Current pain and headache reports
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Curr Pain Headache Rep · Jun 2004
ReviewTargeted peripheral analgesics therapy for neuropathic pain.
The term targeted peripheral analgesics has been suggested to describe analgesics with a mechanism of action that appears to be primarily through reducing pain transmission within the peripheral nervous system. Key differences between targeted peripheral (topical) and systemic analgesics and the difference between topical and transdermal analgesics are discussed in this article. A review of the clinical conditions, which have been reported to respond to targeted peripheral analgesics, also is described in detail.
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Curr Pain Headache Rep · Jun 2004
ReviewNeuromodulating drugs for the symptomatic treatment of neuropathic pain.
Significant improvement of neuropathic pain has been achieved with studies that have demonstrated efficacy of newer anticonvulsants in relieving this type of pain, by having a neuromodulatory effect on the hyperexcitable damaged nervous system. Two drugs from this class, gabapentin and lamotrigine, have been submitted to a number of clinical trials. ⋯ Pregabalin, the newest agent that has demonstrated efficacy in the treatment of post-herpetic neuralgia, is awaiting approval. A number of available anticonvulsants are undergoing clinical trials and many drugs with neuromodulatory properties are being considered for further development.
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In this paper, new treatment options for migraine prevention are reviewed. An overview about migraine pathophysiology is provided and current indications for migraine prevention and new and upcoming preventive medications are discussed briefly. Data are presented on topiramate, levetiracetam, zonisamide, botulinim toxin, tizanidine, nefazodone, lisinopril, candesartan, carabersat, petasites, and coenzyme Q.
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Curr Pain Headache Rep · Jun 2004
ReviewPharmacokinetic studies in migraine: what questions should physicians ask?
Migraine is a benign self-limiting condition for which the objective of treatment is to maximize the patient's quality of life by reducing the frequency of attacks and attenuating the pain and suffering of an individual attack as quickly and safely as possible. Evaluating the efficacy of antimigraine treatments, particularly those for the management of the acute attack, is relatively easy because acute symptomatic benefit is the criterion of success. ⋯ Given that the clinical response to antimigraine therapies relatively is readily assessed by history, the role of more sophisticated investigations such as pharmacokinetic studies may not be immediately clear. This paper aims to provide clinicians with a guide to interpretation of such studies.
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Curr Pain Headache Rep · Jun 2004
ReviewToward a molecular genetic classification of familial hemiplegic migraine.
The genetics of migraine is a fascinating and rapidly moving research area. Familial hemiplegic migraine, a rare subtype of migraine with a Mendelian pattern of inheritance, is caused by mutations in the chromosome 19 CACNA1A gene or in the chromosome 1 ATP1A2 gene. Familial migraine variants are classified on the basis of clinical, descriptive criteria, but this is insufficient. In the future, a diagnostic classification based on mutation-analysis is needed.