Articles: neuralgia.
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The aim of this investigation was to determine whether murine models of inflammatory, neuropathic and cancer pain are each characterized by a unique set of neurochemical changes in the spinal cord and sensory neurons. All models were generated in C3H/HeJ mice and hyperalgesia and allodynia behaviorally characterized. A variety of neurochemical markers that have been implicated in the generation and maintenance of chronic pain were then examined in spinal cord and primary afferent neurons. ⋯ However, in this cancer-pain model, changes including massive astrocyte hypertrophy without neuronal loss, increase in the neuronal expression of c-Fos, and increase in the number of dynorphin-immunoreactive neurons were observed in the spinal cord, ipsilateral to the limb with cancer. These results indicate that a unique set of neurochemical changes occur with inflammatory, neuropathic and cancer pain in C3H/HeJ mice and further suggest that cancer induces a unique persistent pain state. Determining whether these neurochemical changes are involved in the generation and maintenance of each type of persistent pain may provide insight into the mechanisms that underlie each of these pain states.
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Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, and as such has been an area of extensive medical research for the past three decades. The patients at highest risk for PHN include those older than 50 years, those with severe acute cases of zoster, and those with shingles in a trigeminal distribution. As persons with malignancy are at a high risk for developing zoster itself, PHN is a complication that will be faced by many of these patients and their caregivers. This article reviews the available treatments and preventative measures for this debilitating condition.
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Pain following spinal cord injury (SCI) is a common problem and can interfere with functional recovery. Radicular pain (pain at the level of injury) is one type of SCI pain. Traditional analgesic agents are sometimes ineffective and can have significant systemic side effects. ⋯ Based on these favorable results and minimal side effects, topical capsaicin should be considered in the treatment of localized radicular pain secondary to SCI.
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In this study, 54 patients suffering from chronic cervicobrachialgia (mean pain duration 7 years) were treated with radiofrequency lesioning of the cervical spinal dorsal root ganglion (RF-DRG). The aim of the study was to investigate whether psychological variables would be predictive for the changes in pain intensity after medical treatment. ⋯ The level of catastrophizing before treatment appeared to predict 10% of the changes in pain intensity after treatment. Changes in pain intensity after RF-DRG were positively correlated with changes in psychosocial dysfunction and negative self-efficacy.
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Uncommon stimulation refers to the use of peripheral nerve and spinal cord stimulation for nontraditional applications. There has been much interest recently with subcutaneous suboccipital stimulation for occipital neuralgia, sacral stimulation for pelvic pain, trigeminal stimulation for trigeminal neuralgia, and spinal cord stimulation for angina and peripheral ischemia. The indications and techniques used for accomplishing each method are discussed.