Articles: neuropathic-pain.
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British journal of pain · May 2016
'Pseudofailure' of spinal cord stimulation for neuropathic pain following a new severe noxious stimulus: learning points from a case series of failed spinal cord stimulation for complex regional pain syndrome and failed back surgery syndrome.
Failure of spinal cord stimulation (SCS) may be due to hardware problems, migration of electrodes and, in the long-term, plasticity in the spinal cord with habituation to the stimulation current. We describe a series of seven patients who experienced acute therapeutic loss of SCS effects following an acute nociceptive event unrelated to primary pathology. There were no hardware problems. ⋯ We conclude that SCS may seem to fail following a separate strong nociceptive stimulus. Stimulation may be regained with reprogramming or following a period with stimulation switched off. We would, therefore, advise against removal of SCS hardware in the first instance.
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Randomized Controlled Trial Multicenter Study
Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial.
Data from previous studies suggest that botulinum toxin A has analgesic effects against peripheral neuropathic pain, but the quality of the evidence is low. We aimed to assess the safety and efficacy of repeated administrations of botulinum toxin A in patients with neuropathic pain. ⋯ Institut National de la Santé et de la Recherche Médicale (INSERM) and Fondation CNP (France).
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Neuropathic pain, a chronic pain condition following nerve damage and degeneration, involves aberrant excitability in the dorsal horn of the spinal cord. A growing body of evidence has shown that the aberrant excitability might not be a consequence merely of changes in neurons, but rather of multiple alterations in glial cells, such as microglia, the immune cells of the central nervous system. ⋯ Here, we describe recent advances in the understanding of neuron-microglia interactions by purinergic signaling in neuropathic pain following neurodegeneration. This article is part of the Special Issue entitled 'Purines in Neurodegeneration and Neuroregeneration'.
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J Plast Reconstr Aesthet Surg · May 2016
Prevalence and factors associated with persistent pain following body contouring surgery.
Persistent postsurgical pain (PPP) has been reported by patients following various surgeries. Body contouring procedures are being performed more frequently, but no data are available regarding the effects of these procedures. Long-term disability occurring after performing "functional" procedures on healthy subjects is a particular concern. The aim of this study was to describe the risk factors, prevalence, characteristics, and effects of persistent pain after body contouring procedures. ⋯ Persistent chronic pain is frequent after body contouring procedures. Preemptive approaches and early postoperative diagnosis are important measures that can be used to limit the effects of this complication on the patient's quality of life.
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Palliative medicine · May 2016
Is there pain with neuropathic characteristics in patients with amyotrophic lateral sclerosis? A cross-sectional study.
Amyotrophic lateral sclerosis is a progressive debilitating and lethal disorder, characterized by degeneration of motor neurons that warrant palliative care. Pain is frequent in patients with amyotrophic lateral sclerosis and significantly impacts on quality of life. ⋯ Even if amyotrophic lateral sclerosis is a disease of the motor system, pain is frequent and can rarely have neuropathic characteristics. Pain must be always sought and appropriately treated to limit quality of life impairment.