Myofascial mimic of temporomandibular pain: differential diagnosis and treatment with combination therapy

Article Abstract:

Temporomandibular joint dysfunction is an abnormality of the temporomandibular joint or TMJ, which is located where the temple and mandible (lower jaw) meet. This disorder can cause severe pain in the neck, shoulders, face and jaw and limit movement at this joint, interfering with chewing and other normal activities. TMJ dysfunction is increasingly being recognized as a major health problem. Myofascial pain has symptoms similar to those of TMJ, but is not as well recognized. Pain is caused by localized areas of tissue damage in muscle fascia. These areas, called trigger points, become nonelastic and pain results when the muscles are used. This study examined the case of a patient with symptoms that initially indicated TMJ dysfunction, but turned out to be the result of myofascial-related causes. The patient suffered from severe pain on the left side of her head and neck. Close examination of the patient's history and a careful physical examination led to the determination that TMJ was not the cause of the pain, but that the pain had a myofascial origin. Combination therapy was prescribed for the patient, involving a pulsed, hi-volt current superimposed over pulsed ultrasound. This treatment causes localized contractions of muscle fibers. When the trigger points are stimulated, pain occurs and the points can be mapped. After the points are mapped, treatment can begin; the points are stimulated for 30 to 60 seconds. The patient was treated in this manner and received spinal adjustments as well. This case represents myofascial pain mimicking the symptoms of TMJ. This problem may occur more often than is thought and research is needed to examine this issue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Myofascial pain syndrome, Myofascial pain syndromes, Temporomandibular joint disorders

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Multiple sclerosis and imaging of the corpus callosum

Article Abstract:

The corpus callosum (CC) is a structure in the brain that connects nerves from the two brain hemispheres. It has been difficult to image or examine the CC because of its orientation, and thus abnormalities of the structure, as well as its involvement in diseases, are little understood. Magnetic resonance imaging (MRI) has been found useful in imaging the CC. It uses differences in the magnetic properties of various molecules to produce images that differentiate tissues and organs. Recent studies have used MRI to define differences in the CC in normal adults and those with multiple sclerosis (MS). MS is characterized by patches or plaques that form in the brain and on the spinal cord which result in tremor and paralysis. In the July 1991 issue of Radiology, an article by Gean-Marton et al. discusses the MRI findings of differences of the CC in patients with MS and in normal adults. MRI images from MS patients show abnormal signal intensities in the CC where it borders the septum pellucidum, another brain structure. The results of this study are significant, but whether they can be used to diagnose MS is still uncertain. Although their findings clearly show a difference in the CC of diagnosed MS patients, they do not indicate whether such findings would be seen in someone in the early stages of MS. The subjects in the study were examined long after their MS was diagnosed. If further studies can establish that CC abnormalities involving the septum pellucidum (as found by MRI) are an early indication of MS, then it can be a useful addition to the diagnostic criteria for MS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Magnetic resonance imaging, editorial, Corpus callosum

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Multiple sclerosis and early diagnosis: a literature review

Article Abstract:

Multiple sclerosis (MS) is a disease of the nervous system with symptoms resulting from the demyelination of the nerve cells. Demyelination involves the destruction of the myelin sheath, a fat-like substance that surrounds the nerve cell and is important in nerve function. The degeneration of the myelin sheath is thought to be caused by the body's own white blood cells, predominantly T lymphocytes and macrophages. Why this happens is still unclear, and autoimmune, viral, environmental, and genetic theories have been suggested. MS is difficult to diagnose because the clinical signs and symptoms are similar to other neurological disease processes, including syphilis, pernicious anemia, lupus, tumors and small cerebral infarctions. A definite diagnosis is not usually obtained until the later stages of the disease. Early symptoms usually include visual disturbances, speech difficulties, muscle numbness and tingling, fatigue, dizziness, incontinence, and pain in the joints. A list of nine functional categories which include these symptoms appears in this article. The symptoms usually develop slowly, and can subside and recur. A case study and the differential diagnoses are provided. It is important for the chiropractor to be familiar with MS because these symptoms are commonly seen in chiropractic practice. (Consumer Summary produced by Reliance Medical Information, Inc.)

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