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Conjunctival Injection (conjunctival + injection)

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Medical Sciences100%

Selected Abstracts

Impairment due to cannabis and ethanol: clinical signs and additive effects

ADDICTION, Issue 6 2010
Jørgen G. Bramness
ABSTRACT Aims Studies have shown that the impairing effects of ,-9-tetrahydrocannabinol (THC) are dose-related. Cannabis intake increases the risk of traffic accidents. The purpose of this study was to see how different clinical tests and observations were related to blood THC concentrations and to determine whether the combined influence of THC and ethanol was different from either drug alone. Design A retrospective cross-sectional forensic database study. Setting Drivers apprehended by the police suspected of driving under the influence of alcohol other drugs. Participants We investigated 589 cases positive for THC only. In addition, 894 cases with THC and ethanol were included. A comparison was made with 3480 drivers with only ethanol in their blood and 79 drivers who tested negative. Measurements Data were analytical results of blood samples and the 27 clinical tests and observations included in the Norwegian clinical test for impairment (CTI). Findings No relationship was found between blood THC concentration and most of the CTI tests. Blood THC concentration was, however, related to conjunctival injection, pupil dilation and reaction to light and to the overall risk of being judged impaired. When THC and ethanol were detected together the risk of being judged impaired was increased markedly. Conclusions This study demonstrates that cannabis impairs driving ability in a concentration-related manner. The effect is smaller than for ethanol. The effect of ethanol and cannabis taken simultaneously is additive. Conjunctival injection, dilated pupils and slow pupil reaction are among the few signs to reveal THC influence. [source]

SUNCT Responsive to Percutaneous Balloon Compression of the Gasserian Ganglion , 10-Year Follow-Up

HEADACHE, Issue 1 2010
Marcos Baabor MD
(Headache 2010;50:143-145) We report the case of a woman with short-lasting unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) whose severe headache attacks ceased after percutaneous balloon compression of the Gasserian ganglion. The patient remains pain free after 10-year follow-up. This may be the first literature report of SUNCT in Chile. [source]

Trigeminal Autonomic Cephalalgias: Current and Future Treatments

HEADACHE, Issue 6 2007

The trigeminal autonomic cephalgias include cluster headache, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). The evidence for the current treatment options for each of these syndromes is considered, including oxygen, sumatriptan, and verapamil in cluster headache, indomethacin in paroxysmal hemicrania, and intravenous lidocaine and lamotrigine in SUNCT. Some treatments such as topiramate have an effect in all of these, as well as in migraine and other pain syndromes. The involvement of the hypothalamus in functional imaging studies implies that this may be a substrate for targeting treatment options in the future. [source]

Hemicrania Continua Secondary to an Ipsilateral Brainstem Lesion

HEADACHE, Issue 3 2007
Marcelo M. Valença MD
We describe a 47-year-old woman with a 3-year history of a continuum mild-moderate right-side headache, with exacerbations, associated with stabbing volleys of pain on right orbit-temporal region (10/10) and right eye ptosis and lacrimation with conjunctival injection. The pain was completely abolished with indomethacin (100 mg per day). The diagnosis of hemicrania continua was made according to the International Headache Society (IHS) criteria. The headache presentation was precipitated by a stroke and a right-side brainstem lesion was present at magnetic resonance imaging. This case report shows anatomoclinical evidence of the involvement of brainstem structures on the pathophysiology of hemicrania continua. [source]

SUNCT Syndrome in Association With Persistent Horner Syndrome in a Chinese Patient

HEADACHE, Issue 3 2004
K. M. Prakash MD
This is the first case report of a chinese patient with SUNCT (shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) presenting with persistent Horner's syndrome. She had episodic, brief, right periorbital pain in association with ipsilateral eye injection, lacrimation and rhinorrhea as well as persistent ipsilateral miosis and ptosis. She had partial response to a combination of indomethacin and carbamazepine therapy. [source]

SUNCT Syndrome Responsive to Lamotrigine

HEADACHE, Issue 8 2002
Jose M. Gutierrez-Garcia MD
Background.,Short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection, tearing, rhinorrhea (SUNCT syndrome) is a headache form generally refractory to drug therapy. Occasional patients with SUNCT have been reported with a successful response to lamotrigine. Objective.,To report two patients with SUNCT treated with lamotrigine. Methods.,Clinical history, neurologic examination, and brain magnetic resonance imaging. Results.,Both patients with SUNCT syndrome were successfully treated with lamotrigine. In both cases, when lamotrigine was tapered off, the attacks reappeared, only to disappear when the dose was again increased. In addition, lamotrigine was well tolerated and no undesired side-effects were reported. Conclusion.,If the positive effect of lamotrigine in patients with SUNCT is confirmed in other cases, lamotrigine could become the first specific treatment for SUNCT syndrome. [source]

Headache induced by dopamine agonists prescribed for prolactinoma: think SUNCT!

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2006
A. J. Larner
Summary Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome may be associated with pituitary prolactinoma and may be induced by treatment of prolactinoma with dopamine agonists. Endocrinologists treating patients with prolactinoma need to be aware of this syndrome as its pathophysiology and treatment differ from that of other headache syndromes. [source]

Xeroderma pigmentosum with limited involvement of the UV-exposed areas: a case report

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2003
Mostafa Mirshams-Shahshahani MD
A 21-year-old woman with skin type IV, who had developed photophobia and brown, spotty, hyperpigmented lesions on her face from early childhood, presented to our center for treatment of her facial lesions. Examination on admission revealed numerous, freckle-like, hyperpigmented macules and actinic keratoses over the central part of the face, with sparing of the forehead, chin, and peripheral area (Fig. 1). The area involved was approximated to be around 2% of the total body surface. The dorsal parts of the hands showed no lesions (Fig. 2), but guttate hypomelanotic lesions were apparent on both forearms. Figure 1. Limitation of xeroderma pigmentosum lesions to the center of the face Figure 2. Hands are devoid of any lesions Histologic examination of biopsies from four different facial lesions revealed them to be keratoacanthoma (1.5 × 2.5 cm ulcerative nodule on the right cheek), sclerosing basal cell epithelioma (nasal lesion), lentigo simplex, and hypertrophic actinic keratosis. Corneal clouding, conjunctival injection, loss of lashes, and atrophy of the lids were apparent on ophthalmologic examination. Other parts of the physical examination, including examination of the oral cavity, were nonsignificant. In addition, except for the presence of mild eczema in a sibling, the patient's family history regarding the presence of any similar problem and also any other important dermatologic or general disorder was negative. [source]