Current pain and headache reports
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Neuropathic pain is an increasingly common problem facing the cancer patient. Painful neuropathy can come from various sources and significantly impact quality of life. ⋯ Neuropathic pain should be addressed ideally with the help of a neuro-oncologist, and it usually can be successfully treated with a variety of agents, including atypical analgesics such as antidepressants, newer drugs with analgesic benefit, and opioids for more refractory cases. Direct and indirect effects of the primary neoplasm need to be considered in the etiology of specific syndromes of mononeuropathies and plexopathies.
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Among the established and potential comorbidities of migraine, the temporomandibular disorders (TMD) are rarely discussed, although they are of importance for several reasons. TMD may cause headaches per se, worsen existent primary headaches, and add to the burden of headache disorders. ⋯ We discuss the similarities between both conditions, review evidence to support the idea that both disorders are comorbid, and highlight the limited evidence suggesting that TMD influence migraine progression. Finally, we discuss the importance of cutaneous allodynia mediating the TMD/frequent headache relationship.
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Curr Pain Headache Rep · Aug 2009
ReviewVertebroplasty in the management of painful bony metastases.
Percutaneous vertebroplasty is the injection of bone cement, usually polymethylmethacrylate into the vertebral body. This procedure is most often performed in a percutaneous fashion on an outpatient (or short-stay) basis. Among other indications, the procedure is designated for painful vertebral compression fractures due to primary or metastatic spinal tumors. ⋯ The overall risk of the procedure is low, although serious complications (including spinal cord compression) can occur. Recent advances in technique and materials may reduce the incidence of adverse outcomes. Proper patient selection and meticulous technique are required to achieve best results and to avoid complications.
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Curr Pain Headache Rep · Aug 2009
ReviewMedical imaging in the diagnosis and management of cancer pain.
Within the past few decades medical imaging has evolved very rapidly, now becoming an indispensable tool for the diagnosis, treatment, and follow-up of patients with cancer-related pain. Multiple imaging modalities are available for the assessment of cancer patients, each one with different advantages and limitations that are important to consider at the time we order a diagnostic study or plan an image-guided procedure. This article reviews the role that various imaging modalities play in the management of cancer pain and provides an overview of the latest technological advances.