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Biomedical subjects

G J Mulford

Publications and source records attributed to G J Mulford.

4 recordsLinked to original sources

Iatrogenic trigeminal sensorimotor neuropathy resulting from local anesthesia: a case report.

Trigeminal neuropathy resulting from local anesthetic injection has not been reported in the literature. We present a 49-year-old man with 8 months of unilateral facial sensorimotor deficits in the distribution of the trigeminal nerve, following a local anesthetic injection. His medical history was significant for resection of an ipsilateral tongue carcinoma 4 years earlier with only postsurgical dysarthria and no other neurologic deficits. Magnetic resonance imaging of the head and face showed postsurgical changes and ipsilateral atrophic muscles of mastication without evidence of infection or tumor recurrence. Electrodiagnostic evaluation revealed prolonged ipsilateral R1, ipsilateral and contralateral R2 responses of the blink reflex, and neurogenic electromyographic changes in ipsilateral masseter and temporalis muscles, consistent with ipsilateral trigeminal nerve injury. Although trigeminal neuropathies from various etiologies have been reported, this unique case offers another etiology to consider: iatrogenic trigeminal neuropathy secondary to local anesthetic injection.

Anesthesia, Local↗

Ballroom dancing and cervical radiculopathy: a case report.

Dance injuries associated with cervical radiculopathy have not been described in the literature. This report describes the case of an international-style ballroom dancer who developed a cervical radiculopathy as a result of frequent lateral rotation and hyperextension of the cervical spine during dancing. The patient's symptoms and signs suggestive of a left C7 radiculopathy were confirmed and documented by both magnetic resonance imaging and electrodiagnostic testing. The patient was treated conservatively with activity modification, nonsteroidal anti-inflammatory drugs, and alternative medicine approaches, including herbs and acupuncture. Her neck pain and cervical radicular symptoms declined in severity, but continued even 4 1/2 months after the onset of her symptoms. She did not wish to try steroids either through an oral or epidural route and refused surgical intervention. This case report illustrates an unconventional manner in which a left cervical radiculopathy was clinically produced. The neck motions and positions of frequent hyperextension and lateral rotation demonstrated by this ballroom dancer simulated a pattern and sequence of movements that promoted the development of signs and symptoms of a left cervical radiculopathy.

Acupuncture Therapy↗

Extracorporeal photochemotherapy in progressive systemic sclerosis.

BACKGROUND: Extracorporeal photochemotherapy, an immune-modulating form of therapy, has been shown to be effective in the treatment of autoimmune diseases. We evaluated the effects of extracorporeal photochemotherapy in the treatment of patients with progressive systemic sclerosis (PSS). METHODS: Nine patients with active progressive systemic sclerosis were treated with extracorporeal photochemotherapy on 2 successive days monthly. The duration of therapy ranged from 6 to 21 months. RESULTS: A significant improvement was noted in the skin, musculoskeletal system, functional index, and symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, and arthralgias, as well as improvement of cutaneous ulcers. Stabilization of the pulmonary function studies was also noted in the majority of patients over the course of therapy. No serious side effects were noted throughout the course of therapy in the 9 patients. CONCLUSIONS: The results suggest that photopheresis may be beneficial in selected early cases of progressive systemic sclerosis.

Activities of Daily Living↗