Articles: neuralgia.
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Review Meta Analysis
Invasive Motor Cortex Stimulation Influences Intracerebral Structures in Patients With Neuropathic Pain: An Activation Likelihood Estimation Meta-Analysis of Imaging Data.
Invasive motor cortex stimulation (iMCS) has been proposed as a treatment for intractable neuropathic pain syndromes. Although the mechanisms underlying the analgesic effect of iMCS remain largely elusive, several studies found iMCS-related changes in regional cerebral blood flow (rCBF) in neuropathic pain patients. The aim of this study was to meta-analyze the findings of neuroimaging studies on rCBF changes to iMCS. ⋯ These findings suggested that iMCS induces changes in principal components of the default mode-, the salience-, and sensorimotor network.
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Randomized Controlled Trial
Clinical Study of Spinal Cord Stimulation and Pulsed Radiofrequency for Management of Herpes Zoster-Related Pain Persisting Beyond Acute Phase in Elderly Patients.
Postherpetic neuralgia (PHN) occurs in 9% to 34% of herpes zoster (HZ) patients, and the incidence of PHN is positively correlated with age. A number of patients suffer from poor therapeutic effects or intolerable side effects and need to accept minimally invasive analgesia. ⋯ Spinal cord stimulation, pulsed radiofrequency, postherpetic neuralgia.
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J. Peripher. Nerv. Syst. · Jun 2020
Real world, open label experience with lacosamide against acute painful oxaliplatin-induced peripheral neurotoxicity.
We report the outcome of a pilot, open-label study that tested the potential of lacosamide (200 mg/bi.d) as an effective and safe symptomatic treatment against acute painful oxaliplatin-induced peripheral neurotoxicity (OXAIPN). Lacosamide was introduced in 18 colorectal cancer patients with evidence of clinically significant acute, painful OXAIPN after infusion of the third course (T1) of oxaliplatin-based chemotherapy (FOLFOX4) and was maintained until completion of all 12 courses (T4). The OXA-Neuropathy Questionnaire (OXA-NQ) was used to record the severity of acute OXAIPN; the PI-NRS estimated the severity of neuropathic pain, while the chronic OXAIPN was graded with TNSc. ⋯ Twelve patients scored PGIC ≥5 (lacosamide-attributed) at T4. There were no incidences of early drop-outs for safety reasons. Lacosamide appears to be an effective and well-tolerated symptomatic treatment against acute, painful OXAIPN.
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J Pain Palliat Care Pharmacother · Jun 2020
Case ReportsPhenytoin Cream for the Treatment of Sciatic Pain: Clinical Effects and Theoretical Considerations: Case Report.
Chronic sciatic pain is difficult to treat. Patients often suffer from considerable pain and are severely hampered in their everyday activities. Most pharmacologic analgesic treatments have disappointing effects, and often are limited due to adverse events. ⋯ Recently it has been documented that proximal nerve lesions are followed by small fiber pathology in the skin. This might be a responsible peripheral wind-up generator for the chronification of pain in sciatic nerve compression. Topical application of the broad-acting voltage-gated sodium channel blocker phenytoin could reduce neuropathic pain in our case completely, supporting a peripheral mechanism of action for phenytoin cream in sciatic pain.
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Chemotherapy-induced peripheral neuropathy (CIPN) is regarded as one of the most common dose-limiting adverse effects of several chemotherapeutic agents, such as platinum derivatives (oxaliplatin and cisplatin), taxanes, vinca alkaloids and bortezomib. CIPN affects more than 60% of patients receiving anticancer therapy and although it is a nonfatal condition, it significantly worsens patients' quality of life. The number of analgesic drugs used to relieve pain symptoms in CIPN is very limited and their efficacy in CIPN is significantly lower than that observed in other neuropathic pain types. Importantly, there are currently no recommended options for effective prevention of CIPN, and strong evidence for the utility and clinical efficacy of some previously tested preventive therapies is still limited. ⋯ Emerging novel chemical structures-potential future preventative pharmacotherapies for CIPN caused by oxaliplatin are reported.