Articles: neuropathic-pain.
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Over the past few decades, substantial advances have been made in neuropathic pain clinical research. An updated definition and classification have been agreed. Validated questionnaires have improved the detection and assessment of acute and chronic neuropathic pain; and newer neuropathic pain syndromes associated with COVID-19 have been described. ⋯ Innovative approaches to improving therapeutic strategies are required. These mainly encompass rational combination therapy, drug repurposing, non-pharmacological approaches (such as neurostimulation techniques), and personalised therapeutic management. This narrative review reports historical and current perspectives regarding the definitions, classification, assessment, and management of neuropathic pain and explores potential avenues for future research.
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We describe here the development and validation of the Osteoarthritis Symptom Inventory Scale (OASIS), a new self-administered questionnaire specifically designed to evaluate the various osteoarthritis (OA) pain symptoms with different dimensions related to OA pain mechanisms. The initial development phase and qualitative study generated a list of 17 descriptors reflecting OA pain and other associated symptoms, leading to the first version of the questionnaire (OASIS17). Each item was quantified on a 0 to 10 Numerical Scale. ⋯ The final OASIS version includes 9 items discriminating and quantifying 3 distinct, clinically relevant OA pain dimensions sensitive to treatment. OASIS9 psychometric properties suggest that it could improve the characterization of OA pain profiles for 3 clinically relevant domains: localized, neuropathic-like, and deep pain. The OASIS9 questionnaire could be used to phenotype OA pain patients and identify responders to various therapeutic interventions as a function of OA pain dimensions.
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Computed tomography-guided percutaneous selective radiofrequency thermocoagulation (RFT) of the trigeminal nerve is a novel, minimally invasive technique for the treatment of trigeminal neuralgia, but the high recurrence rate after surgery might pose a serious problem. ⋯ Increasing temperature can effectively reduce the recurrence rate after RF, and the combination of atypical pain and higher NRS-11s could be a risk factor increasing the recurrence rate. The novel nomogram exhibited favorable survival stratification accuracy and shown a great potential for screening high-risk groups and evaluating the risk of recurrence rate.
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Dorsal root entry zone (DREZ) lesioning may be used to treat neuropathic pain in patients with traumatic brachial plexus injuries. The clinical outcome after surgery is variable in the medical literature. We aimed to report the surgical outcome after DREZ lesioning by radiofrequency and to analyze prognostic factors such as the presence of a spinal cord injury identified before surgery. ⋯ DREZ lesioning using radiofrequency represents a significant therapeutic approach for managing neuropathic pain after a traumatic brachial plexus injury. Importantly, we found that the presence of a spinal cord injury is not associated with the surgical outcome.
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Case Reports
Virtual Reality Treatment of Severe Neuropathic Pain in an Adolescent Child: A Case Report.
We describe virtual reality (VR) used as an effective intervention to treat severe chronic neuropathic pain in an otherwise healthy adolescent boy. The patient presented with severe pain and allodynia in the right foot after calcaneus extension surgery. ⋯ VR gaming intervention provided the patient with significant pain relief and substantial improvement in functionality. This case report details the VR intervention and its effect on the patient's severe, medically refractory pain syndrome.