Der Nervenarzt
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Levetiracetam was released in 2000 as an antiepileptic drug for add-on treatment of focal epilepsies. Its efficacy and tolerability were investigated in this retrospective study. ⋯ Levetiracetam is a potent and generally well tolerable new antiepileptic drug which is also efficacious in patients with difficult-to-treat focal epilepsies.
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Recently we were able to describe the successful treatment of phantom pain and stump pain with botulinum toxin A in a first pilot study. This case report over a 1-year period now demonstrates that long-term treatment for this indication is possible. ⋯ Intrathecal clonidine was eliminated completely, as were the oral analgesics. A surgical treatment suggested for the stump pain was no longer necessary, and we suppose that botulinum toxin can also improve the tolerance of artificial limbs in cases of stump pain.
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We evaluated the 1-year prevalence of pain syndromes and quality of care among 157 consecutive multiple sclerosis (MS) inpatients (90 f, 67 m) aged 19-85 years, with extended disability status scores of 1.0-8.5 and clinically definite MS. In a standardized questionnaire, only severe pain (pain intensity on visual analog scale of at least 4/10) was documented and classified which had occurred more often than three times or lasted longer than 1 week within the last year. ⋯ This was even true for the most frequent pain, migraine, in which clear treatment recommendations exist. There is thus an urgent need for physicians to keep this problem in mind when treating MS patients.