Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology
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J Neuroimmune Pharmacol · Jun 2013
EditorialImaging biomarkers and the role of neuroinflammation in neuropathic pain.
The papers from this thematic issue followed a translational research workshop, Imaging Neuroinflammation and Neuropathic Pain, that focused on the search for neuroimaging biomarkers to assess neuroinflammation associated with neuropathic pain. The topics covered in this issue include overviews of the historical and current knowledge regarding neuropathic pain, the potential mechanisms involved, the often under-recognized clinical presentations that can delay diagnosis, the various neuroimaging techniques that have been applied to evaluate neuropathic pain and neuroinflammation, to case series illustrating novel treatments of neuropathic pain. Furthermore, the use of telemedicine to disseminate knowledge and improve the diagnosis and treatment of pain syndromes is also discussed.
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J Neuroimmune Pharmacol · Jun 2013
Case ReportsTreatment of Complex Regional Pain Syndrome (CRPS) using low dose naltrexone (LDN).
Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome, which involves glial activation and central sensitization in the central nervous system. Here, we describe positive outcomes of two CRPS patients, after they were treated with low-dose naltrexone (a glial attenuator), in combination with other CRPS therapies. Prominent CRPS symptoms remitted in these two patients, including dystonic spasms and fixed dystonia (respectively), following treatment with low-dose naltrexone (LDN). LDN, which is known to antagonize the Toll-like Receptor 4 pathway and attenuate activated microglia, was utilized in these patients after conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms.
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J Neuroimmune Pharmacol · Jun 2013
Case ReportsImproving the diagnosis and treatment of CRPS: insights from a clinical immunologist's personal experience with an underrecognized neuroinflammatory disorder.
Complex regional pain syndrome is a neuroinflammatory condition associated with overactive glial cells that can be challenging to diagnose and treat. Early recognition and treatment are thought to be critical for good outcomes, yet many patients experience a delay in diagnosis and have difficulty accessing expert medical care. While there are no universally effective treatments, there are several promising new therapies, but these are not widely available. Some of the specific barriers to diagnosis and treatment are reviewed, with suggestions as to how they might be eliminated, leading to better care for all patients with CRPS.