Articles: neuralgia.
-
Neuropathic pain is defined as pain caused by a lesion or a disease affecting the somatosensory nervous system. Development of neuropathic pain is induced by many pathophysiological mechanisms affecting pain pathways. Neuropathic pain has diverse origins, making its management difficult, hence, many patients with neuropathic pain do not receive appropriate treatment. ⋯ Capsaicin and lidocaine patches are second line treatments, tramadol and strong opioids are third line treatments. This work also highlighted molecules with inconclusive recommendations or non-recommended pharmacological treatments based on a low quality of evidence, a lack of efficacy or a bad safety profile. The objective of this paper is to present the different treatments and to detail their mechanisms of action.
-
Journal of anesthesia · Dec 2019
Association between treatment-related early changes in psychological factors and development of postherpetic neuralgia.
To examine the association between catastrophizing and pain intensity with acute herpes zoster, and the association of treatment-related early changes in depressive symptoms, anxiety, and catastrophizing with postherpetic neuralgia (PHN) development, independent of acute pain intensity. ⋯ Catastrophizing was associated with acute pain intensity, and lower pain-related catastrophizing among patients with acute herpes zoster was associated with less risk of PHN development, independent of acute pain intensity.
-
About half of patients with spinal cord injury (SCI) develop debilitating central neuropathic pain (CNP), with no effective treatments. Thus, effective, safe, and novel therapies are needed urgently. Previously, docosahexaenoic acid (DHA) was reported to confer neuroprotection in preclinical SCI models. ⋯ Spinal microgliosis, a known hallmark associated with neuropathic pain behaviours, was reduced by DHA treatments. Finally, we revealed novel potential roles of peroxisome proliferator-activated and retinoid X receptors and docosahexaenoyl ethanolamide (DHA's metabolite) in mediating DHA's effects on microglial activation. Our findings, coupled with the excellent long-term clinical safety of DHA even in surgical and critically ill patients, suggest that systemic DHA treatment is a translatable, effective, safe, and novel approach for preventing and managing SCI-CNP.
-
Plast. Reconstr. Surg. · Dec 2019
The Cutting Edge of Headache Surgery: A Systematic Review on the Value of Extracranial Surgery in the Treatment of Chronic Headache.
Migraine is a debilitating neurologic condition, with a large socioeconomic impact. There is a subgroup of patients that does not adequately respond to pharmacologic management and may have underlying neuralgia. Surgical decompression of extracranial sensory nerves has been proposed as an alternative therapy. The aim of this article is to review the evidence for the surgical treatment of neuralgias. ⋯ Nerve decompression surgery is an effective way of treating headaches in a specific population of patients with neuralgia. Although a meta-analysis of the current data was not possible, the extracranial decompression of peripheral head and neck sensory nerves has a high success rate.