Articles: neuralgia.
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The study aims to describe an ultrasound (US)-guided peripheral nerve stimulation implant technique and describe the effect of high-frequency peripheral nerve stimulation on refractory postherpetic neuralgia. ⋯ We report the implant of a supraorbital peripheral nerve stimulating electrode that utilizes a high-frequency program resulting in sustained suppression of intractable postherpetic neuralgia.
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The most common surgical options for trigeminal neuralgia (TN) are microvascular decompression (MVD) and gamma knife surgery (GKS). Currently, there is no definitive consensus as to which of the 2 options is more effective at providing immediate and long-lasting pain relief. This study seeks to better evaluate the differences between these 2 options in terms of rates of complete pain relief and pain-free recurrence. ⋯ MVD may be a more effective intervention than GKS because of the higher rates of initial pain-free outcomes and long-term pain-free outcomes, and lower rates pain-free recurrences.
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Comparative Study
Wide nervous section to prevent post-operative inguinodynia after prosthetic hernia repair: a single center experience.
Chronic post-operative inguinodynia occurs in about 10 % of patients undergoing inguinal hernioplasty with prosthesis; it is characterized by a broad pleomorphism of symptoms, including relative to individual variability of algic perception. Its intensity can also potentially jeopardize patient's work and social activities. The most notorious cause of inguinodynia is neuropathy, resulting from the involvement of one or more inguinal nerves (iliohypogastric, ilioinguinal and genitofemoral nerves) in fibroblastic processes, or from nervous stimulation, caused by prosthetic material on adjacent nervous trunks. The aim of our study was to provide a comparative analysis between outcomes of wide nerve resection vs. nerve sparing. ⋯ Despite the apparent paradox of an higher tissue damage, elective neurectomy of selected segments of inguinal nerves, appears an effective technique in preventing chronic postherniorraphy pain, considering both the lower incidence and the faster resolution of painful symptomatology.
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The role for nucleus caudalis (NC) and spinal dorsal root entry zone (DREZ) lesioning in the management of chronic pain emanating from increased electrical activity in the dorsal horn of the spinal cord and brainstem remains largely uncharted. ⋯ Spinal and NC DREZ lesioning can provide effective relief in well-selected patients with intractable chronic pain conditions arising from trigeminal pain, spinal cord injury, brachial plexus avulsions, post-herpetic neuralgia, and phantom limb pain.
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Treatment in trigeminal neuralgia (TN) must be adapted in each patient. Surgeons must be conscious of medical, surgical, and radiation treatment modalities to suggest ideal management. Gamma knife radiosurgery (GKRS) could be used multiple times compared with percutaneous retrogasserian balloon compression for pain control. The objective of this study is evaluate the efficacy of Gamma Knife Radiosurgery and retrogasserian balloon compression in TN refractory for prior GKRS. ⋯ Balloon compression decreased acute primary trigeminal neuralgia, but did not provide a clinically substantial advantage compared with GKRS in terms of decreasing pharmacological dosage and pain relief in a 24-month period.