Pain
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Controlled radiant heat stimulation for a combined psychophysical and electrophysiological research in pain was achieved by the use of an infrared Laser beam. The computer controlled stimuli, being of very brief duration (down to 5 msec) and sharply localized, are suitable for recording of averaged evoked responses as well as for determination of pain and thermal thresholds. ⋯ The threshold energy delivered by this technique is similar to that obtained by the Hardy-Wolff-Goodell method. Special precautions were taken to avoid injury to the skin and the eyes.
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The authors describe two patients with posterior thoracic pain associated with cysts of the septum posticum. One patient's pain was relieved by surgical removal of the cysts; the second patient's symptoms temporarily resolved after myelography. Posterior thoracic pain can be ascribed to myelographically proven arachnoid cysts when the pain is persistent, positionally exacerbated and associated with radicular sensory changes. Excision of the cysts may provide pain relief for some patients.
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Five patients out of a group of ten who had dorsal column electrodes implanted for the relief of chronic pain were examined for the influence of the stimulation on the spontaneous pain and on the thresholds for touch, vibration and cutaneous pain induced by pinching. Stimulation producing paraesthesias resulted in an almost immediate abolishment of spontaneous pain and was accompanied by significant elevations of both tactile and vibratory thresholds. ⋯ Elevation of sensory thresholds is presumably not due to blocking of the primary neurones but to central inhibitory mechanisms. The thresholds for induced cutaneous pain were not influenced by dorsal column stimulation except for one case in whom an abnormally low threshold within an hyperaestethic area became normalized.
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The McGill Pain Questionnaire consists primarily of 3 major classes of word descriptors--sensory, affective and evaluative--that are used by patients to specify subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience. The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. ⋯ Correlation coefficients among these measures, based on data obtained with 297 patients suffering several kinds of pain, are presented. In addition, an experimental study which utilized the questionnaire is analyzed in order to describe the nature of the information that is obtained. The data, taken together, indicate that the McGill Pain Questionnaire provides quantitative information that can be treated statistically, and is sufficiently sensitive to detect differences among different methods to relieve pain.