Annals of physical and rehabilitation medicine
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain in spinal cord injury: efficiency of deep brain and motor cortex stimulation therapies for neuropathic pain in spinal cord injury patients.
In spite of all the scientific advances in pharmacological research, a great number of patients cannot efficiently manage their chronic pain with conventional pharmacological treatments. Brain stimulation techniques have considerably improved these last 10 years. These techniques could be an interesting option after a rigorous selection of patients. We aim to evaluate the efficacy of brain stimulation (deep brain stimulation [DBS] and motor cortex stimulation [MCS]) within the framework of neuropathic pain management in spinal cord injury (SCI) patients and elaborate some recommendations. ⋯ For central pain in SCI patients, there is no sufficient level of evidence to validate the use of DBS. There is however a low level of evidence for MCS. These results must be validated by larger comparative or controlled versus placebo clinical studies.
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain in spinal cord injury patients: what is the impact of social and environmental factors on care management?
In order to refine therapeutic strategies for spinal cord injury (SCI) patients with chronic neuropathic pain, it appears essential to assess the impact of socioenvironmental factors on the onset of pain or its chronic nature. The aim of this article is to answer the following question regarding these factors: is there any evidence that managing these social and environmental factors could have a positive impact on the treatment of chronic neuropathic pain in SCI patients? ⋯ It was impossible to directly answer this question based on the literature review only. Nonetheless, some socioenvironmental factors can be considered as potential triggering factors for the onset of chronic pain in spinal cord injury patients, i.e. a low degree of independence (C), low socioeconomic status (B), unemployment (B), and family and friends with a "negative attitude" (C).
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Ann Phys Rehabil Med · Mar 2009
The chronic neuropathic pain of spinal cord injury: which efficiency of neuropathic stimulation?
Determine the efficacy of spinal cord stimulation (SCS) for treating neuropathic pain in spinal cord injury (SCI) patients. ⋯ There is no significant level of proof to recommend the use of this technique in this indication. Conducting further studies, either physiological or clinical, could help to promote this technique with very minor adverse effects in an indication which, to this day, has no gold standard.
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Ann Phys Rehabil Med · Mar 2009
What are the risk factors of occurence and chronicity of neuropathic pain in spinal cord injury patients?
Analyze the epidemiological data on neuropathic pain in spinal cord injury patients and determine the risk factors for its occurrence and chronicity. ⋯ Neuropathic pain in SCI patients is a major issue, its determining factors still need to be evaluated properly by refining the epidemiological data.
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Ann Phys Rehabil Med · Mar 2009
Chronic neuropathic pain of spinal cord injury: what is the effectiveness of psychocomportemental management?
To determine the efficacy of treating neuropathic pain in spinal cord injury (SCI) patients by psychological, cognitive or behavioral therapies and suggest recommendations for clinical practices. ⋯ There is no scientific evidence for validating this type of pain management care. However, the high level of evidence of the articles studying the efficacy of these therapies in patients with chronic pain suggest that it could be applied to SCI patients. These techniques must be developed in France and further studies should be conducted on SCI patients affected by neuropathic pain.