Neuropathic pain

2016 ◽  
Author(s):  
Sathiji Nageshwaran ◽  
Heather C Wilson ◽  
Anthony Dickenson ◽  
David Ledingham
Keyword(s):  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Diabetic Neuropathy ◽  
Clinical Features ◽  
Phantom Pain ◽  
Evidence Based ◽  
Post Herpetic Neuralgia ◽  
Central Neuropathic Pain ◽  
Pain Syndromes

This chapter on neuropathic pain discusses the classification, clinical features, and evidence-based management of major neuropathic pain syndromes (painful polyneuropathy, diabetic neuropathy, post-herpetic neuralgia, HIV neuropathy, cancer neuropathic pain, phantom pain, traumatic neuropathic pain, chronic radiculopathy, central neuropathic pain, and trigeminal neuralgia).

Ketamine for acute and subacute pain in opioid-tolerant patients

2018 ◽  
Vol 4 (3) ◽  
pp. 173 ◽  
Author(s):  
Shoshana Chazan, RN ◽  
Margaret P. Ekstein, MD ◽  
Nissim Marouani, MD ◽  
Avi A. Weinbroum, MD
Keyword(s):  
Neuropathic Pain ◽  
Epidural Analgesia ◽  
Severe Pain ◽  
Bone Pain ◽  
Phantom Pain ◽  
Chronic Ischemia ◽  
Central Neuropathic Pain ◽  
Pain Syndromes ◽  
Metastatic Bone Pain ◽  
New Onset

Prolonged acute pain, especially that of oncologic neurological origin, is at times difficult to control; it is seldom entirely alleviated by opioids. We report eight patients with severe pain, three of whom suffered from new onset oncologic metastatic bone pain, others had previous pain syndromes and presented with exacerbation of pain. Pain was associated with hyperalgesia and allodynia phenomena in two patients and with phantom pain in a third one. Tolerance to opioids had developed, and high IV doses of morphine, meperidine or fentanyl, and patient-controlled intravenous and epidural analgesia were insufficient. Several patients became dependent on opioids and could not be weaned from assisted ventilation.Pain was controlled with decreasing adjunct doses of ketamine. Within 5-10 days of ketamine and opioid protocols, pain was controlled and after an additional 5-7 days, ketamine could be stopped and pain controlled on oral regimens compatible with outpatient care.Ketamine is an efficient adjuvant analgesic for intractable severe pain, caused by metastasis, trauma, chronic ischemia, or central neuropathic pain. It is effective even when mega doses of IV, epidural, or oral opioids prove ineffective and when signs of tolerance have developed.

scholarly journals Pain in Multiple Sclerosis: Understanding Pathophysiology, Diagnosis, and Management Through Clinical Vignettes

2022 ◽  
Vol 12 ◽  
Author(s):  
Michael K. Racke ◽  
Elliot M. Frohman ◽  
Teresa Frohman
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Disease Course ◽  
Central Neuropathic Pain ◽  
Muscular Pain ◽  
Clinical Vignettes ◽  
Pain Syndromes

Neuropathic pain and other pain syndromes occur in the vast majority of patients with multiple sclerosis at some time during their disease course. Pain can become chronic and paroxysmal. In this review, we will utilize clinical vignettes to describe various pain syndromes associated with multiple sclerosis and their pathophysiology. These syndromes vary from central neuropathic pain or Lhermitte's phenomenon associated with central nervous system lesions to trigeminal neuralgia and optic neuritis pain associated with nerve lesions. Muscular pain can also arise due to spasticity. In addition, we will discuss strategies utilized to help patients manage these symptoms.

scholarly journals Neuralgias of the Trigeminal Nerve

2000 ◽  
Vol 5 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Allan S Gordon
Keyword(s):  
Neuropathic Pain ◽  
Differential Diagnosis ◽  
Trigeminal Neuralgia ◽  
Clinical Features ◽  
Trigeminal Nerve ◽  
Postherpetic Neuralgia ◽  
Facial Pain ◽  
The Other ◽  
Atypical Facial Pain ◽  
Trigeminal Neuropathic Pain

Practitioners are often presented with patients who complain bitterly of facial pain. The trigeminal nerve is involved in four conditions that are sometimes mixed up. The four conditions - trigeminal neuralgia, trigeminal neuropathic pain, postherpetic neuralgia and atypical facial pain - are discussed under the headings of clinical features, differential diagnosis, cause and treatment. This article should help practitioners to differentiate one from the other and to manage their care.

scholarly journals What do general neurologists need to know about neuropathic pain?

2009 ◽  
Vol 67 (3a) ◽  
pp. 741-749 ◽  
Author(s):  
Pedro Schestatsky ◽  
Osvaldo José M. Nascimento
Keyword(s):  
Neuropathic Pain ◽  
Somatosensory System ◽  
Relevant Information ◽  
Diagnostic Tools ◽  
Post Herpetic Neuralgia ◽  
Therapeutic Approaches ◽  
Pain Syndromes ◽  
Cord Injury ◽  
Common Causes ◽  
Nociceptive Pathway

Neuropathic pain (NP) is defined as pain caused by lesion or dysfunction of the somatosensory system, as a result of abnormal activation of the nociceptive pathway (small fibers and spinothalamic tracts). The most common causes of this syndrome are the following: diabetes, post-herpetic neuralgia, trigeminal neuralgia, stroke, multiple sclerosis, spinal cord injury, HIV infection, cancer. In the last few years, the NP has been receiving special attention for two main reasons: (1) therapeutical refractoriness of a variety of pain syndromes with predominant neuropathic characteristics and (2) the development of diagnostic tools for neuropathic pain complaints. The present review article provides relevant information on the understanding and recognition of NP, as well as evidence-based therapeutic approaches.

Adjuvants

2016 ◽  
Author(s):  
Richard D.W. Hain ◽  
Satbir Singh Jassal
Keyword(s):  
Neuropathic Pain ◽  
Bone Pain ◽  
Muscle Spasm ◽  
Evidence Based ◽  
Pain Syndromes ◽  
Selection Of

An adjuvant is not analgesic but is capable of relieving pain in certain specific pain situations. Selection of an appropriate adjuvant is a key element of a rational and evidence-based approach to management of pain in children. It depends on the diagnosis of the type of pain, considered in this chapter in relation to the selection of a suitable adjuvant, based on recognizing the nature of the pain to be treated. Adjuvants for specific types of pain, including neuropathic pain, bone pain, muscle spasm, and cerebral irritation, and pain syndromes are discussed in detail, with information provided on symptoms and management.

Transcranial Direct Current Stimulation for the Management of Neuropathic Pain: A Narrative Review

2021 ◽  
Vol 24 (6) ◽  
pp. E771-E781
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Phantom Pain ◽  
Direct Current Stimulation ◽  
Cord Injury

BACKGROUND: Neuropathic pain (NP) is common and often resistant to conventional analgesics. Among different types of noninvasive brain stimulation techniques, transcranial direct current stimulation (tDCS) has been widely used to mitigate pain in patients with NP. OBJECTIVE: The aim of this study was to review the effects of tDCS on the management of various types of NP. STUDY DESIGN: Narrative review. METHODS: A PubMed search was conducted for articles published until October 1, 2020, using tDCS to treat NP. The key search phrase, transcranial direct current stimulation and pain, was used to identify potentially relevant articles. The following inclusion criteria were applied for article selection: (1) studies involving patients with NP and (2) studies that used tDCS to treat NP. Review articles were excluded from the analysis. RESULTS: A total of 524 potentially relevant articles were identified. After reading the titles and abstracts and assessing eligibility based on the full-text articles, 34 publications were included in our review. Overall, our results suggest that tDCS induced pain reduction in patients with NP due to stroke or spinal cord injury, multiple sclerosis, or trigeminal neuralgia. There is insufficient evidence to validate the efficacy of tDCS for treating other painful conditions, such as complex regional pain syndrome, phantom pain, or NP of various origins. LIMITATIONS: The review did not include studies indexed in databases other than PubMed. CONCLUSION: The results of the included studies suggest that tDCS may be beneficial in treating patients with NP due to stroke, spinal cord injury, multiple sclerosis, and trigeminal neuralgia. Further studies are recommended to validate the efficacy of tDCS in treating other types of NPs. KEY WORDS: Transcranial direct current stimulation, neuropathic pain, central post-stroke pain, spinal cord injury, multiple sclerosis, complex regional pain syndrome, phantom pain, trigeminal neuralgia

Effects of Gabapentin on the Different Components of Peripheral and Central Neuropathic Pain Syndromes: A Pilot Study

1998 ◽  
Vol 40 (4) ◽  
pp. 191-200 ◽  
Author(s):  
Nadine Attal ◽  
Louis Brasseur ◽  
Fabrice Parker ◽  
Marcel Chauvin ◽  
Didier Bouhassira
Keyword(s):  
Neuropathic Pain ◽  
Pilot Study ◽  
Central Neuropathic Pain ◽  
Pain Syndromes
Sign in / Sign up

Export Citation Format

Share Document