Articles: neuralgia.
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Acta medica Hungarica · Jan 1989
Review Case ReportsTreatment of chronic pain syndromes with transcutaneous iontophoresis of vinca alkaloids, with special regard to post-herpetic neuralgia.
Successful treatment of 35 post-herpetic neuralgia (PHN) patients by means of transcutaneous iontophoresis of Vincristine is reported. This technique, based on transganglionic regulation--a novel neurobiological principle discovered by Csillik and Knyihár-Csillik-, alleviated pain in both fresh and inveterated PHN cases. Statistical analysis of the results excludes a placebo-like action.
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The Sphenopalatine neuralgia of the ganglion is characterized for a throbbing pain mostly unilateral encircling the orbit and occasionally extended to the neighborhood. A vegetative component hydrorrhea, sneezing crisis and abnormal lacrimation is associated. The ideal therapy, giving excellent results, is the iontophoresis of the ganglion, which technic was published years ago by F. Barceló.
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This study concerns the posterior ramus of the second cervical spinal n., or greater occipital of Arnold. By means of dissections in formalin embalmed cadavers, an attempt was made to define its winding course and to locate it in relation to clinical or radiographic landmarks, so as to provide a guide for infiltration of the nerve with local anesthetic. At the same time a dynamic study was made to elucidate the relations of the nerve to adjacent structures during the different movements of the neck. This allowed us to propose clinical tests of nerve involvement and to reveal the zones where the nerve is anatomically vulnerable.
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The authors report on a series of patients with severely painful disorders of peripheral nerves--they review the modern theories on the nature of causalgia and reflex sympathetic dystrophy. Peripheral causes include spontaneous discharges from neuroma sprouts, their sensitivity to adrenergic compounds, ectopic generator activity in abnormally myelinated fires and increased firing in dorsal root ganglia. Central causes include spontaneous activity of deafferented nerves in the dorsal horn and development of response to new receptive fields. ⋯ Recurrences depend on the degree of initial response. Those who obtained virtually complete relief of pain had a lower recurrence rate but a high proportion needed repeated sessions of treatment at yearly intervals. Follow-ups must therefore be indefinite.