Articles: neuralgia.
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Randomized Controlled Trial Multicenter Study
A randomized trial of pregabalin in patients with neuropathic pain due to spinal cord injury.
To assess the efficacy and tolerability of pregabalin for the treatment of central neuropathic pain after spinal cord injury (SCI). ⋯ This study provides class I evidence that pregabalin, 150 to 600 mg/d, is effective in reducing duration-adjusted average change in pain compared with baseline in patients with SCI over a 16-week period (p = 0.003, 95% confidence interval = -0.98, -0.20).
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Randomized Controlled Trial
Sensory and affective pain descriptors respond differentially to pharmacological interventions in neuropathic conditions.
Pain management is limited by inability to match a patient's condition-and pain mechanisms-to optimal treatment(s). Much is known about pain treatment from animal investigations, but antinociceptive mechanisms cannot be readily explored in clinical studies. Evidence suggests that self-report verbal pain descriptors characterize important pain dimensions and may reflect diverse underlying mechanisms. ⋯ These results point to the hypothesis that sensory and affective pain descriptor profiles exhibit a treatment-specific response. Larger, more definitive, investigations to evaluate treatment-specific effects on multiple sensory and affective pain descriptors, and prediction of treatment response by these descriptors, will advance efforts toward developing and implementing more effective individualized pain therapies.
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Randomized Controlled Trial
Low-dose vaporized cannabis significantly improves neuropathic pain.
We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling medium-dose (3.53%), low-dose (1.29%), or placebo cannabis with the primary outcome being visual analog scale pain intensity. Psychoactive side effects and neuropsychological performance were also evaluated. Mixed-effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the 2 active dose groups' results (P > .7). The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo versus low-dose, 2.9 for placebo versus medium-dose, and 25 for medium- versus low-dose. As these NNTs are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well tolerated, and neuropsychological effects were of limited duration and readily reversible within 1 to 2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain. ⋯ The analgesia obtained from a low dose of delta-9-tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning.
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Randomized Controlled Trial
Levetiracetam in patients with central neuropathic post-stroke pain--a randomized, double-blind, placebo-controlled trial.
Central post-stroke pain (CPSP) is a severe chronic neuropathic pain condition defined as a spontaneous pain or allodynia corresponding to a vascular lesion. It usually evolves weeks after stroke, and can distinctively impair the quality of life. Treatment is complex and mostly unsatisfactory. We hypothesized that the anti-epileptic drug levetiracetam (LEV) improves CPSP compared with placebo. The purpose of this study was to examine the efficacy and tolerability of LEV in patients with CPSP. ⋯ LEV is not effective in treatment for CPSP. The mode of action of LEV does not exert an analgesic effect in chronic CPSP.
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Randomized Controlled Trial
[Clinical observation of post-herpetic neuralgia treated with TCM herbal cupping therapy].
To compare the difference in the efficacy on post-herpetic neuralgia among TCM herbal cupping therapy, Chinese medicine thermal compressing therapy and mecobalamine. ⋯ TCM herbal cupping therapy achieves the superior efficacy for post-herpetic neuralgia and relieves pain effectively of the patients, which is more advantageous than CM herbal thermal compressing therapy and Mecobalamine.