Current pain and headache reports
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Whether opioids are effective for neuropathic pain has been a matter of controversy for decades. Within limits, it is clear that opioids in general are effective for neuropathic pain. ⋯ Although some patients appear to enjoy long-term benefits, most studies have been short-term. Opioids have an important role in the treatment of neuropathic pain; however, skillful opioid use balances the benefits with management of side effects and prevention and treatment of abuse and addiction.
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Postherpetic neuralgia (PHN) remains one of the most troublesome common chronic neuropathic pain conditions. Many controlled trials have been published showing good efficacy and reasonable tolerability. ⋯ Combination therapies are possible, but have not been proven, and long-term follow-up is limited. Only few case series exist for surgical and other invasive therapies and their role remains uncertain.
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Headache in the pediatric population remains substantially underdiagnosed and undertreated. The recently revised International Headache Society (IHS) criteria, The International Classification of Headache Disorders, is a step in the right direction to improve our diagnostic accuracy. In this article, the diagnostic issues related to childhood periodic syndromes and migraine in the IHS 2004 revisions are reviewed.