Der Schmerz
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Progressive muscle relaxation (PMR) after Jacobson has been used for migraine prophylaxis since the early 1970s. Migraine patients are assumed to have an enhanced autonomic arousal which can be counterbalanced by systematic relaxation. Relaxation techniques are thought to reduce the activation level, to alter cortical pain processing and to enhance activation in pain-reducing cortical structures in the periaqueductal grey matter. ⋯ The initially increased CNV amplitude became normalized after regular PMR training in migraine patients. With the review of PMR studies on migraine prophylaxis and the results of our own study it could be shown that PMR is an efficacious non-pharmacological treatment option for migraine prophylaxis. In addition to its clinical effects, alterations in cortical stimulation processing in terms of a normalization of the CNV could be documented.
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Chronic back pain is of enormous health and economic relevance for industrialized countries because a small group of patients with chronic disease is responsible for a large proportion of medical costs. The prevention of chronic disease is therefore a primary goal in the treatment of patients with acute low back pain. Psychological factors are the central risk factors for later chronification. ⋯ It remains unclear which exact cognitive mechanisms are involved in the maintenance and reinforcement of depression and pain-related disability. In this review, the current results of cognitive bias research and theoretical models are presented and summarized regarding the relationship between chronic pain and depression. Finally, the clinical implications and recommendations for clinical research will be presented.
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Besides postictal headaches, epileptic seizures are infrequently associated with pain experiences. Nevertheless, seizure-associated pain is an important clinical symptom to recognize, diagnose and to differentiate from non-epileptic disorders. ⋯ Different aspects of pain phenomena in the context of epileptic seizures will be addressed by following these systematic classifications. In relation to seizures with unilateral somatosensory manifestation the functional anatomical context is described while differential diagnostic aspects in association with abdominal epilepsies are emphasized and terminological points as well as genetic epidemiological interrelationships between epilepsy and migraine are highlighted.