Articles: pain.
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Applied neurophysiology · Jan 1980
Long-term follow-up study after pulvinotomy for intractable pain.
Pulvinotomy was performed on 42 cases with intractable pain. 19 cases survived for more than 1 year, the results were classified as follows: 4 were excellent, 4 good, 5 fair, and 4 were poor. The effects of the operation are discussed based on the disease. 2 cases, who survived for more than 1 year, suffered from the pain due to infiltration or metastasis of cancer, they died 22 and 14 months after the operation, respectively, but they had no intractable pain during the year before death. 14 cases who underwent CVD survived for more than 1 year. ⋯ After more than 1 year, 2 cases with atypical facial pain were considered as being either fair or poor, one (fair case) of whom still does routine housework and is not drug dependent. A case of causalgia has been free from pain for 5 years after the operation.
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Careful assessment is a necessary preliminary to treatment; pain may be caused by a variety of mechanisms or associated with a non-malignant condition. In the majority of patients treatment should be planned on a multimodality basis. The fact that pain is a somato-psychic phenomenon must not be forgotten. ⋯ When used as described, escalation of dose (tolerance) is not a practical problem. Physical dependence does not prevent the downward adjustment of dose should this become feasible as a result of non-drug intervention. Psychological dependence (addiction) does not occur if the patient is closely supervised and given adequate emotional support.
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Applied neurophysiology · Jan 1980
Experimental pain and transcutaneous electrical nerve stimulation at high frequency.
Transcutaneous electrical nerve stimulation (TENS) at high frequency and high intensity caused human pain threshold elevation for thermal stimuli only when thermal stimuli were applied at a site distal to the TENS electrodes. High-frequency TENS applied over the belly of m. biceps brachii did not cause a marked misestimation of elbow angle at any of the TENS intensities used. It is concluded that pain threshold elevation during high-frequency TENS is due to peripheral electrogenic blockade or fatigue of pain-mediating fibers. A minor effect of TENS on kinesthesia suggests a minor role of muscle afferents in mediating the effects of high-frequency TENS.
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Res Publ Assoc Res Nerv Ment Dis · Jan 1980
Neurophysiology of nociception and pain in the spinal cord.
Our experiments on the primate spinothalamic tract cells are consistent with the traditional view that the spinothalamic tract in primates is the main pathway responsible for pain sensation. However, we have no evidence concerning the possible role of other pathways, either in pain sensation or in the motivational-affective or reflex responses to painful stimuli. ⋯ Wide-dynamic-range cells can signal intensity, but they are not likely to provide good spatial resolution of stimuli. On the contrary, they are well suited to explain such phenomena as referred pain and pain radiation.