Articles: neuralgia.
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Case Reports
Long-term epidural ketamine, morphine and bupivacaine attenuate reflex sympathetic dystrophy neuralgia.
There is considerable evidence that NMDA receptor antagonists can abolish nociceptor hypersensitivity in animals. In the present case report, two patients with reflex sympathetic dystrophy were treated with ketamine, a NMDA antagonist, morphine and bupivacaine. ⋯ Epidural coadministration of low doses of morphine, ketamine and bupivacaine provided effective pain relief in two patients. This suggests synergy from this combination that provides an alternative treatment for reflex sympathetic dystrophy.
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Journal of neurosurgery · Feb 1998
Follow-up results of using microvascular decompression for treatment of glossopharyngeal neuralgia.
Glossopharyngeal neuralgia (GPN) is an uncommon disorder that is characterized by a severe lancinating pain commonly induced by swallowing. There has been some debate among various authors as to which surgical procedure should be adopted to treat cases of GPN: microvascular decompression (MVD) or partial rhizotomy. The latter necessitates the partial destruction of normal neural structures. ⋯ Pain was relieved in all cases. Two patients complained of persistent mild hoarseness, causing the inability to speak loudly, and two patients complained of occasional coughing episodes that occurred for a couple of years after the surgery. No other complications were reported and no recurrence of pain was noted during the follow-up period. This procedure provided satisfactory results by preserving important perforating arteries in this area and by repositioning offending arteries in a safer and surer fashion, thus reducing complications and recurrence of GPN.
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Neuroscience letters · Jan 1998
Tactile allodynia, but not thermal hyperalgesia, of the hindlimbs is blocked by spinal transection in rats with nerve injury.
Spinal nerve ligation produces signs of neuropathic pain in rats. Different neuronal pathways may underlie the abnormal sensory responses to thermal and tactile stimuli. Here, the possibility that local circuitry in the spinal cord and/or spinal-supraspinal loops might be involved in tactile allodynia and thermal hyperalgesia of the hindpaws was investigated by transecting the spinal cord of sham-operated or L5/L6 nerve ligated rats. ⋯ Tail-withdrawal responses to tactile probing were very robust after spinal transection in both groups, demonstrating loss of descending inhibition. These observations suggest that thermal hyperalgesia of the paw seen after nerve injury involves both spinal and supraspinal circuits, while tactile allodynia depends on a supraspinal loop. This difference may reflect afferent inputs associated with different fiber types.