acetylcholine at the neuromuscular junction, leading to muscle paralysis. Botulinum toxin type A is used in medical treatments for various conditions characterized by muscle spasticity or excessive muscle activity, such as cervical dystonia, blepharospasm, strabismus, and chronic migraine. It is also used cosmetically to reduce the appearance of wrinkles by temporarily paralyzing the muscles that cause them. The commercial forms of botulinum toxin type A include Botox, Dysport, and Xeomin.
Oxytocics are a class of medications that stimulate the contraction of uterine smooth muscle. They are primarily used in obstetrics to induce or augment labor, and to control bleeding after childbirth. Oxytocin is the most commonly used oxytocic and is naturally produced by the posterior pituitary gland. Synthetic forms of oxytocin, such as Pitocin, are often used in medical settings to induce labor or reduce postpartum bleeding. Other medications with oxytocic properties include ergometrine and methylergometrine. It's important to note that the use of oxytocics should be monitored carefully as overuse can lead to excessive uterine contractions, which may compromise fetal oxygenation and increase the risk of uterine rupture.
The cerebellopontine angle (CPA) is a narrow space located at the junction of the brainstem and the cerebellum, where the pons and cerebellum meet. This region is filled with several important nerves, blood vessels, and membranous coverings called meninges. The CPA is a common site for various neurological disorders because it contains critical structures such as:
1. Cerebellum: A part of the brain responsible for coordinating muscle movements, maintaining balance, and fine-tuning motor skills.
2. Pons: A portion of the brainstem that plays a role in several vital functions, including facial movements, taste sensation, sleep regulation, and respiration.
3. Cranial nerves: The CPA is home to the following cranial nerves:
* Vestibulocochlear nerve (CN VIII): This nerve has two components - cochlear and vestibular. The cochlear part is responsible for hearing, while the vestibular part contributes to balance and eye movement.
* Facial nerve (CN VII): This nerve controls facial expressions, taste sensation in the anterior two-thirds of the tongue, salivary gland function, and lacrimation (tear production).
4. Blood vessels: The CPA contains critical blood vessels like the anterior inferior cerebellar artery (AICA), which supplies blood to various parts of the brainstem, cerebellum, and cranial nerves.
5. Meninges: These are protective membranes surrounding the brain and spinal cord. In the CPA, the meninges include the dura mater, arachnoid mater, and pia mater.
Disorders that can affect the structures in the cerebellopontine angle include acoustic neuromas (vestibular schwannomas), meningiomas, epidermoids, and arteriovenous malformations. These conditions may cause symptoms such as hearing loss, tinnitus (ringing in the ears), vertigo (dizziness), facial weakness or numbness, difficulty swallowing, and imbalance.
Acetylcholine is a neurotransmitter, a type of chemical messenger that transmits signals across a chemical synapse from one neuron (nerve cell) to another "target" neuron, muscle cell, or gland cell. It is involved in both peripheral and central nervous system functions.
In the peripheral nervous system, acetylcholine acts as a neurotransmitter at the neuromuscular junction, where it transmits signals from motor neurons to activate muscles. Acetylcholine also acts as a neurotransmitter in the autonomic nervous system, where it is involved in both the sympathetic and parasympathetic systems.
In the central nervous system, acetylcholine plays a role in learning, memory, attention, and arousal. Disruptions in cholinergic neurotransmission have been implicated in several neurological disorders, including Alzheimer's disease, Parkinson's disease, and myasthenia gravis.
Acetylcholine is synthesized from choline and acetyl-CoA by the enzyme choline acetyltransferase and is stored in vesicles at the presynaptic terminal of the neuron. When a nerve impulse arrives, the vesicles fuse with the presynaptic membrane, releasing acetylcholine into the synapse. The acetylcholine then binds to receptors on the postsynaptic membrane, triggering a response in the target cell. Acetylcholine is subsequently degraded by the enzyme acetylcholinesterase, which terminates its action and allows for signal transduction to be repeated.
Nerve compression syndromes refer to a group of conditions characterized by the pressure or irritation of a peripheral nerve, causing various symptoms such as pain, numbness, tingling, and weakness in the affected area. This compression can occur due to several reasons, including injury, repetitive motion, bone spurs, tumors, or swelling. Common examples of nerve compression syndromes include carpal tunnel syndrome, cubital tunnel syndrome, radial nerve compression, and ulnar nerve entrapment at the wrist or elbow. Treatment options may include physical therapy, splinting, medications, injections, or surgery, depending on the severity and underlying cause of the condition.
Microvascular decompression surgery (MVD) is a surgical procedure used to alleviate the symptoms of certain neurological conditions, such as trigeminal neuralgia and hemifacial spasm. The primary goal of MVD is to relieve pressure on the affected cranial nerve by placing a small pad or sponge between the nerve and the blood vessel that is causing compression. This procedure is typically performed under a microscope, hence the term "microvascular."
During the surgery, the neurosurgeon makes an incision behind the ear and creates a small opening in the skull (a craniotomy) to access the brain. The surgeon then identifies the affected nerve and the blood vessel that is compressing it. Using specialized instruments under the microscope, the surgeon carefully separates the blood vessel from the nerve and places a tiny pad or sponge between them to prevent further compression.
The benefits of MVD include its high success rate in relieving symptoms, minimal impact on surrounding brain tissue, and lower risk of complications compared to other surgical options for treating these conditions. However, as with any surgery, there are potential risks and complications associated with MVD, including infection, bleeding, cerebrospinal fluid leakage, facial numbness, hearing loss, balance problems, and very rarely, stroke or death.
It is essential to consult a qualified neurosurgeon for a thorough evaluation and discussion of the risks and benefits of microvascular decompression surgery before making a treatment decision.
Anticonvulsants are a class of drugs used primarily to treat seizure disorders, also known as epilepsy. These medications work by reducing the abnormal electrical activity in the brain that leads to seizures. In addition to their use in treating epilepsy, anticonvulsants are sometimes also prescribed for other conditions, such as neuropathic pain, bipolar disorder, and migraine headaches.
Anticonvulsants can work in different ways to reduce seizure activity. Some medications, such as phenytoin and carbamazepine, work by blocking sodium channels in the brain, which helps to stabilize nerve cell membranes and prevent excessive electrical activity. Other medications, such as valproic acid and gabapentin, increase the levels of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which has a calming effect on nerve cells and helps to reduce seizure activity.
While anticonvulsants are generally effective at reducing seizure frequency and severity, they can also have side effects, such as dizziness, drowsiness, and gastrointestinal symptoms. In some cases, these side effects may be managed by adjusting the dosage or switching to a different medication. It is important for individuals taking anticonvulsants to work closely with their healthcare provider to monitor their response to the medication and make any necessary adjustments.
Nitroglycerin, also known as glyceryl trinitrate, is a medication used primarily for the treatment of angina pectoris (chest pain due to coronary artery disease) and hypertensive emergencies (severe high blood pressure). It belongs to a class of drugs called nitrates or organic nitrites.
Nitroglycerin works by relaxing and dilating the smooth muscle in blood vessels, which leads to decreased workload on the heart and increased oxygen delivery to the myocardium (heart muscle). This results in reduced symptoms of angina and improved cardiac function during hypertensive emergencies.
The drug is available in various forms, including sublingual tablets, sprays, transdermal patches, ointments, and intravenous solutions. The choice of formulation depends on the specific clinical situation and patient needs. Common side effects of nitroglycerin include headache, dizziness, and hypotension (low blood pressure).
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which is one of the largest nerves in the head. It carries sensations from the face to the brain.
Medically, trigeminal neuralgia is defined as a neuropathic disorder characterized by episodes of intense, stabbing, electric shock-like pain in the areas of the face supplied by the trigeminal nerve (the ophthalmic, maxillary, and mandibular divisions). The pain can be triggered by simple activities such as talking, eating, brushing teeth, or even touching the face lightly.
The condition is more common in women over 50, but it can occur at any age and in either gender. While the exact cause of trigeminal neuralgia is not always known, it can sometimes be related to pressure on the trigeminal nerve from a nearby blood vessel or other causes such as multiple sclerosis. Treatment typically involves medications, surgery, or a combination of both.
Coronary vessels refer to the network of blood vessels that supply oxygenated blood and nutrients to the heart muscle, also known as the myocardium. The two main coronary arteries are the left main coronary artery and the right coronary artery.
The left main coronary artery branches off into the left anterior descending artery (LAD) and the left circumflex artery (LCx). The LAD supplies blood to the front of the heart, while the LCx supplies blood to the side and back of the heart.
The right coronary artery supplies blood to the right lower part of the heart, including the right atrium and ventricle, as well as the back of the heart.
Coronary vessel disease (CVD) occurs when these vessels become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle. This can result in chest pain, shortness of breath, or a heart attack.
Manometry is a medical test that measures pressure inside various parts of the gastrointestinal tract. It is often used to help diagnose digestive disorders such as achalasia, gastroparesis, and irritable bowel syndrome. During the test, a thin, flexible tube called a manometer is inserted through the mouth or rectum and into the area being tested. The tube is connected to a machine that measures and records pressure readings. These readings can help doctors identify any abnormalities in muscle function or nerve reflexes within the digestive tract.
Vasodilator agents are pharmacological substances that cause the relaxation or widening of blood vessels by relaxing the smooth muscle in the vessel walls. This results in an increase in the diameter of the blood vessels, which decreases vascular resistance and ultimately reduces blood pressure. Vasodilators can be further classified based on their site of action:
1. Systemic vasodilators: These agents cause a generalized relaxation of the smooth muscle in the walls of both arteries and veins, resulting in a decrease in peripheral vascular resistance and preload (the volume of blood returning to the heart). Examples include nitroglycerin, hydralazine, and calcium channel blockers.
2. Arterial vasodilators: These agents primarily affect the smooth muscle in arterial vessel walls, leading to a reduction in afterload (the pressure against which the heart pumps blood). Examples include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and direct vasodilators like sodium nitroprusside.
3. Venous vasodilators: These agents primarily affect the smooth muscle in venous vessel walls, increasing venous capacitance and reducing preload. Examples include nitroglycerin and other organic nitrates.
Vasodilator agents are used to treat various cardiovascular conditions such as hypertension, heart failure, angina, and pulmonary arterial hypertension. It is essential to monitor their use carefully, as excessive vasodilation can lead to orthostatic hypotension, reflex tachycardia, or fluid retention.
Adrenocorticotropic Hormone (ACTH) is a hormone produced and released by the anterior pituitary gland, a small endocrine gland located at the base of the brain. ACTH plays a crucial role in the regulation of the body's stress response and has significant effects on various physiological processes.
The primary function of ACTH is to stimulate the adrenal glands, which are triangular-shaped glands situated on top of the kidneys. The adrenal glands consist of two parts: the outer cortex and the inner medulla. ACTH specifically targets the adrenal cortex, where it binds to specific receptors and initiates a series of biochemical reactions leading to the production and release of steroid hormones, primarily cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid).
Cortisol is involved in various metabolic processes, such as regulating blood sugar levels, modulating the immune response, and helping the body respond to stress. Aldosterone plays a vital role in maintaining electrolyte and fluid balance by promoting sodium reabsorption and potassium excretion in the kidneys.
ACTH release is controlled by the hypothalamus, another part of the brain, which produces corticotropin-releasing hormone (CRH). CRH stimulates the anterior pituitary gland to secrete ACTH, which in turn triggers cortisol production in the adrenal glands. This complex feedback system helps maintain homeostasis and ensures that appropriate amounts of cortisol are released in response to various physiological and psychological stressors.
Disorders related to ACTH can lead to hormonal imbalances, resulting in conditions such as Cushing's syndrome (excessive cortisol production) or Addison's disease (insufficient cortisol production). Proper diagnosis and management of these disorders typically involve assessing the function of the hypothalamic-pituitary-adrenal axis and addressing any underlying issues affecting ACTH secretion.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
MedlinePlus is not a medical term, but rather a consumer health website that provides high-quality, accurate, and reliable health information, written in easy-to-understand language. It is produced by the U.S. National Library of Medicine, the world's largest medical library, and is widely recognized as a trusted source of health information.
MedlinePlus offers information on various health topics, including conditions, diseases, tests, treatments, and wellness. It also provides access to drug information, medical dictionary, and encyclopedia, as well as links to clinical trials, medical news, and patient organizations. The website is available in both English and Spanish and can be accessed for free.
Esophageal motility disorders are a group of conditions that affect the normal movement (motility) of the muscles in the esophagus, which is the tube that connects the throat to the stomach. The esophageal muscles normally contract and relax in a coordinated manner to help move food from the mouth to the stomach.
In esophageal motility disorders, this muscle movement is impaired, leading to difficulty swallowing (dysphagia), chest pain, heartburn, or regurgitation of food. Some common examples of esophageal motility disorders include:
1. Achalasia: a condition in which the lower esophageal sphincter muscle fails to relax properly, preventing food from passing into the stomach.
2. Diffuse esophageal spasm: a disorder characterized by uncoordinated contractions of the esophageal muscles, leading to difficulty swallowing and chest pain.
3. Nutcracker esophagus: a condition in which the esophageal muscles contract too forcefully, causing pain and difficulty swallowing.
4. Hypertensive lower esophageal sphincter: a disorder in which the lower esophageal sphincter muscle is too tight, making it difficult to swallow and leading to symptoms such as heartburn and regurgitation.
5. Ineffective esophageal motility: a condition in which the esophageal muscles have weak or disorganized contractions, leading to difficulty swallowing and other symptoms.
Esophageal motility disorders can be diagnosed through tests such as manometry, which measures the pressure and coordination of esophageal muscle contractions, or barium swallow studies, which use X-rays to visualize the movement of food through the esophagus. Treatment may include medications, lifestyle changes, or surgery, depending on the specific disorder and its severity.
Consent forms are documents used in medical settings to obtain a patient's voluntary and informed agreement to undergo a specific medical procedure, treatment, or participate in research. These forms typically outline the nature of the proposed intervention, its purpose, risks, benefits, alternatives, and any potential complications or side effects. The patient is provided with sufficient time and opportunity to ask questions, seek clarification, and discuss concerns with their healthcare provider before making a decision. By signing the consent form, the patient acknowledges that they have been fully informed about the proposed intervention and understand its implications. Consent forms serve as legal records of the patient's authorization for the medical procedure or treatment, protecting both the patient and the healthcare provider in case of any disputes or complications.
Informed consent is a process in medical care where patients are provided with all relevant information about their health status, proposed treatments, potential risks and benefits, and alternative options. This allows patients to make informed decisions regarding their healthcare and understand the consequences of their choices. The process includes ensuring that the patient has adequate mental capacity to make such decisions, is fully aware of the implications, and gives their voluntary agreement for the proposed treatment or procedure. It's a fundamental principle in medical ethics and is required by law in many jurisdictions to protect patients' rights.
Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.
Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.