Articles: neuralgia.
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Comment Randomized Controlled Trial Multicenter Study
Safety of herpes zoster vaccine in the shingles prevention study: a randomized trial.
The herpes zoster vaccine is effective in preventing herpes zoster and postherpetic neuralgia in immunocompetent older adults. However, its safety has not been described in depth. ⋯ Cooperative Studies Program, Department of Veterans Affairs, Office of Research and Development; grants from Merck to the Veterans Affairs Cooperative Studies Program; and the James R. and Jesse V. Scott Fund for Shingles Research.
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Anesthesia and analgesia · May 2010
Randomized Controlled TrialLidocaine eye drops attenuate pain associated with ophthalmic postherpetic neuralgia.
Topical lidocaine (LDC) treatment using a gel or patch preparation is effective in the treatment of postherpetic neuralgia (PHN), but neither is suited for the eye in patients with ophthalmic PHN. Herein, we examined the effect of LDC 4% eye drops on ophthalmic PHN pain. ⋯ This study suggests that LDC provides a significant improvement of ophthalmic PHN because of its prompt analgesia, lack of systemic side effects, and convenience of use.
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Wien. Klin. Wochenschr. · May 2010
Randomized Controlled Trial Comparative StudyEffects of pregabalin on acute herpetic pain and postherpetic neuralgia incidence.
Acute zoster pain usually disappears with regression of the rash but may be of significant intensity and prolonged duration leading to postherpetic neuralgia. We evaluated the effect of pregabalin on alleviation of acute zoster pain and onset of postherpetic neuralgia. ⋯ The study did not prove any statistically significant effect of pregabalin in pain relief in patients with acute zoster pain or in the onset of postherpetic neuralgia in comparison with the placebo. The use of pregabalin was related to a statistically significant increase in the appearance of adverse effects.
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Randomized Controlled Trial Multicenter Study
Efficacy of intrathecal midazolam with or without epidural methylprednisolone for management of post-herpetic neuralgia involving lumbosacral dermatomes.
Post herpetic neuralgia is a chronic neuropathic pain syndrome which remains one of the most difficult pain disorders to treat. Epidural injection of methylprednisolone with or without local anesthetic provides relief for neuralgia for a short duration only. Recent studies have shown a promising anti nociceptive effect for intrathecal midazolam, a water soluble benzodiazepine, due to its interaction with benzodiazepine-GABA-A receptor complex within the spinal cord. ⋯ The dose-response relationship of intrathecal midazolam was not evaluated in our study, so further study should be conducted with different doses of intrathecal midazolam for management of PHN.
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Randomized Controlled Trial
Effects of anodal transcranial direct current stimulation on chronic neuropathic pain in patients with multiple sclerosis.
Neuropathic pain in patients with MS is frequent and is associated with a great interference with daily life activities. In the present study, we investigated whether anodal transcranial direct current stimulation (tDCS) may be effective in reducing central chronic pain in MS patients. Patients received sham tDCS or real tDCS in a 5-day period of treatment in a randomized, double blind, sham-controlled study. Pain was measured using visual analog scale (VAS) for pain and the short form McGill questionnaire (SF-MPQ). Quality of life was measured using the Multiple Sclerosis Quality of Life-54 scale (MSQoL-54). Depressive symptoms and anxiety were also evaluated as confounding factors using the Beck Depression Inventory (BDI) and VAS for anxiety. Evaluations were performed at baseline, immediately after the end of treatment, and once a week during a 3-week follow-up period. Following anodal but not sham tDCS over the motor cortex, there was a significant pain improvement as assessed by VAS for pain and McGill questionnaire, and of overall quality of life. No depression or anxiety changes were observed. Our results show that anodal tDCS is able to reduce pain-scale scores in MS patients with central chronic pain and that this effect outlasts the period of stimulation, leading to long-lasting clinical effects. ⋯ This article presents a new, noninvasive therapeutic approach to chronic, central neuropathic pain in multiple sclerosis, poorly responsive to current conventional medications. tDCS is known to cause long-lasting changes of neuronal excitability at the site of stimulation and in the connected areas in healthy subjects. This led us to hypothesize that pain decrease may be the result of functional plastic changes in brain structures involved in the pathogenesis of chronic neuropathic pain.