A to Z of Medical Conditions

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Peripheral nerve block provides some with long-lasting pain relief for severe facial pain

Trigeminal neuralgia

Trigeminal neuralgia

A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

TGN is a condition involving sudden episodes of severe facial pain that significantly reduces quality of life in those affected. When medication fails to control the pain, some patients turn to

invasive procedures that require a high level of expertise and can result in long-standing numbness. Peripheral Trigeminal Nerve Blocks (PTNB), a procedure in which a numbing medication is injected at the sites where the problem nerve reaches the face, is a promising alternative to the riskier, ganglion-level procedures, although its efficacy in both short-term and long-term management of TGN has not been well studied.

In a case series in this week’s American Journal of Emergency Medicine, Michael Perloff, MD, assistant professor of neurology at Boston University School of Medicine, examines nine patients with TGN treated with PTNB. He finds that all nine had immediate relief of their pain after the procedure, with most reporting that they were pain-free. In addition, six of the nine patients noted continued pain relief from a range of one to eight months following the procedure, with two of them having complete resolution of their pain months after the injections.

Perloff, also a neurologist at Boston Medical Center, sees these results as a promising step for treating patients with TGN. “PTNB can be a simple, safe alternative compared to opioids, invasive ganglion level procedures or surgery.”

Posted on A to Z of Medical Conditions

How to relieve LEG CRAMPS naturally

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Hi Beauties! Have you ever had a leg cramp? It is the most painful thing to experience, and often happens unexpectedly in the most awkward places. This is why I have compiled a few useful tips and simple exercises to help you prevent and relieve LEG CRAMPS

Posted on A to Z of Medical Conditions

Acute flaccid myelitis: Five things to know

Acute flaccid myelitis

Acute flaccid myelitis

Acute flaccid myelitis, a syndrome with rapid muscle weakness in children, has been seen in hospitals in the United States and Canada this fall. A practice article in CMAJ (Canadian Medical Association Journal) https://soundcloud.com/cmajpodcasts/181442-five/s-ejyaBoutlines five things to know about this health issue:

  • Acute flaccid myelitis is characterized by rapid-onset muscle weakness, with patients presenting with weak limbs, pain and absent reflexes
  • Enteroviruses are the main cause of the disease in children
  • Urgent testing should be performed, including infectious workup and neuroimaging, and suspected cases should be reported to the Public Health Agency of Canada
  • Acute flaccid myelitis can progress rapidly and should be managed as a medical emergency
  • It often results in persistent health deficits 4-6 months after detection, with less than one-fifth of children making a full recovery, and 8%-14% needing assistive devices to walk or being completely dependent on caregivers.
Posted on A to Z of Medical Conditions

What is Klinefelter’s syndrome?

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Klinefelter’s syndrome is a genetic condition that only affects males. It is congenital, which means that the condition is present from birth. Klinefelter’s syndrome is one of the most common genetic disorders, affecting about one in 650 men, but it is believed that many men with Klinefelter’s syndrome are never diagnosed.

In this overview Professor Rob McLachlan discusses Klinefelter’s syndrome. He explains how it can present differently in each individual but a common feature is that all men with Klinefelter’s syndrome will have small testes.

Posted on A to Z of Medical Conditions

Urinary incontinence – signs, symptoms and treatments

Urinary incontinence

Urinary incontinence

Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people.There are several types of urinary incontinence, including:

stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh

urge incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards

overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking

total incontinence – when your bladder can’t store any urine at all, which causes you to pass urine constantly or have frequent leaking

It’s also possible to have a mixture of both stress and urge urinary incontinence.

Read about the symptoms of urinary incontinence.

When to seek medical advice

See your GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you shouldn’t feel embarrassed talking to them about your symptoms.

This can also be the first step towards finding a way to effectively manage the problem.

Urinary incontinence can usually be diagnosed after a consultation with your GP, who will ask about your symptoms and may carry out a pelvic examination (in women) or rectal examination (in men).

Your GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.

Read about diagnosing urinary incontinence.

Causes of urinary incontinence

Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.

Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.

Overflow incontinence is often caused by an obstruction or blockage to your bladder, which prevents it emptying fully.

Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a bladder fistula.

Certain things can increase the chances of urinary incontinence developing, including:

pregnancy and vaginal birth

obesity

a family history of incontinence

increasing age – although incontinence is not an inevitable part of ageing

Read about the causes of urinary incontinence.

Treating urinary incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms.

These may include:

lifestyle changes – such as losing weight and cutting down on caffeine and alcohol

pelvic floor exercises – exercising your pelvic floor muscles by squeezing them, taught by a specialist

bladder training – where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist

You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.

Medication may be recommended if you’re still unable to manage your symptoms.

Read about non-surgical treatments for urinary incontinence.

Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.

Surgical treatments for stress incontinence, such as sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.

Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Read about surgery and procedures for urinary incontinence.

Preventing urinary incontinence

It’s not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it developing.

These include:

controlling your weight

avoiding or cutting down on alcohol

keeping fit – in particular, ensuring that your pelvic floor muscles are strong

Healthy weight

Being obese can increase your risk of developing urinary incontinence. You may therefore be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.

Use the healthy weight calculator to see if you are a healthy weight for your height.

Get more information and advice about losing weight.

Drinking habits

Depending on your particular bladder problem, your GP can advise you about the amount of fluids you should drink.

If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.

The recommended weekly limits for alcohol consumption are 14 units for men and women.

A unit of alcohol is roughly half a pint of normal-strength lager or a single measure (25ml) of spirits.

Read more about drinking and alcohol.

If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.

Pelvic floor exercises

Being pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. If you’re pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence.

Read more about staying active during pregnancy.

Men may also benefit from strengthening their pelvic floor muscles with pelvic floor exercises.

Find out more about pelvic floor exercises.