The Clinical journal of pain
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Letter Case Reports
The term "chronic" with respect to pain should be dropped.
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The purpose of this review is to examine the accumulating evidence indicating that lamotrigine is effective in the treatment of neuropathic pain. ⋯ A review of the literature suggests that lamotrigine may be effective in the management of neuropathic pain.
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To determine the general risk and the prognostic factors of postherpetic neuralgia and focal sensory denervation in ophthalmic zoster disease. ⋯ The severity of acute skin rash, based on a specific manifestation of cutaneous herpes zoster eruptions, and the extent of infection to other neural pathways were clearly associated with postherpetic neuralgia and focal sensory denervation at a 2-month follow-up. These findings suggest that the inability of the immune system to control the spread of replicating varicella-zoster virus in the initial phase of the disease is an important factor in the pathogenesis of chronic zoster-related neuropathy.
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Twenty-seven clinical trials that evaluated the efficacy of acupuncture in the treat ment of primary headaches (migraine headache, tension-type headache, and mixed forms) were reviewed. In the majority of the trials (23 of the 27 trials), it was concluded that acupuncture offers benefits in the treatment of headaches. ⋯ Acupuncture methods need individualization, a carefully selected placebo ("minimal acupuncture" seems to be best), and the crossover design must have adequate time between the two treatment periods. Clinical trials that evaluate acupuncture frequently are characterized by several inadequacies (including some from these evaluating headaches), but it seems that additional clinical research is necessary to confirm its efficacy and to clarify its indications.
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The objective of this study was to determine if intractable pain from erythromelalgia could be successfully treated with intrathecal hydromorphone and clonidine. ⋯ Administration of intrathecal opioid and an alpha2-agonist can be effective in the treatment of the pain of erythromelalgia and offers an alternative pain treatment modality for patients with unremitting pain refractory to more conservative therapy.