Articles: neuralgia.
-
Case Reports
Paresthesia-Free Spinal Nerve Root Stimulation for the Treatment of Chronic Neuropathic Pain.
Stimulation of the dorsal spinal roots, or spinal nerve root stimulation (SNRS), is a neuromodulation modality that can target pain within specific dermatomal distributions. The use of paresthesia-free stimulation has been described with conventional dorsal column spinal cord stimulation, although has yet to be described for SNRS. This objective of this study was to investigate the efficacy of paresthesia-free high-frequency (1000-1200 Hz) SNRS in the treatment of intractable, dermatomal neuropathic pain. ⋯ We present real-world outcomes of patients with intractable dermatomal neuropathic pain treated with paresthesia-free, high-frequency SNRS. We demonstrate its effectiveness in providing pain reduction at a level comparable to tonic SNRS up to 24 months follow-up, without producing uncomfortable paresthesias.
-
Central post-stroke pain (CPSP) can arise after lesions anywhere in the central somatosensory pathways, essentially within the spinothalamic system (STS). Although the STS can be selectively injured in the mesencephalon, CPSP has not been described in pure midbrain infarcts. ⋯ Selective spinothalamic injury caused by small lateral midbrain lesions is a very rare cause of central post-stroke pain that can remain undiagnosed for years. It appears to obey to haemorrhagic, sometimes post-traumatic lesions. Sudden development of contralateral burning pain with isolated spinothalamic deficits may be the only localizing sign, which can be easily objectively detected with electrophysiological testing.
-
Aim To investigate the impact of pain intensity of postherpetic neuralgia (PHN) patients. Methods This cross sectional study included 30 PHN patients attended to the Dermatology and Venereology Department of the School of Medicine of Universitas Sumatera Utara during the period between April 2019 and October 2019. Zoster Brief Pain Inventory questionnaire including the worst pain in 24 hours and the level of interference with seven domains of quality of life (QoL) (general activity, mood, walking ability, working, relationship with other people, sleep and enjoyment of life) were used. ⋯ Therefore, the correlation between worst pain intensity and walking ability was moderate (r=0.475). The worst pain intensity had a significant correlation with all seven domains of QoL (p<0.05). Conclusion Pain intensity influences the QoL with directly proportional correlation between pain intensity and disturbance of QoL.
-
Cell. Mol. Neurobiol. · Aug 2020
ReviewRegional Hyperexcitability and Chronic Neuropathic Pain Following Spinal Cord Injury.
Spinal cord injury (SCI) causes maladaptive changes to nociceptive synaptic circuits within the injured spinal cord. Changes also occur at remote regions including the brain stem, limbic system, cortex, and dorsal root ganglia. These maladaptive nociceptive synaptic circuits frequently cause neuronal hyperexcitability in the entire nervous system and enhance nociceptive transmission, resulting in chronic central neuropathic pain following SCI. ⋯ Current literature describes regional studies of electrophysiological or neurochemical mechanisms for enhanced nociceptive transmission post-SCI, but few studies report the electrophysiological, neurochemical, and neuroanatomical changes across the entire nervous system following a regional SCI. We, along with others, have continuously described the enhanced nociceptive transmission in the spinal dorsal horn, brain stem, thalamus, and cortex in SCI-induced chronic central neuropathic pain condition, respectively. Thus, this review summarizes the current understanding of SCI-induced neuronal hyperexcitability and maladaptive nociceptive transmission in the entire nervous system that contributes to chronic central neuropathic pain.
-
Brain Behav. Immun. · Aug 2020
In vivo intrathecal IL-1β quantification in rats: Monitoring the molecular signals of neuropathic pain.
Neuropathic pain, or pain after nerve injury, is a disorder with a significant reliance on the signalling of cytokines such as IL-1β. However, quantifying the cytokine release repeatedly over time in vivo is technically challenging. ⋯ For the first time we have established that the SS based immunosensing platform technology can repeatedly sample the intrathecal space for bioactive peptides, such as IL-1β. Using this novel approach, we have been able to establish the correlation of the intrathecal concentration of IL-1β with the extent of mechanical allodynia, providing a molecular biomarker of the degree of the exaggerated pain state.