Articles: neuralgia.
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Randomized Controlled Trial
Effectiveness and Tolerability of a Moderate Dose of Tapentadol Prolonged Release for Managing Severe, Chronic Low Back Pain with a Neuropathic Component: An Open-label Continuation Arm of a Randomized Phase 3b Study.
To evaluate the effectiveness and tolerability of tapentadol prolonged release (PR) for severe, chronic low back pain with a neuropathic component in a subpopulation that achieved adequate pain relief with tapentadol PR 300 mg/day in a randomized, double-blind, phase 3b study. ⋯ A subpopulation of patients with low back pain with a neuropathic component responded very well to tapentadol PR 300 mg/day, with significant improvements in pain intensity, neuropathic pain-related symptoms, and quality of life. Further research is needed to identify factors associated with a very positive treatment response.
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Chronic neuropathic pain is estimated to affect 3%-4.5% of the worldwide population. It is associated with significant loss of productive time, withdrawal from the workforce, development of mood disorders such as depression and anxiety, and disruption of family and social life. Current medical therapeutics often fail to adequately treat chronic neuropathic pain. ⋯ In this review, the authors briefly discuss the history of DBS for chronic neuropathic pain in the United States and present evidence supporting dACC DBS for this indication. They review existent literature on dACC DBS and summarize important findings from imaging and neurophysiological studies supporting a central role for the dACC in the processing of chronic neuropathic pain. The available neurophysiological and empirical clinical evidence suggests that dACC DBS is a viable therapeutic option for the treatment of chronic neuropathic pain and warrants further investigation.
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To determine the prevalence and characteristics of pain experienced by children who have had microsurgical reconstruction for obstetrical brachial plexus palsy (OBPP). ⋯ Prognostic IV.
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Nihon Shinkei Seishin Yakurigaku Zasshi · Jun 2015
Review[Exploration of novel therapeutic targets for neuropathic pain based on the regulation of immune cells].
The pathogenesis of neuropathic pain is quite complicated and diverse. Because pre-existing analgesics, such as opioid analgesics and nonsteroidal anti-inflammatory drugs, are not sufficient to treat it, it is a serious task to establish a strategy of remedy for neuropathic pain. Recently, increasing evidence suggests that immune cell-mediated neuroinflammation in the nervous system induces central and peripheral sensitization, resulting in chronic pain. ⋯ Activated immune cells produce and release several kinds of inflammatory mediators, which act directly on sensory neurons and promote a recruitment of immune cells, developing the feedback loop of inflammatory exacerbation. We've focused on the role of crosstalk between immune cells and neurons in peripheral neuroinflammation, and explored a novel candidate for a remedy of neuropathic pain. In this review, we will introduce recent reports and our research work that suggest the functional significance of neuroinflammation in neuropathic pain, and survey possibilities of new strategies for chronic pain from the point of view of basic research.
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Review Meta Analysis Comparative Study
Perineural steroids for trauma and compression-related peripheral neuropathic pain: a systematic review and meta-analysis.
Perineural steroids are often used to treat chronic peripheral neuropathic pain (NP) secondary to trauma or compression. Nevertheless, when compared with local anesthetics (LA) or conventional medical management (CMM), their efficacy and safety in patients with trauma or compression-related neuropathic pain syndromes is unclear. The purpose of this systematic review and meta-analysis was to determine the efficacy and safety of perineural steroids in compression or trauma-related NP after one to three months of injection. ⋯ Perineural steroids may provide analgesic efficacy for one to three months in patients with chronic peripheral NP of traumatic or compressive origin; however, the strength of this recommendation is weak. Well-designed large randomized studies are required.