Articles: neuralgia.
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Responses of spinal progenitors to spinal cord stimulation (SCS) following spinal cord injury (SCI) in rats were assessed to reveal their potential contribution to SCS-induced analgesia. ⋯ Spinal progenitor cells appear to be activated by SCS via descending pathways, which may be enhanced by gabapentin and potentially contributes to relief of SCI-induced neuropathic pain.
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Randomized Controlled Trial
High Frequency (HF10) Spinal Cord Stimulation for Chronic Neuropathic Pain.
Spinal cord stimulation (SCS) is well established treatment. In a prospective randomised controlled trial, novel 10-kHz High-frequency Therapy (HF10 Therapy) was superior to traditional low-frequency SCS for the treatment of chronic back and leg pain. ⋯ The patient reported 90% pain reduction at follow-up. Thoracic HF10 SCS is effective modality in managing chronic neuropathic pain.
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Chronic, focal, neuropathic pain is difficult to treat. Local nerve blocks are either ineffective or do not last. Regular neuromodulation modalities like spinal cord stimulation (SCS) or pain pump are invasive and affect a larger area. ⋯ Peripheral neuromodulation using peripheral nerve field stimulation (PNFS) is an effective, minimally invasive, targeted method of treatment. It is a relatively new modality in the field of neuromodulation but is used more often.
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It is widely accepted that neuroinflammation in the spinal cord contributes to the development of central sensitization in neuropathic pain. Mitogen-activated protein kinase (MAPK) activation plays a vital role in the development of neuroinflammation in the spinal cord. In this study, we investigated the effect of bexarotene (bex), a retinoid X receptor agonist, on MAPKs activation in chronic constriction injury (CCI)-induced neuropathic pain. ⋯ Therefore, bex might be a potential agent for the treatment of neuropathic pain. PERSPECTIVE: Bex could relieve neuropathic pain behaviors in animals by reversing MKP-1 downregulation and MAPKs activation in the spinal cord. Therapeutic applications of bex may be extended beyond cutaneous T-cell lymphoma.
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The usefulness of early sympathetic blockade in the prevention of postherpetic neuralgia (PHN) has been reported. However, the optimal duration and frequency of paravertebral blocks that prevent or maximally reduce the incidence of PHN need to be clarified. ⋯ Repeated paravertebral blocks using local anesthetic and steroids weekly over 2 or 3 weeks in the management of acute thoracic herpes zoster can provide safe and effective pain relief and minimize the incidence of PHN. However, no added benefit was detected from repeated blocks more than twice.