Articles: neuralgia.
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Previous studies have shown that the peripheral nerve regeneration process is linked to pain in several neuropathic pain models. Other studies show that sympathetic blockade may relieve pain in some pain models and clinical conditions. This study examined reduction in peripheral nerve regeneration as one possible mechanism for relief of neuropathic pain by sympathetic blockade. ⋯ In both models, microsympathectomy reduced macrophage density in the sensory ganglia and peripheral nerve. This corroborates previous work showing that sympathetic nerves may locally affect immune function. The results further highlight the challenge of improving pain in neuropathic conditions without inhibiting peripheral nerve regeneration that might otherwise be possible and desired.
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Aim To investigate the impact of pain intensity of postherpetic neuralgia (PHN) patients. Methods This cross sectional study included 30 PHN patients attended to the Dermatology and Venereology Department of the School of Medicine of Universitas Sumatera Utara during the period between April 2019 and October 2019. Zoster Brief Pain Inventory questionnaire including the worst pain in 24 hours and the level of interference with seven domains of quality of life (QoL) (general activity, mood, walking ability, working, relationship with other people, sleep and enjoyment of life) were used. ⋯ Therefore, the correlation between worst pain intensity and walking ability was moderate (r=0.475). The worst pain intensity had a significant correlation with all seven domains of QoL (p<0.05). Conclusion Pain intensity influences the QoL with directly proportional correlation between pain intensity and disturbance of QoL.
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Case Reports
Paresthesia-Free Spinal Nerve Root Stimulation for the Treatment of Chronic Neuropathic Pain.
Stimulation of the dorsal spinal roots, or spinal nerve root stimulation (SNRS), is a neuromodulation modality that can target pain within specific dermatomal distributions. The use of paresthesia-free stimulation has been described with conventional dorsal column spinal cord stimulation, although has yet to be described for SNRS. This objective of this study was to investigate the efficacy of paresthesia-free high-frequency (1000-1200 Hz) SNRS in the treatment of intractable, dermatomal neuropathic pain. ⋯ We present real-world outcomes of patients with intractable dermatomal neuropathic pain treated with paresthesia-free, high-frequency SNRS. We demonstrate its effectiveness in providing pain reduction at a level comparable to tonic SNRS up to 24 months follow-up, without producing uncomfortable paresthesias.
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Journal of neurotrauma · Aug 2020
FTY720 attenuates neuropathic pain after spinal cord injury by decreasing systemic and local inflammation in a rat spinal cord compression model.
Neuropathic pain severely impairs rehabilitation and quality of life after spinal cord injury (SCI). The sphingosine-1-phosphate receptor agonist, FTY720, plays an important protective role in neuronal injury. This study aims to examine the effects of FTY720 in a rat acute SCI model, focusing on neuropathic pain. ⋯ Whereas there was no difference in the CGRP expression between the two groups, FTY720 significantly preserved the MOR in both the caudal and rostral areas of the spinal dorsal horn. Whereas HTT was preserved in the FTY720 group, it was significantly increased in the rostral side and decreased in the caudal side of the injury in the vehicle group. These results suggest that FTY720 ameliorates post-traumatic allodynia through regulation of neuroinflammation, maintenance of the blood-brain barrier, and inhibition of glial scar formation, thereby preserving the connectivity of the descending inhibitory pathway and reducing neuropathic pain.
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Interplay between body schema, visuospatial perception and pain in patients with spinal cord injury.
Changes in body representations (body image and/or body schema) have been reported in several chronic musculoskeletal pain syndromes, but rarely in patients with neuropathic pain and never in patients with spinal cord injury (SCI)-related pain. ⋯ Spinal cord injury is associated with alterations of lower body scheme as assessed with the laterality judgement task, which are directly related to pain intensity in patients with below-level neuropathic pain.