Articles: neuralgia.
-
Pulsed radiofrequency (PRF), as a new technique, is used to treat a variety of chronic pain syndromes, but it has a high recurrence rate for herpetic neuralgia and is often combined with drugs therapy. The aim of this study was to comprehensively evaluate the efficacy and safety of PRF combined with pregabalin in the treatment of herpetic neuralgia. ⋯ PRF combined with pregabalin can effectively alleviate the pain intensity and improve sleep quality in patients with herpetic neuralgia, and the incidence of complications was low, so it was worthy of clinical application.
-
Chronic pain involves sensitization of nociceptors and synaptic transmission of painful signals in nociceptive circuits in the dorsal horn of the spinal cord. We investigated the contribution of clathrin-dependent endocytosis to sensitization of nociceptors by G protein-coupled receptors (GPCRs) and to synaptic transmission in spinal nociceptive circuits. We determined whether therapeutic targeting of endocytosis could ameliorate pain. mRNA encoding dynamin (Dnm) 1 to 3 and adaptor-associated protein kinase 1 (AAK1), which mediate clathrin-dependent endocytosis, were localized to primary sensory neurons of dorsal root ganglia of mouse and human and to spinal neurons in the dorsal horn of the mouse spinal cord by RNAScope. ⋯ Patch clamp recordings of dorsal horn neurons revealed that Dnm1 and AAK1 disruption inhibited synaptic transmission between primary sensory neurons and neurons in lamina I/II of the spinal cord dorsal horn by suppressing release of synaptic vesicles from presynaptic primary afferent neurons. Patch clamp recordings from dorsal root ganglion nociceptors indicated that Dnm siRNA prevented sustained GPCR-mediated sensitization of nociceptors. By disrupting synaptic transmission in the spinal cord and blunting sensitization of nociceptors, endocytosis inhibitors offer a therapeutic approach for pain treatment.
-
Randomized Controlled Trial
Efficacy of Duloxetine in Patients with Central Post-Stroke Pain: A Randomized Double Blind Placebo Controlled Trial.
Central post-stroke pain (CPSP) refers to neuropathic pain in areas of the body corresponding to stroke lesions. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, is safe and effective against neuropathic pain. In this randomized double-blind placebo-controlled study, we studied the effect of duloxetine in CPSP patients. ⋯ Duloxetine can be an effective treatment option for patients with moderate to severe central post-stroke pain.
-
J Pain Palliat Care Pharmacother · Jun 2023
ReviewAnalgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review.
Post-herpetic neuralgia (PHN) is an entity derived from peripheral nerve damage that occurs during the reactivation of the Varicella Zoster Virus (VZV), which manifests itself through pain with neuropathic characteristics. This can prove to be very difficult to manage in the chronic stages of disease reappearance. There currently exists a multitude of treatment alternatives for PHN, however, prevention through the early initiation of antiviral regimens is vital. ⋯ Interventional procedures have become a cornerstone in difficult-to-manage cases, and have shown promising outcomes when used in a multimodal approach by experienced specialists. It is necessary to make an objective diagnosis of PHN and start early treatment. Additionally there is current evidence that vouches for interventional therapies as well as individualization, with a clear establishment of therapeutic objectives according to the needs of each patient.