Lancet neurology
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Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. ⋯ Basic research is enabling the identification of different pathophysiological mechanisms, and clinical assessment of symptoms and signs can help to determine which mechanisms are involved in specific neuropathic pain disorders. Management of neuropathic pain requires an interdisciplinary approach, centred around pharmacological treatment. A better understanding of neuropathic pain and, in particular, of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effects of antihypertensive treatment after acute stroke in the Continue or Stop Post-Stroke Antihypertensives Collaborative Study (COSSACS): a prospective, randomised, open, blinded-endpoint trial.
Up to 50% of patients with acute stroke are taking antihypertensive drugs on hospital admission. However, whether such treatment should be continued during the immediate post-stroke period is unclear. We therefore aimed to assess the efficacy and safety of continuing or stopping pre-existing antihypertensive drugs in patients who had recently had a stroke. ⋯ The Health Foundation and The Stroke Association.
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Although the interaction between comorbidities and chronic diseases is strong, the effect of comorbidities receives little attention in many chronic diseases. In multiple sclerosis (MS), an increasing amount of evidence suggests that physical and mental comorbidities, and adverse health factors such as smoking and obesity, are common and can affect the disease. These comorbid diseases and lifestyle factors affect clinical phenotype, the diagnostic delay between symptom onset and diagnosis, disability progression, and health-related quality of life. ⋯ Studies of the frequency of comorbidities in patients with MS should be population based, incorporating appropriate comparator groups. These studies should expand the range of comorbidities assessed, and examine how the frequency of comorbidities is changing over time. Further research is needed to answer many other questions about comorbidities and their associations with MS, including the best way to measure and analyse comorbidities to understand these associations.
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Randomized Controlled Trial Multicenter Study
Methylprednisolone in combination with interferon beta-1a for relapsing-remitting multiple sclerosis (MECOMBIN study): a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial.
Interferon beta is commonly used to treat patients with relapsing-remitting multiple sclerosis; however, the treatment is only partially effective in reducing relapses and progression of disability. Corticosteroids are used to treat relapses in patients with multiple sclerosis. We therefore aimed to investigate the combination of cyclic methylprednisolone and interferon beta for the treatment of relapsing-remitting multiple sclerosis. ⋯ Biogen Idec.
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Randomized Controlled Trial Clinical Trial
Lamotrigine for neuroprotection in secondary progressive multiple sclerosis: a randomised, double-blind, placebo-controlled, parallel-group trial.
Partial blockade of voltage-gated sodium channels is neuroprotective in experimental models of inflammatory demyelinating disease. In this phase 2 trial, we aimed to assess whether the sodium-channel blocker lamotrigine is also neuroprotective in patients with secondary progressive multiple sclerosis. ⋯ Multiple Sclerosis Society of Great Britain and Northern Ireland.