Zh Nevrol Psikhiatr
-
The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels. ⋯ There are clear indications of the efficacy of local injections in primary chronic cephalgia (migraine and headache of tension). The possibility of the abortion of the pain information flow in peripheral nociceptive pathways and, as a consequence, breaking the vicious circle is emphasized. Issues on the efficacy of local injections at trigger points in the treatment of chronic pain are highlighted.
-
Treatment of neuropathic pain (NP) is a serious medical problem. Antiepileptic drugs and antidepressants, used to relief pain, act on the central pain mechanisms and cause several side-effects, thus substantially restricting possibilities of their clinical application. At the same time, NP often has a peripheral component. ⋯ Recently it has been shown that the local use of single high doses of capsaicin during 30-60 min causes a marked stable(> 12 weeks) effect. The decrease in NP (>50%) is seen in about half of patients. Current studies will allow to single out groups of patients with the maximal treatment effect of capsaicin.
-
The article reviews the process of migration of nociogenic zones and principles of their integrative switching - off from the point of systematic approach and the informational-structural theory of pain. The phenomenon of migration of nociogenic zones underlies the development of clinical manifestations of pain.
-
Zh Nevrol Psikhiatr · Jan 2014
Comparative Study[Clinical characteristics of internal carotid and vertebral arteries dissection].
To compare demographic, clinical, and imaging characteristics of patients with internal carotid artery dissection (ICAD) and vertebral artery dissection (VAD) in a Russian population. ⋯ There were significant differences between patients with ICAD and VAD in terms of gender distribution, precipitating events, clinical and imaging features. Different embryonic origin of ICA and VA, their anatomical differences, and intramural hematoma location in relation to intima and adventitia may underlay these differences.
-
Delirium is a serious complication of disorders of nervous system and requires early detection for successful treatment. Confusion assessment method for intensive care unit (CAM-ICU) is a fast and reliable tool for detection of delirium. We performed screening for delirium among patients of neurological ward using CAM-ICU. Our experience showed that CAM-ICU could be used for the identification of delirium in neurological patients excluding those who suffer from severe aphasia.