Articles: neuralgia.
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Reg Anesth Pain Med · Mar 1999
Case ReportsAcute herpetic neuralgia and postherpetic neuralgia in the head and neck: response to gabapentin in five cases.
The clinical presentations and pharmacologic management of three patients with acute herpetic neuralgia (AHN) and two patients with postherpetic neuralgia (PHN), confined to the head and neck region, are described. ⋯ In view of the results in these patients, blinded, controlled studies are needed to determine the efficacy of gabapentin for treating AHN and PHN.
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To review treatment options for postherpetic neuralgia (PHN). ⋯ Early diagnosis and treatment of herpes zoster may offer patients the best chance of preventing the development of PHN. However, if PHN does develop, the patient should seek treatment early for the best chance of pain relief.
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Anticonvulsant drugs, especially carbamazepine, are the treatment of choice for glossopharyngeal neuralgia. If no clinical response is obtained, surgical treatment, including nerve section or decompression, may be required. ⋯ Response was poor in patients who had undergone surgical nerve decompression. Gabapentin was concluded to be an effective therapeutic option for neuralgia of the IXth cranial nerve before surgery.
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J Pain Symptom Manage · Mar 1999
Randomized Controlled Trial Clinical TrialIontophoretic vincristine in the treatment of postherpetic neuralgia: a double-blind, randomized, controlled trial.
The effect of iontophoretic administration of vincristine in the treatment of postherpetic neuralgia (PHN) was investigated in a prospective, double-blind, placebo-controlled trial. Twenty patients with intercostal or lumbar PHN for more than 6 months that was unresponsive to conventional medical therapy were randomized to receive vincristine 0.01% (n = 11) or saline (n = 9), by iontophoresis over 1 hour daily for 20 days. Demographics and median duration of pain were similar in both groups. ⋯ Moderate or greater pain relief was maintained in 30% of patients with vincristine and 33% of patients with placebo at follow-up on day 90. We conclude that iontophoresed vincristine is no better than iontophoresed saline in the treatment of PHN. The maintained improvement in both groups at 3 months follow-up may reflect the natural history of PHN, or might possibly by related to a beneficial effect of iontophoresis.
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Case Reports
[Greater occipital neuralgia associated with occipital osteolytic lesion. Case report].
The anatomic distribution of the greater occipital nerve during its path permits a close relationship with muscular structures, tendons, vessels and bones. The rupture of this relationship can origin its irritation and headache. We describe an uncommon association between an osteolytic lesion on occipital bone and greater occipital nerve. ⋯ The symptoms started spontaneously or by pressure on the trapezius tendon. The pain lasted about 30 minutes, compressive, mild intensity, with no autonomic symptoms and no improvement after the infiltration in the greater occipital nerve. The total improvement of the symptoms after releasing the nerve has allowed us to associate this lesion to the presence of algic symptoms.