Pain physician
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Trigeminal neuralgia (TN) is usually established using characteristic clinical features such as sudden, severe, and unilateral facial pain. Studies about diverse clinical features and epidemiologic data of TN have been reported previously; however, most of the previous studies have evaluated in and focused on Caucasian and Western populations. ⋯ There is little difference between Korean and other Asian patients with TN in their demographic and clinical characteristics.
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Observational Study
The Value of the Optic Nerve Sheath Diameter (ONSD) in Predicting Postdural Puncture Headache (PDPH): A Prospective Observational Study.
Postdural puncture headache (PDPH) is one of the serious complications after lumbar puncture, but there is no effective tool to predict it. ⋯ We believe that continuous measurements of ONSD may be a useful tool for predicting PDPH.
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Mild traumatic brain injury (mTBI), or concussion, is the most common presentation of TBI in the emergency department (ED), but a diagnosis of mTBI may be missed in patients presenting with other acute injuries after a motor vehicle collision (MVC). ⋯ Patients presenting to the ED following an MVC have a high prevalence of mTBI. Patients whose diagnosis of mTBI is missed end up with significantly more severe postconcussion symptoms. While all patients included in this study were either referred or being treated for chronic pain after an MVC, they all also went on to develop PCS and disability following their accident, suggesting that better screening for mTBI after an MVC might identify those who may require more follow-up or rehabilitation therapy. In particular, those presenting with loss of consciousness, an altered mental state, posttraumatic amnesia, or postinjury headache are at increased risk of PCS.
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Randomized Controlled Trial Multicenter Study
Improved Sensation Resulting From Spinal Cord Stimulation for the Treatment of Painful Diabetic Neuropathy: The Possible Role of Stochastic Resonance.
Painful diabetic neuropathy (PDN) is a progressive chronic pain condition that significantly affects the quality of life of patients with long-standing diabetes mellitus. Sensory deficits may result in falls, foot ulceration, and lower limb amputations. Recently, spinal cord stimulation (SCS) was studied for treatment of painful diabetic neuropathy. In addition to pain relief, we were surprised to discover that sensory improvements were also demonstrated. No mechanistic explanation has yet been offered to explain these findings. ⋯ SCS might have unexpected benefits in patients with PDN beyond pain reduction. The Senza-PDN trial is the first to describe improved sensation in association with SCS. While the mechanism of action are still unknown, we hypothesize that noise-enhanced signal processing via stochastic resonance may explain these results. Stochastic resonance, or the benefit of additional randomness, should be further studied in the context of spinal cord stimulation. Further, SCS programming that optimizes for stochastic resonance should also be investigated for restoration of sensory and possibly even motor function.