Neurol Neurochir Pol
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Neurol Neurochir Pol · Jan 2014
ReviewDiagnosis and management of neuropathic pain: review of literature and recommendations of the Polish Association for the Study of Pain and the Polish Neurological Society - Part Two.
Neuropathic pain may be caused by a variety of lesions or diseases of both the peripheral and central nervous system. The most common and best known syndromes of peripheral neuropathic pain are painful diabetic neuropathy, trigeminal and post-herpetic neuralgia, persistent post-operative and post-traumatic pain, complex regional pain syndrome, cancer-related neuropathic pain, HIV-related neuropathic pain and pain after amputation. ⋯ A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on various types of neuropathic pain, with special focus on the available international guidelines, and has formulated recommendations on their diagnosis and treatment, in accordance with the principles of evidence-based medicine (EBM). High quality studies on the efficacy of various medicines and medical procedures in many neuropathic pain syndromes are scarce, which makes the recommendations less robust.
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Neurol Neurochir Pol · Jan 2014
ReviewSymptomatology and pathogenesis of different types of pain in multiple sclerosis.
Multiple sclerosis (MS) is a progressive disease of the central nervous system. It is characterized by disseminated foci of demyelination, which are responsible for the diverse clinical picture of MS. Pain is a frequent but underestimated symptom of multiple sclerosis. ⋯ The pain experienced by MS patients is generally caused by nervous system damage during the course of the disease process and can usually be characterized as central neuropathic pain (less frequently as peripheral or nociceptive pain). The most frequent symptoms include dysesthetic extremity pain, painful tonic spasms, Lhermitte's sign, trigeminal neuralgia, headaches and low back pain. This paper discusses the probable mechanisms behind the development of pain in MS, the prevalence, classification, types of pain, as well as the most effective treatment methods.
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In this paper, we present some impressions and thoughts about CRPS which we found useful in our proceedings with CRPS patients. The clinical sub-types of the CRPS are presented and differences in their characteristics are discussed. The current pathophysiological concepts for CRPS are outlined. ⋯ The "Szczecin" protocol of management of early CRPS is presented in details. Some information about prevention of the syndrome is given. We believe that the information presented may support doctors in resolving their diagnostic dilemmas associated with CRPS.
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Neurol Neurochir Pol · Jan 2014
Comparative StudyComparison of perioperative complications following staged versus one-day anterior and posterior cervical decompression and fusion crossing the cervico-thoracic junction.
Multilevel cervical pathology may be treated via combined anterior cervical decompression and fusion (ACDF) followed by posterior spinal instrumented fusion (PSIF) crossing the cervico-thoracic junction. The purpose of the study was to compare perioperative complication rates following staged versus same day ACDF combined with PSIF crossing the cervico-thoracic junction. ⋯ Staging anterior cervical decompression and fusion with posterior cervical instrumented fusion 1 week apart does not decrease the incidence of perioperative complications.
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We present our experience with surgery of jugular foramen schwannomas with special consideration of clinical presentation, surgical technique, complications, and outcomes. ⋯ Jugular foramen schwannomas can be radically managed with the use of skull base surgery techniques. However, the surgical treatment of jugular foramen schwannomas carries a significant risk of the lower CN deficits.