Articles: neuralgia.
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Revista de neurologia · Dec 2002
Review[Advances in physiopathology and the treatment of neuropathic pain].
In this paper we review the most significant studies on the treatment of neuropathic pain over the last few decades, as well as the most recent research work in which the physiopathological mechanisms of pain, with the intention of looking for evidence based criteria that can help us to choose the most appropriate treatment. ⋯ Different neurophysical alterations induce the most diverse clinical manifestations, such as paresthesia, hyperalgesia or allodynia, regardless of the etiological processes that condition them. The efficiency of tricyclic antidepressants and of carbamazepine is made clear in different clinical studies, but the new antiepileptics (with the exception of gabapentin) have frequently been used in open clinical studies, which means there is a need for double blind controlled clinical trials in order to determine the efficiency and the tolerability of the different therapeutic alternatives in each of the clinical manifestations of neuropathic pain.
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This article reviews the prevalence, risk factors, natural history, and impact on quality of life of painful diabetic neuropathy (PDN) and postherpetic neuralgia (PHN). ⋯ Both conditions are common complications of their underlying disorders and can profoundly diminish the quality of life of affected persons.
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Postherpetic neuralgia (PHN) is a common complication of herpes zoster, particularly in the elderly and in persons with severe symptoms at presentation. Unless varicella vaccination reduces the incidence of herpes zoster and attenuates the risk and/or severity of complications, PHN will continue to result in significant suffering and remain a consumer of health care and related social support resources. ⋯ Other interventions require further evaluation (nerve blocks, acute-phase tricyclic antidepressant or anticonvulsant use). Because prevention of PHN requires early recognition and prompt management of patients presenting with herpes zoster, public education and dissemination of information to all health care personnel involved with the disease are essential.
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Molecular neurobiology · Aug 2002
ReviewContribution of the spared primary afferent neurons to the pathomechanisms of neuropathic pain.
Neuropathic pain is caused by nervous-system lesions. Early studies on the pathomechanisms of this abnormal pain state have focused on the directly injured fibers and neurons. ⋯ Electrophysiological changes and behavioral data also favor the contribution of the spared neurons. These attractive targets of study will give us new approaches for understanding the abnormal pain.
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Br J Community Nurs · Jun 2002
ReviewLife after shingles: the management of postherpetic neuralgia.
Chronic pain may have devastating effects on the physical and psychological well being of many patients (Harden, 1999). Most community nurses are in contact with a number of patients with chronic pain and will be asked for advice and recommendations with regards to its management. Chronic neuropathic pain is a complex and sometimes intractable condition that patients will seek help for, from either GPs or from the community nursing teams. This article will examine one neuropathic pain syndrome - post-herpetic neuralgia - and review the evidence base in relation to treatment strategies, in an attempt to support community staff in the management of this difficult to treat pain syndrome.