Articles: neuralgia.
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Central Neuropathic Pain (CNP) is a frequent chronic condition in people with spinal cord injury (SCI). Previously, we showed that using laboratory brain-computer interface (BCI) technology for neurofeedback (NFB) training, it was possible to reduce CNP in people with SCI. In this study, we show results of patient self-managed treatment in their homes with a BCI-NFB using a consumer EEG device. ⋯ Portable NFB is a feasible solution for home-based self-managed treatment of CNP. Compared to pharmacological treatments, NFB has less side effects and provides users with active control over pain.
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Case Reports
Intravenous Ketamine as an Adjunct for Pachyonychia Congenita-Associated Pain: A Case Report.
Pachyonychia congenita (PC) is a rare, inherited disorder of keratin filaments characterized by palmoplantar hyperkeratosis, keratoderma, and extreme pain. Management is largely symptomatic and typically involves multimodal pain control strategies. ⋯ Within 1 night of beginning treatment, his pain diminished to a 0/10 without any adverse effects, with effects lasting 2 weeks. No reported PC pain regimens have made use of intravenous ketamine; thus, we suggest recurrent ketamine infusions as an additional option in the multimodal pain regimen for patients with PC.
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Zhonghua yi xue za zhi · Oct 2019
[Ultrasound-guided erector spinae plane block combined with pregabalin for post-herpetic neuralgia].
Objective: To analyze the clinical effect of ultrasound-guided erector spinae block combined with pregabalin on post-herpetic neuralgia (PHN) in the elderly. Methods: Sixty patients with post-herpetic neuralgia from January 2018 to January 2019 in the Department of Pain, First Affiliated Hospital of Bengbu Medical College were selected. The patients were divided into two groups according to the random number table (n=30): group C and ultrasound-guided erector spinae block (ESPB) group. ⋯ The difference was statistically significant (χ(2)=6.694, P<0.05). Adverse reactions were mild in both groups. Conclusion: Ultrasound-guided erector spinae block can effectively alleviate the pain of elderly patients with PHN in the chest, significantly reduce the dosage of oral drugs, improve the sleep quality of patients, and have higher safety.
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Although recent studies have shown that botulinum toxin-A (BTX-A) has a good analgesic effect on trigeminal neuralgia (TN) and peripheral neuropathic pain (PNP), the quality of evidence is low due to limited data. This meta-analysis is used to synthesize existing evidence for the treatment of these conditions with BTX-A. ⋯ Pooled data from our meta-analysis suggest that BTX-A is efficacious and safe in treating TN and PNP. However, due to the limited sample size and heterogeneity, further larger and well-designed RCTs are imperative to validate these findings.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled Trial Multicenter StudyAdditive Duloxetine for Cancer-related Neuropathic Pain Nonresponsive or Intolerant to Opioid-Pregabalin Therapy: A Randomized Controlled Trial (JORTC-PAL08).
Although opioids and pregabalin are widely used for cancer-related neuropathic pain (CNP), no clinical trials exist to determine which medications are effective when an opioid-pregabalin combination therapy fails. ⋯ Adding duloxetine to opioid-pregabalin therapy might have clinical benefit in alleviating refractory CNP. Further studies are needed to conclude the efficacy of adding duloxetine.