l*h
发帖数: 4124 | 1 if 疼 is the only symptom, and it lasts so short, it should be a sharp pain.
such pain is usually neuralgia. the location you mentioned is at the
interface of the area innervated by trigeminal nerve (trigeminal neuralgia)
and the area innervated by C2-3 (occipital neuralgia). |
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y******7
发帖数: 17 | 2 The following is what I collected when I was a student doing capstone in a
local hospital. Not sure if it is useful.
Lidocaine topical is a amide-type local anesthetic. for production of
topical anesthesia, relief of pain associated with postherpetic neuralgia,
reduction of gagging during dental procedures, prevention and control of
urethral pain, anesthetic lubricant for endotracheal intubation, and relief
of hemorrhoidal pain.
Polyethylene glycol(Miralax) is a nonabsorbed solution used to trea... 阅读全帖 |
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g*2
发帖数: 658 | 3 刚刚去uptodate查了一下，输入“pepper"或 "chili", 出来的只有Cayenne。原来它就
是造Capsaicin的原料。好处还不少，有抗炎止痛， 促进心血管循环，促进消化。我也
是到了美国才发现，从国内来的几乎没有不吃辣的（除了我），以前我室友， 湖南来
的， 吃饭就是西兰花加上老干妈。好处很多，当然如果有消化道溃疡的要当心，而且
也会可能对其他药物有干扰，比如抗高血压药，因为会产生catecholamine儿茶酚胺.有
兴趣的可以看看。
Dosage and Standardization
Oral: 400 mg 3 times/day, standardized to contain ≥0.25% capsaicin content
per dose; may also be standardized to Scoville heat units, with 150,000
being average
Topical: Apply as directed by manufacturer
Reported Uses
Anti-inflammatory and ... 阅读全帖 |
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A*******s
发帖数: 9638 | 4 This is not trigeminal neuralgia but post- herpetic neuralgia. I emphasize
the difference because the localization for Gamma knife may be different.
Topical anesthetics could be beneficial besides oral medicines. |
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s*******y
发帖数: 2977 | 5 有网友给我发信问hsv I会不会母乳传染？其实我不是专家，也不是很清楚。不过我以
前压力大的时候曾得过，所以做了一番研究。
总起来说美国70%的人都有这个病毒，所以并不是什么大事情，如果你得了hsv I，就不
会再得II了。前者多生在唇、颈处，后者多生在隐私部位，可通过XXOO传染，所以从这
个角度来看，得了I也不时什么坏事情 :)
至于母婴传染，我的医生说只要不是在怀孕/哺乳期间爆发的话，就不会传染。
我重点想说的是：如果想避免这个病毒的爆发，一定要多多锻炼身体，增强自身的免疫
力。
现身说法吧，我曾经有一段时间，因为压力，吃饭都吃不下去，更别提锻炼身体了，结
果hsv I爆发。很不幸长在眼睛旁，当时弄得眼睛红肿，疼的都睁不开，医生说再严重
可能会致盲，吃了一周的抗病毒药，每次吃药肚子都隐隐作痛，可能是副作用吧！
后来虽然好了，却留下一种后遗症叫Post-Herpetic Neuralgia，就是神经性头疼，发
作时，每隔几秒钟，脑袋就被电击一下，你们能想象到那种疼痛吗？反正我之前以为头
疼这种小事根本不能算病，那次之后算是见识到了。医生说大概10%的人会有这个后遗
症，没想到让我碰 |
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f******I
发帖数: 769 | 6
better
have seen surgical decompression for trigeminal neuralgia |
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f******I
发帖数: 769 | 7
better
have seen surgical decompression for trigeminal neuralgia |
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b******8
发帖数: 24 | 8 probable Occipital neuralgia. May see Neurologist. there are some
medication help a great deal. |
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f******I
发帖数: 769 | 9
acyclovir 800mg 4-5 times a day for 7 to 10 days,
oral steroid might reduce the pain somewhat, but doesn't reduce post
herpetic neuralgia, which is something you have to worry about in several
weeks later, |
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l*h
发帖数: 4124 | 10 this doesn't sound like a sinusitis. it fits better with a branch cranial
neuralgia. in this case, small branches of CN V. meningeal branches could be
involved. |
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d*w
发帖数: 384 | 11 If it is formally diagnosed and failed drug therapy, consult with a
neurosurgeon. However, trigeminal neuralgia is considered a trivial disease
in China and very few neurologists/neurosurgeons want to touch it. |
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D*******y
发帖数: 189 | 12 A few top dental schools in China have trigeminal neuralgia clinic. Some are
very good. |
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a*****e
发帖数: 69 | 13 我父母有个朋友，得了带状疱疹后遗性神经痛病（一种顽固疾病），英文应该叫做”
postherpetic neuralgia”。在国内多家医院治疗，没什么好转。估计挺痛苦的。她想
让我打听一下，看美国有没有治疗这病的医院或良方。
如果你们或者有朋友了解这方面情况，请回复该贴或发信到我邮箱.。
不胜感谢！ |
|
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m**********r
发帖数: 2099 | 15 google trigeminal neuralgia to see if your symptoms fit |
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h***f
发帖数: 162 | 16 Your mother has trigeminal neuralgia. She needs microvascular decompression
surgery. Michael Lim at Johns Hopkins does 2 to 4 of these a week. You need
to go to Johns Hopkins. |
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h***f
发帖数: 162 | 17 Your mother has trigeminal neuralgia. She needs microvascular decompression
surgery. Michael Lim at Johns Hopkins does 2 to 4 of these a week. You need
to go to Johns Hopkins. |
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Y****r
发帖数: 3473 | 18 the strongest non-prescription drug is this guy:
"Cuprofen Maximum StrengthTablets" are for the relief of rheumatic, muscular
, dental and period pains and pain in backache, lumbago, fibrositis,
neuralgia, migraine and headache and for the symptomatic relief of colds,
flu and feverishness.
it is a condensed form of ibprofen so IN THEORY if you have trouble buy
cuprofen, you can find the amount of ibprofen in it and take the equivalence
in tylenol or advil |
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A*******s
发帖数: 9638 | 19 Occipital neuralgia. Not migraine. |
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b*s
发帖数: 82482 | 20 你比较不幸
The prevalence of postherpetic neuralgia in herpes zoster cases increases
with age, with a 14.7-fold higher prevalence in patients older than 50 years
compared with their younger counterparts
http://emedicine.medscape.com/article/218683-overview |
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l******k
发帖数: 27533 | 21 postherpetic neuralgia 就是后遗症的名字
你很幸运：）
但不是每个人都这样幸运的，得了就一辈子的痛了 |
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D*******a
发帖数: 1723 | 22 http://apps.who.int/medicinedocs/en/d/Js4926e/5.html
Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials
3. Diseases and disorders that can be treated with acupuncture
The diseases or disorders for which acupuncture therapy has been tested in
controlled clinical trials reported in the recent literature can be
classified into four categories as shown below.
1. Diseases, symptoms or conditions for which acupuncture has been proved-
through controlled trials-to be an effec... 阅读全帖 |
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p****n
发帖数: 9263 | 24 Adverse ReactionsBased upon normal doses for either indication or route. (
Adverse effects such as flushing, diarrhea, myalgia, and visual disturbances
may be increased with doses >100 mg/24 hours.)
>10%:
Central nervous system: Headache (16% to 46%)
Gastrointestinal: Dyspepsia (7% to 17%; dose related)
2% to 10%:
Cardiovascular: Flushing (10%)
Central nervous system: Insomnia (≤7%), pyrexia (6%), dizziness (2%)
Dermatologic: Erythema (6%), rash (2%)
Gastrointestinal: Diarrhea (3% to 9%), gastri... 阅读全帖 |
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b*******l
发帖数: 856 | 25 bless first!
根据楼主简单的描述，如果我是医生首先怀疑的就是 Atypical trigeminal neuralgia
，这个病症和第七对脑神经（面神经）关系似乎不太。俺没见到病人以及labtest，如
何导致的三叉神经病变就不好说了。再做个MR看看左侧内耳道，鼻窦什么的也未尝不可
。要真是三叉神经的问题，（我随便臆测的，因为这种情况太少见了）估计医生就只能
给你开点小剂量的抗癫痫药看看疗效了。 |
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A***i
发帖数: 1351 | 26 thanks.
很感谢您的分析. 左侧内耳道MIR没有作过,倒是做过一个鼻腔镜,什么都没有看出来.
现在有一个还不错的西医给我开了些药(但不是抗癫痫药),加上我妈妈给我按摩,刮痧,
症状缓解改善了很多,口腔内感觉已经恢复
我自己还是充满希望的,好的时候肯定上来报告.
neuralgia |
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n********n
发帖数: 2248 | 27 我不懂医学，只是即使是三叉神经的问题，西医的解决方式就是开抗癫痫药？要是我，
宁愿痛着也不会去服用，不知版上的有几位会去吃这个药？这让我想起一个朋友告诉我
的，她有个同事好几年了每到春夏膝关节就要肿痛一段时间，很痛影响走路的那种，去
看西医，查不出原因，就给止痛药，痛是缓解了，但病根没除，然后一年比一年严重
neuralgia |
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J**********i
发帖数: 925 | 28 An open study of botulinum-A toxin treatment of trigeminal neuralgia--E. J.
Piovesan
Thank you very much in advance |
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b*w
发帖数: 2062 | 29 some protective practice:
Documentation, documentation, documentation is key. We had a representation
from our malpractice carrier come out and review our charting. This was a
service they offered free of charge. She picked 10 random charts and read
through them, found no serious errors but made some suggestions about
wording or detail.
You need to document any patient complaints and your response to them. For
example, I documented my patient's pain and that she was not using the pain
medication... 阅读全帖 |
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b*w
发帖数: 2062 | 30 some protective practice:
Documentation, documentation, documentation is key. We had a representation
from our malpractice carrier come out and review our charting. This was a
service they offered free of charge. She picked 10 random charts and read
through them, found no serious errors but made some suggestions about
wording or detail.
You need to document any patient complaints and your response to them. For
example, I documented my patient's pain and that she was not using the pain
medication... 阅读全帖 |
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A*******s
发帖数: 9638 | 31 Case 2,
Is the symptom unilateral or bilateral? I suspect it might be radiculopathy,
or post-herpetic neuralgia.
Do a MRI of thoracic spine if it is unilateral.
Considering the cost issue, you may try Tegretol which is very cheap and
could be effective for this type pain. You need to monitor blood work for
safety. Lidoderm is too costly to him.
|
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A*******s
发帖数: 9638 | 32 不一定有rash， 或者可能忽视了， shingle的rash就几天， neuralgia可以很长时间。 |
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r*********s
发帖数: 1027 | 33 postherpetic neuralgia
Tx with TCA? |
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A*******s
发帖数: 9638 | 34 看来我们CMG比那几个美国医生都强啊， lol
shingle发病一个月，急性期的症状应该过去了， 后遗症疼痛可以非常严重，
postherpetic neuralgia是正确的诊断。
我觉得这么多医生看过这个病人， 居然没有一个说出正确诊断的， 这确实很悲哀。
他wife尤其对医生给他外敷药物和包扎感到不解， 前后两次， 还给抗生素。
这是一个常见病， 多发病， 任何非外科医生都可以诊断（不是歧视外科哈）。 关键
是你要亲眼看， 眼见为实， 特别是你一头雾水的时候。 Chest pain可能大多数是肋
软骨炎和GERD， 如果你多看一眼， shingle没准就是下一个诊断。 |
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A*******s
发帖数: 9638 | 35 我最近刚刚放弃allscript，转成Epic了， 据说是当今最好的EMR.
好处不用多说，我想说说我的担忧：
这个EMR从某种程度上是一个智能体，它潜移默化地影响你的每一个看病步骤，从病史
，到查体，再到诊断，然后就是治疗。 你如果有自己的想法，这个智能体不接受，你
就只能放弃。当然这个系统同时防止了你的出错。但不得不承认，它对每一个医生的影
响是深远的。
举一个例子：
头疼是一个常见症状，大多数情况，你不知道什么病因，所以可能有几个假设，比方说
migraine， cluster headache， trigeminal neuralgia，etc。传统的病历我们会把
这些可能性写下来， 然后说出自己对每个可能性的想法， 具体相应的方案是什么。
但在EMR里，你必须给出诊断。 你可以说headache，鉴别诊断你就需要另外写下来，而
写那些notes不是EMR所鼓励的，在billing也得不到任何credit。 一个好的H/P或
consult就是要看诊断分析，这是病历的灵魂， 在EMR却大大的弱化了。
不管你承认不承认， EMR喜欢和鼓励的就是一切从简，TIA就是TIA， 你要是... 阅读全帖 |
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f**********n
发帖数: 246 | 36 Gabapentine is not really usefully for the acute neuritis phase. Instead it
will help if it's post-herpatic neuralgia.
We usually should always first try with Tyleno and NSAIDs, then Percocet
kind of medication. Like Nabla said, we need to be cautious to use
Amitriptyline, especially with old patients. If any other medication I
mentions previously does not work, we may think of Amitriptyline. Most of
Dermatologist don't use Amitriptyline for zoster. |
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W********g
发帖数: 610 | 37 06/29/2012 Astellas Pharma Inc. ALPMY.PK, ALPMF.PK Mirabegron (NDA) FDA
decision on Mirabegron for proposed treatment of overactive bladder
-News
06/28/2012 Bristol-Myers Squibb Co. BMY ELIQUIS (NDA) FDA decision on
ELIQUIS for prevention of stroke and systemic embolism in patients with
atrial fibrillation
06/27/2012 Arena Pharmaceutical Inc. ARNA Lorcaserin (NDA) FDA decision on
Lorcaserin for proposed treatment of obesity
06/21/2012 Repligen Corp RGEN SecreFlo... 阅读全帖 |
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