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one or more of the following symptoms: sensation of a flu-like state, extreme fatigue or exhaustion, weakness of musculature, experiences of feverishness or perspiration, mood disturbances and / or irritability, memory difficulties, concentration problems, incoherent speech, congestion of nose or watery nose, itching eyes;
While fatigue is often prominent, it is "more than fatigue following a stressor". [6] Other symptoms that may occur during PEM include cognitive impairment, flu-like symptoms, pain, weakness, and trouble sleeping. [6] [4] Though typically cast as a worsening of existing symptoms, patients may experience some symptoms exclusively during PEM. [6]
Many pituitary tumors (25%) are found to have areas of hemorrhagic infarction on MRI scans, but apoplexy is not said to exist unless it is accompanied by symptoms. [1] [4] In some instances, lumbar puncture may be required if there is a suspicion that the symptoms might be caused by other problems (meningitis or subarachnoid hemorrhage).
Pituitary adenomas are tumors that occur in the pituitary gland. Most pituitary tumors are benign, approximately 35% are invasive and just 0.1% to 0.2% are carcinomas . [ 1 ] Pituitary adenomas represent from 10% to 25% of all intracranial neoplasms , with an estimated prevalence rate in the general population of approximately 17%.
A CT or MRI of the pituitary may also show the ACTH-secreting tumor if present. However, in 40% of Cushing's disease patients MRI is unable to detect a tumor. [8] In one study of 261 patients with confirmed pituitary Cushing's disease, only 48% of pituitary lesions were identified using MRI prior to surgery.
Joint instability and soft tissue injuries: Dislocations, subluxations, or damage to muscles, ligaments, tendons, synovium, or cartilage as a result of excessive joint movement. Chronic pain : Recurrent joint pain that can develop into hyperalgesia , with a higher rate of small fiber neuropathy in some individuals.
Other hormone-secreting cells of the pituitary undergo rapid growth in pregnant women as well, which contribute to the gland's enlargement. [10] The anterior pituitary is supplied by a low pressure portal venous system. [15] The anterior pituitary is more commonly affected in Sheehan's syndrome because of the structure of the portal venous system.
One study [25] found that infection was the cause of pain in four percent of nearly 300 people with cancer who were referred for pain relief. Another report described seven people with cancer, whose previously well-controlled pain escalated significantly over several days. Antibiotic treatment produced pain relief in all of them within three days.
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