Challenging Neuropathic Pain Syndromes

Get a quick, expert overview of the many key facets of neuropathic pain syndromes with this concise, practical resource by Drs. Mitchell Freedman, Jeff Gehret, George Young, and Leonard Kamen.

Author: Mitchell Freedman

Publisher: Elsevier Health Sciences

ISBN: 9780323496070

Category: Medical

Page: 350

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Get a quick, expert overview of the many key facets of neuropathic pain syndromes with this concise, practical resource by Drs. Mitchell Freedman, Jeff Gehret, George Young, and Leonard Kamen. This easy-to-read reference presents a summary of today’s best evaluation methods and evidence-based treatment options for complex regional pain syndrome as well as other challenging syndromes. Covers key topics such as: Evidence Based Approach to Many Uncommon and Difficult Neuropathic Pain Syndromes Review of Pathophysiology of Pain Approach to Chronic Pain Syndromes Work Up and Treatments for Complex Regional Pain Syndromes Consolidates today’s available information and experience in this multifaceted area into one convenient resource.

Neuropathic Pain

This book is essential reading for all pain specialists, neurologists, psychiatrists and anesthesiologists who wish to better understand their patients' neuropathic pain.

Author: Cory Toth

Publisher: Cambridge University Press

ISBN: 9781107470439

Category: Medical

Page: 384

View: 636

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Central or peripheral neuropathic pain can be caused by a wide range of injuries, infections and diseases such as: spinal cord injury, multiple sclerosis, stroke, herpes zoster, diabetes and cancer. Many of these pain syndromes are difficult to treat, representing a challenge for many neurologists not routinely trained in pain management. Written by an international team of experts in the field, Neuropathic Pain: Causes, Management and Understanding gives readers an in-depth understanding of the multitude of conditions causing neuropathic pain. Epidemiology, clinical diagnosis, pathophysiology, outcome measurement and the best evidence-based management of individual and general neuropathic pain conditions are also described in depth. A unique chapter, written from a patient's viewpoint, gives new insight into how chronic neuropathic pain affects the lives of those patients with the condition. This book is essential reading for all pain specialists, neurologists, psychiatrists and anesthesiologists who wish to better understand their patients' neuropathic pain.

SEARCHING OF RELIEF OF THE SENSORY SIGNS IN A POST ISCHEMIC PAIN MODEL IN RATS

Background and aims: Complex Regional Pain Syndrome (CRPS) is a painful, disabling and often chronic condition that usually develops after limb trauma, and it is accompanied by signs of inflammation and sensory, autonomic, and motor ...

Author: Paniagua Lora Antonieta

Publisher:

ISBN: OCLC:1163848781

Category:

Page:

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Background and aims: Complex Regional Pain Syndrome (CRPS) is a painful, disabling and often chronic condition that usually develops after limb trauma, and it is accompanied by signs of inflammation and sensory, autonomic, and motor disturbances. This pathology remains one of the most clinically challenging neuropathic pain syndromes.Our aim was to test if the co-administration of sub-analgesic doses of morphine and pregabalin induce antinociception in an animal model of CRPS.Methods: Male Wistar rats were used and the Post- Ischemia Pain model (CPIP) was developed by placing an O-ring around the distal ankle for 3 hours (Coderre et al., 2004). The development of mechanical allodynia and hyperalgesia was evaluated on days 7, 8 and 9 after the removing of the ring and in separate groups (n=6-10) the effect of the administration of morphine (0.3-5 mg/kg), pregabalin (10-80 mg/kg) or the co-administration of sub-analgesic doses of morphine and pregabalin were tested at day 8.Results: Rats developed mechanica l allodynia and mechanical hyperalgesia in the ipsilateral hindpaw from day 7. Morphine and pregabalin reduced these painful signs in a dose dependent manner. The combination of sub-analgesic doses of pregabalin (10-20 mg/kg) and morphine (1.3 mg/kg), significantly decreases the allodynia.Conclusions: The co-administration of small (sub -analgesic) doses of these drugs was effective to treat the allodynia which is often resistant to treatment. Since the doses used are small, it is expected that the side effects occur with less intensity.Acknowledgment: SAF2012-40075-C02-01, Lab Dr Esteve SA.

Challenging Pain Syndromes An Issue of Physical Medicine and Rehabilitation Clinics of North America

This issue of Physical Medicine and Rehabilitation Clinics of North America is devoted to "Difficult to Treat Pain Syndromes," and is edited by Adam L. Schreiber, DO of the Jefferson Medical College of Thomas Jefferson University.

Author: Adam L. Schreiber

Publisher: Elsevier Health Sciences

ISBN: 9780323297240

Category: Medical

Page: 838

View: 523

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This issue of Physical Medicine and Rehabilitation Clinics of North America is devoted to "Difficult to Treat Pain Syndromes," and is edited by Adam L. Schreiber, DO of the Jefferson Medical College of Thomas Jefferson University. Articles in this issue will include: Carpal Tunnel Syndrome Diagnosis; Non-surgical Treatment of Carpal Tunnel Syndrome; Parsonage Turner Syndrome Diagnosis and Treatment; Trochanteric Pain Syndrome Diagnosis and Treatment; Complex Regional Pain Syndrome Diagnosis and Treatment; Discogenic Spine Pain Syndrome Diagnosis and Treatment; Failed Back Surgery Syndrome Diagnosis and Treatment; Myofascial Pain Syndrome Diagnosis and Treatments; Opioid Syndrome Diagnosis and Treatment; Spinal Cord Pain Syndrome Diagnosis and Treatment; Cerebral Vascular Accident Hemishoulder Pain Syndrome Diagnosis and Treatment; and Cancer Pain Syndromes.

INTEGRATIVE MEDICINE APPROACH TO NEUROPATHIC PAIN TREATMENT EFFECTIVE PAIN CONTROL WITH PHARMACOTHERAPY AND ACUPUNCTURE

Integrative medicine approach to neuropathic pain treatment u2013 effective pain control with pharmacotherapy and acupunctureKocot-Ku0119pska M, Dobrogowski J, Zaju0105czkowska R, Wordliczek J, Przeklasa-Muszyu0144ska A.AimThe aim of this ...

Author: Jan Dobrogowski

Publisher:

ISBN: OCLC:1163836472

Category:

Page:

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Integrative medicine approach to neuropathic pain treatment u2013 effective pain control with pharmacotherapy and acupunctureKocot-Ku0119pska M, Dobrogowski J, Zaju0105czkowska R, Wordliczek J, Przeklasa-Muszyu0144ska A.AimThe aim of this paper is to present effective pain control with combination of standard antineuropathic analgesics and acupuncture in patient with severe neuropathic pain following traumatic left brachial plexus avulsion. Neuropathic pain after brachial plexus avulsion is one of the most challenging neuropathic pain syndromes for clinicians, mainly due to complex pathogenesis (peripheral and central component) and lack of satisfactory treatment. Standard antineuropathic drugs are effective in less than 50% patients, intervention techniques are not easily available, thus the integrative medicine approach may be beneficial in certain clinical situations.Case historyThe male patient AB, aged 47, had in 2012 a motorcycle accident with polytrauma (brain injury, left brachial plexus avulsion, multiple bone fractures). In 2018 patient was referred to Pain Clinic in Kraku00f3w due to severe, intractable pain of left upper limb.Pain characteristics:u2022tConstant pain (NRS 5) with paroxysms (NRS 10) 10-15 times per day u2022tParoxysms evoked by emotional stress and cold Clinical examination of left upper limb revealed trophic changes of skin, muscle atrophy and weakness, sensory abnormalities u2013 decreased touch and cold sensations.Clinical diagnosis u2013 neuropathic pain due to left brachial plexus avulsionPatient reported that nothing relieved the pain and the pain negatively influenced daily activities.Before referral to Pain Clinic patient was treated with amitriptiline (50 mg OD) and gabapentin (600 mg TID), but ineffectively.Treatment applied in Pain Clinic:1.tIncrease in doses of amitriptyline (75 mg OD) and gabapentin (800 mg TID) u2013 increased doses were not effective, additionally induced side effects, but tapering off resulted in pain exacerbation2.tIntravenous infusions of lidocaine 5 mg/kg OD u2013 not effective 3.tTapentadol 100 mg BID u2013 partially effective, 20% pain relief of pain paroxysms, no AE4.tAcupuncture u2013 30% pain relief (constant and paroxysmal), but only during needle application in HeGu (LI4) pointTreatment continuation:u2022tAmitriptiline 50 mg OD, gabapentin 600 TID, tapentadol 100 mg BIDu2022tacupuncture with semi-permanent needles (Pyonex) inserted in HeGu point (5 days on, 2 days off) u2013 needle application performed by the patient trained by acupuncturist from Pain Clinicu2022tPhysiotherapyResults Clinical outcome:u2022tMild constant pain, not interfering with daily activities u2013 maximum NRS 3u2022t50% less pain paroxysms, less intensity of paroxysms (NRS 6)u2022tBetter functioning at home and better general well-being (patientu2019s self-report)u2022tNo tolerance to analgesic effect of acupuncture observedConclusionsIn clinical settings, especially in patients with intractable, severe pain of neuropathic origin, integrative medicine approach should be always considered, and may result in better pain control and better patientsu2019 well-being. Acupuncture may be recommended due to its low invasiveness, low costs, but high safety and patientsu2019 acceptance.

Neurological Rehabilitation

Neuropathic pain is a clinical entity that presents unique diagnostic and therapeutic challenges.

Author: Eric Kerstman

Publisher: Elsevier Inc. Chapters

ISBN: 9780128078044

Category: Medical

Page: 680

View: 586

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Neuropathic pain is a clinical entity that presents unique diagnostic and therapeutic challenges. This chapter addresses the classification, epidemiology, pathophysiology, diagnosis, and treatment of neuropathic pain syndrome. Neuropathic pain can be distinguished from nociceptive pain based on clinical signs and symptoms. Although neuropathic pain presents a significant burden to individuals and society, a more accurate assessment of resource utilization, costs, and impairments associated with neuropathic pain would facilitate appropriate planning of healthcare policies. The underlying pathophysiology of neuropathic pain is not well defined. Several theories regarding the mechanism of neuropathic pain have been proposed, including central and peripheral nervous system sensitization, deafferentation, neurogenic inflammation, and the wind up theory. Neuropathic pain is a clinical diagnosis and requires a systematic approach to assessment, including a detailed history, physical examination, and appropriate diagnostic testing. The mainstay of treatment for neuropathic pain is pharmacological, including the use of antidepressants, antiepileptics, topical anesthetics, and opioids. Nonpharmacological treatments include psychological approaches, physical therapy, interventional therapy, spinal cord stimulation, and surgical procedures. Neuropathic pain is difficult to treat, but a combination of therapies may be more effective than monotherapy. Clinical practice guidelines provide an evidence-based approach to the treatment of neuropathic pain.

Neuropathic Pain

This book overcomes these barriers and integrates all the critical elements around individual patient care into a coherent management strategy that is practical and applicable to daily clinical practice.

Author: Jianguo Cheng

Publisher: Oxford University Press

ISBN: 9780190298357

Category: Medical

Page: 456

View: 121

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Neuropathic pain is one of the most common, most debilitating, most costly, and most difficult to treat categories of chronic pain conditions that are characterized by a lesion or disease of the somatosensory nervous system. Managing neuropathic pain is challenging and requires skillful assessment and comprehensive and integrated treatment strategies that are mechanism-guided, evidence-based, and individualized. However, these critical and integral elements are very fragmented in the current literature. The mechanistic understanding of neuropathic pain is typically found in basic research articles. Clinical research evidence is presented in forms of clinical trials with emphasis on minimizing biases such as those from patient selection and assessment. Individualized considerations for each patient are usually presented in case reports and problem-based learning discussions. This book overcomes these barriers and integrates all the critical elements around individual patient care into a coherent management strategy that is practical and applicable to daily clinical practice. Rather than compiling what have been published in the literature, this work emphasizes on identifying and highlighting the key points or findings that guide decision-making in clinical practice. It integrates the key points around a typical case scenario that not only represents the core of the diagnostic and therapeutic processes but also allows introduction and differentiation of painful conditions that bare similarities with the case in hand. The overarching goal is to improve clinical outcomes through better understanding of the mechanisms, more accurate diagnosis, and wiser and more comprehensive treatment strategies.

Atlas of Uncommon Pain Syndromes

Recognize the visual manifestations of pain with help from nearly 400 vivid illustrations-more than 100 new to this edition, many in color-depicting the physical symptoms and anatomy of each pain site, and diagnostic images demonstrating ...

Author: Steven D. Waldman

Publisher: Elsevier Health Sciences

ISBN: 9781455709991

Category: Medical

Page: 371

View: 846

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Obtain optimal diagnostic results from the field's foremost pain expert! Noted authority Steven D. Waldman, MD, JD, offers complete, concise, and highly visual guidance on the diagnosis of more than 100 uncommon pain syndromes less frequently encountered in daily practice. Vivid illustrations depict the physical symptoms and anatomy of each pain site as well as key imaging findings involving techniques such as MRI, CT, and conventional radiograph. It's the effective, easy-access resource you need to evaluate uncommon pain syndromes and sharpen your diagnostic skills. Uses a consistent format to explore each pain syndrome, progressing through diagnostic codes . signs and Accurately diagnose and treat uncommon pain syndromes by following a step-by-step approach that progresses from signs and symptoms through physical findings, laboratory and radiographic testing, treatment options, and clinical pearls. Recognize the visual manifestations of pain with help from nearly 400 vivid illustrations-more than 100 new to this edition, many in color-depicting the physical symptoms and anatomy of each pain site, and diagnostic images demonstrating key findings from MRI, CT, and conventional radiography. Effectively apply the latest techniques and approaches with complete updates throughout including new chapters on SUNCT Headache, Primary Thunderclap Headache, Hypnic Headache, Nummular Headache, Atypical Odontalgia, Burning Mouth Syndrome, Nervus Intermedius Neuralgia, Red Ear Syndrome, Clival Chordoma Syndrome, Glomus Tumor of the Shoulder, Osteonecrosis of the Elbow Joint, Driver's Elbow, Boxer's Knuckle, Trigger Wrist, Superior Cluneal Nerve Entrapment Syndrome, Clitoral Priapism, Breaststroker's Knee, Glomus Tumor of the Knee, and Fabella Syndrome. Quickly and easily find the information you need thanks to highly templated chapters. Confidently overcome the clinical challenges you're likely to face with well-rounded guidance from this companion volume to Dr. Waldman'sAtlas of Common Pain Syndromes, 3rd Edition. Access the complete text and illustrations online at expertconsult.com, fully searchable. Features updated chapters throughout, and 19 new chapters to keep you abreast of the conditions presenting in today's practice. Presents over 350 illustrations-175 in full color and more than 100 new to this edition-as well as x-rays, CTs, and MRIs, helping you to confirm your diagnoses and confidently implement techniques. Brand new chapters include: SUNCT Headache Primary Thunderclap Headache Hypnic Headache Nummular Headache Atypical Odontalgia Burning Mouth Syndrome Nervus Intermedius Neuralgia Red Ear Syndrome Clival Chordoma Syndrome Glomus Tumor of the Shoulder Osteonecrosis of the Elbow Joint Driver's Elbow Boxer's Knuckle Trigger Wrist Superior Cluneal Nerve Entrapment Syndrome Clitoral Priapism Breaststroker's Knee Glomus Tumor of the Knee Fabella Syndrome

Evaluation of the Efficacy of Lignocaine in the Treatment of Pain Associated with Diabetic Neuropathy

Pain is a common and disturbing symptom of diabetic peripheral neuropathy which affects between 50-80 percent of the diabetic population.

Author: Vanessa Viola

Publisher:

ISBN: OCLC:271604986

Category: Diabetes

Page: 154

View: 592

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Pain is a common and disturbing symptom of diabetic peripheral neuropathy which affects between 50-80 percent of the diabetic population. Neuropathic pain is one of the most difficult to treat of the chronic pain syndromes and frequently proves unresponsive with conventional therapies. The cause of neuropathic pain is thought to arise spontaneous ectopic discharge from the affected nerve fibres (Mao & Chen, 2000). These ectopic discharges are aberrant action potentials conducted via the activation of sodium channels (Kim & Chung, 1992; Bennet & Xie, 1988).

Handbook of Pain Surgery

Key Highlights The use of spinal cord stimulation in the management of failed back surgery syndrome The pros and cons of nerve surgery for peripheral neuropathic pain An overview on intrathecal analgesic therapies including patient ...

Author: Kim J. Burchiel

Publisher: Thieme

ISBN: 9781626238725

Category: Medical

Page: 400

View: 161

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Functional neurosurgery has experienced unprecedented capabilities because of technological advances in neuroimaging, basic sciences, and increasingly sophisticated therapeutic interfaces. Intractable pain syndromes are among the most prevalent conditions, yet represent one of the most challenging areas of neurosurgery. Handbook of Pain Surgery, edited by esteemed functional neurosurgeon Kim J. Burchiel, explores the science and art of treating patients with intractable pain. The succinct text and videos provide a compact, reader-friendly guide on this unique neurosurgical subspecialty. Ten chapters on craniofacial pain encompass standard and newer approaches for the treatment of trigeminal neuralgia, including microvascular decompression, rhizotomy, neurectomy, stereotactic neurosurgery, percutaneous radiofrequency, percutaneous retrogasserian glycerol rhizolysis, and percutaneous balloon compression. Other sections detail spinal cord and peripheral nerve stimulation techniques, nonsurgical approaches, and destructive procedures such as dorsal rhizotomy and dorsal root ganglionectomy, CT-guided-cordotomy, and midline myelotomy. Key Highlights The use of spinal cord stimulation in the management of failed back surgery syndrome The pros and cons of nerve surgery for peripheral neuropathic pain An overview on intrathecal analgesic therapies including patient selection and implant techniques Innovative treatments for intractable pain such as dorsal root entry zone (DREZ) lesioning More than 130 superb color illustrations by Andy Rekito elucidate pain syndromes and procedures Videos posted in the Thieme MediaCenter provide further guidance on select surgical techniques Highly portable and affordable, this book is an ideal reference for hospitals rounds. It is essential reading for neurosurgical residents, fellows, and practicing neurosurgeons, in particular, those specializing in treating spinal, peripheral nerve, and craniofacial pain syndromes.