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Difference between revisions of "1° Clinical case: Hemimasticatory spasm"

1° Clinical case: Hemimasticatory spasm (view source)

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Basically, given the compatibility and consistency of sentence {{:F:Imo}} (dental context) with the assertions derived from the clinical test reporting {{:F:Delta series}}, consistently say that Orofacial Pain is caused by a Temporomandibular Disorder could become incompatible if another set of clinical statements <math>(\gamma_1,\gamma_2,.....\gamma_n \ )</math> were consistent with sentence <math>\Im_n</math> (neurological context) and contextually opposite, from a diagnostic point of view, to {{:F:Imo}}<blockquote>Therefore, there would be a source of logistical conflict between the two specialist contexts with inevitable diagnostic delay, also polluting the decryption process of the signal in the machine language of the Central Nervous System (CNS).</blockquote>What will determine the access key for decoding the encrypted code in machine language (SNC) and will allow us to intercept a demarcation line will be an irrefutable clinical and / or laboratory data called {{:F:Tau}}, which will confirm or exclude the consistency of an assertion than the other. It is essential, at this point, a <math>\Im_d</math> sentence (demarcation sentence) of the type will be:  <blockquote>Does Mary Poppins have a neuromotor disorder or a Temporomandibular Disorder? </blockquote>We explain this step in detail:
Basically, given the compatibility and consistency of sentence {{:F:Imo}} (dental context) with the assertions derived from the clinical test reporting {{:F:Delta series}}, consistently say that Orofacial Pain is caused by a Temporomandibular Disorder could become incompatible if another set of clinical statements <math>(\gamma_1,\gamma_2,.....\gamma_n \ )</math> were consistent with sentence <math>\Im_n</math> (neurological context) and contextually opposite, from a diagnostic point of view, to {{:F:Imo}}<blockquote>Therefore, there would be a source of logistical conflict between the two specialist contexts with inevitable diagnostic delay, also polluting the decryption process of the signal in the machine language of the Central Nervous System (CNS).</blockquote>What will determine the access key for decoding the encrypted code in machine language (SNC) and will allow us to intercept a demarcation line will be an irrefutable clinical and / or laboratory data called {{:F:Tau}}, which will confirm or exclude the consistency of an assertion than the other. It is essential, at this point, a <math>\Im_d</math> sentence (demarcation sentence) of the type will be:  <blockquote>Does Mary Poppins have a neuromotor disorder or a Temporomandibular Disorder? </blockquote>We explain this step in detail:


Si ricordi che da '[[The logic of classical language - en|The logic of classical language]]' si evince :  
Remember that da '[[The logic of classical language - en|The logic of classical language]]' this shows :  


*A set of {{:F:Im}} sentences, and a <math>n\geq1</math> number of other <math>(\delta_1,\delta_2,.....\delta_n \ )</math> statements they are logically compatible if, and only if, the union between them <math>\Im\cup\{\delta_1,\delta_2.....\delta_n\}</math> it is consistent
*A set of {{:F:Im}} sentences, and a <math>n\geq1</math> number of other <math>(\delta_1,\delta_2,.....\delta_n \ )</math> statements they are logically compatible if, and only if, the union between them <math>\Im\cup\{\delta_1,\delta_2.....\delta_n\}</math> it is consistent
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File:EMG2.jpg|'''Figure 5:''' <math>\delta_2=</math> EMG interference pattern. Overlapping upper traces corresponding to the right masseter, lower to the left masseter.
File:EMG2.jpg|'''Figure 5:''' <math>\delta_2=</math> EMG interference pattern. Overlapping upper traces corresponding to the right masseter, lower to the left masseter.
</gallery>
</gallery>
</center>
</center>          


The sentence {{:F:Imo}} (dental context) with a number <math>n\geq1</math> of other logically compatible <math>(\delta_1,\delta_2,.....\delta_n \ )</math> assertions determine the union and coherence between them <math>\Im_o\cup\{\delta_1,\delta_2.....\delta_n\}</math> and are represented with a mathematical formalism to facilitate the diagnostic dialectic in the following way:             
The sentence {{:F:Imo}} (dental context) with a number <math>n\geq1</math> of other logically compatible <math>(\delta_1,\delta_2,.....\delta_n \ )</math> assertions determine the union and coherence between them <math>\Im_o\cup\{\delta_1,\delta_2.....\delta_n\}</math> and are represented with a mathematical formalism to facilitate the diagnostic dialectic in the following way:             
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Ora di conseguenza anche a frase <math>\Im_n</math> con un numero <math>n\geq1</math> di altre asserzioni <math>(\gamma_1,\gamma_2,.....\gamma_n \ )</math> logicamente compatibili determinano l'unione e coerenza tra di loro <math>\Im_n\cup\{\gamma_1,\gamma_2.....\gamma_n\}</math> e la rappresentazione formale ssarà simile a quella del contesto odontoiatrico:
Now consequently also sentence <math>\Im_n</math> with a number <math>n\geq1</math> of other logically compatible statements <math>(\gamma_1,\gamma_2,.....\gamma_n \ )</math> determine the union and coherence between them <math>\Im_n\cup\{\gamma_1,\gamma_2.....\gamma_n\}</math> and the formal representation will be similar to that of the dental context:




<math>\Im_n\cup\{\gamma_1,\gamma_2.....\gamma_n\}\rightarrow
<math>\Im_n\cup\{\gamma_1,\gamma_2.....\gamma_n\}\rightarrow
\Im_n\cup\{1,1.....1\}=1</math> con contestuale affermazione coerente della frase <math>\Im_n</math> in cui si sostiene che la sintomatologia della paziente Mary Poppins ha un causa neuromotorio e le conseguenze cliniche di tipo occlusali masticatorie non sono altro che una conseguenza del danno neuropatico.
\Im_n\cup\{1,1.....1\}=1</math> with contextual coherent affirmation of sentence <math>\Im_n</math> in which it is argued that the symptomatology of the patient Mary Poppins has a neuromotor cause and the clinical consequences of a masticatory occlusal type are nothing other than a consequence of the neuropathic damage.
 
{{Q2|In questo scenario ambedue le affermazioni <math>\Im_o </math> e <math>\Im_n </math> sono compatibili, coerenti e dunque vere fino a che non si trova un 'Demarcatore di coerenza' che abbiamo chiamato precedentemente 'τ'
.}}
 
==== Demarcatore di Coerenza <math>\tau</math>====
Il <math>\tau</math> è un rappresentativo peso specifico clinico, complesso da ricercare e mettere a punto perchè varia da disciplina a disciplina e per patologie, essenziale per non far collidere le asserzioni logiche  <math>\Im_o</math> e <math>\Im_n</math> nelle procedure diagnostiche e fondamentale per inizializzare la decriptazione del codice di comunicazione logica. Sostanzialmente permette di confermare la coerenza di una unione <math>\Im\cup\{\delta_1,\delta_2.....\delta_n\}</math> rispetto ad una altra <math>\Im\cup\{\gamma_1,\gamma_2.....\gamma_n\}</math> e viceversa, dando un peso maggiore alla gravità delle asserzioni e del referto nel contesto appropriato.  


A volte il medico si trova di fronte ad una serie di refertazioni positive a cui dare il giusto peso, deve considerare la positività di un referto che evidenzia, per esempio,  un rimodernamento osteoarticolare della ATM non può avere lo stesso peso di una positività di un referto che conferma un ritardo di latenza di un riflesso trigeminale.
{{Q2|In this scenario both the statements <math>\Im_o </math> and <math>\Im_n </math> are compatible, consistent and therefore true until a 'coherence marker' is found which we previously called <math>\tau</math>
}}


Il peso di demarcazione <math>\tau</math>, perciò, dà più significatività alle asserzioni più gravi nel contesto clinico da cui derivano e dunque al di là della positività delle asserzioni <math>\delta_n=1</math> oppure <math>\gamma_n=1</math> che comunque sono sempre verificate e rispettate, queste dovranno essere moltiplicate per un <math>\tau=[0|1]</math> dove lo <math>\tau=0</math> indica 'Gravità bassa'  mentre <math>\tau=1</math> 'Gravità severa' .
==== Coherence marker<math>\tau</math>====
The <math>\tau</math> is a representative clinical specific weight, complex to research and fine-tune because it varies from discipline to discipline and for pathologies, essential in order not to make logical assertions collide <math>\Im_o</math> and <math>\Im_n</math> in the diagnostic procedures and essential to initialize the decryption of the logic communication code. Basically it allows you to confirm the consistency of a union <math>\Im\cup\{\delta_1,\delta_2.....\delta_n\}</math> with respect to another <math>\Im\cup\{\gamma_1,\gamma_2.....\gamma_n\}</math> and vice versa, giving greater weight to the severity of the statements and the report in the appropriate context.


Nel contesto neurologico il <math>\tau</math> riguarda la presenza di ritardi e/o assenza in latenza del jaw jerk, durata e/o assenza del periodo silente masseterino oltre altri parametri che per il momento non è necessario descrivere. Un ritardo superiore al valore normativo oppure una assenza dei test sopracitati viene considerato come peso specifico grave ed assoluto corrispondente ad una valenza dominante rispetto all'altro contesto clinico.
Sometimes the physician is faced with a series of positive reports to which to give due weight, he must consider the positivity of a report that highlights, for example, an osteoarticular remodeling of the TMJ cannot have the same weight as a positivity of a report confirming a latency delay of a trigeminal reflex.  


Per ricapitolare abbiamo dunque:
The weight of demarcation <math>\tau</math>, therefore, gives more significance to the most serious assertions in the clinical context from which they derive and therefore beyond the positivity of the <math>\delta_n=1</math> or <math>\gamma_n=1</math> assertions which in any case are always verified and respected, these must be multiplied by a <math>\tau=[0|1]</math> where <math>\tau=0</math> indicates 'Low severity' while <math>\tau=1</math> 'High severity'. 
----


In the neurological context, <math>\tau</math> concerns the presence of delays and/or latency absence of the jaw jerk, duration and/or absence of the masseterine silent period as well as other parameters that for the moment it is not necessary to describe. A delay greater than the normative value or an absence of the aforementioned tests is considered as a serious and absolute specific weight corresponding to a dominant valence with respect to the other clinical context.


To recap we therefore have:


<math>\Im_o\cup \{( \bar{\delta_n)} \tau_o + \Im_n\cup\{( \bar{\gamma_n)}\  
<math>\Im_o\cup \{( \bar{\delta_n)} \tau_o + \Im_n\cup\{( \bar{\gamma_n)}\  
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</math>  
</math>  


dove
where


<math>\bar{\delta_n}=</math> media del valore delle asserzioni cliniche nel contesto odontoiatrico e dunque <math>\bar{\delta_n}=1</math>
<math>\bar{\delta_n}=</math> average of the value of clinical statements in the dental context and therefore <math>\bar{\delta_n}=1</math>


<math>\bar{\gamma_n}=</math> media del valore delle asserzioni cliniche nel contesto neurologico e dunque <math>\bar{\gamma_n}=1</math>
<math>\bar{\gamma_n}=</math> average of the value of clinical statements in the neurological context and therefore<math>\bar{\gamma_n}=1</math>
 
<math>\tau_o=0</math> low severity performance of the dental context
----


<math>\tau_o=0</math> refertazione di bassa gravità del contesto odontoiatrico


<math>\tau_n=1</math> refertazione di alta gravità del contesto neurologico
<math>\tau_n=1</math> refertazione di alta gravità del contesto neurologico
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