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Journal of neuropathic pain & symptom palliation最新文献

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Stump Pain 树桩疼痛
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0014
J. Devarajan, B. Minzter
{"title":"Stump Pain","authors":"J. Devarajan, B. Minzter","doi":"10.1093/med/9780190298357.003.0014","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0014","url":null,"abstract":"This chapter discusses stump pain or residual limb pain, which arises from the distal end of the stump after amputation. The initial phase, which lasts for 6 weeks, manifests as nociceptive pain that may be followed by neuropathic pain. In 5%–10% of patients with stump pain, the pain evolves to become predominantly neuropathic. In addition, stump pain can be arthrogenic, osteogenic, or infectious. History and physical examination are important in order to determine the origin of pain. Residual persistent ischemia of the stump should be ruled out. The stump should be examined and investigated to rule out the presence of a neuroma. Occasionally, radicular pain, which arises from the lumbosacral levels, presents as stump pain. The most effective management of stump pain is multidisciplinary and multimodal. Acute stump pain is treated with either epidural analgesia or, more commonly, peripheral nerve blocks. Chronic neuropathic pain is treated with antiepileptics such as gabapentin or pregabalin and NMDA receptor antagonists. Transcutaneous electrical nerve stimulation, spinal cord stimulation, and peripheral nerve stimulation play a limited role in management of stump pain. Neuromas are treated with radiofrequency ablation, cryoablation, or coblation. Surgery is the least successful modality to treat neuroma.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73039714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Persistent Idiopathic Facial Pain 持续性特发性面部疼痛
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0032
Trevor Van Oostrom
{"title":"Persistent Idiopathic Facial Pain","authors":"Trevor Van Oostrom","doi":"10.1093/med/9780190298357.003.0032","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0032","url":null,"abstract":"Persistent idiopathic facial pain (PIFP) is an enigmatic condition which has caused a great deal of suffering yet has been difficult to define and remains a challenging disorder to treat. In addition, the presentation of PIFP has considerable overlap with many other causes of facial pain making the malady a diagnostic challenge. The condition is often resistant to treatment and patients often have comorbid syndromes or psychological factors. This chapter reviews the history and development of the current diagnostic criteria of PIFP according to the latest edition of the International Classification of Headache Disorders (ICHD). Using a case-based approach, the pathophysiology, epidemiology, differential diagnosis, and treatment options of PIFP are explored.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74503489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuroma 神经瘤
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1007/978-3-642-23499-6_100701
J. Blackburn, A. Bautista
{"title":"Neuroma","authors":"J. Blackburn, A. Bautista","doi":"10.1007/978-3-642-23499-6_100701","DOIUrl":"https://doi.org/10.1007/978-3-642-23499-6_100701","url":null,"abstract":"","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83930441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ischemic Neuropathy 缺血性神经病变
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0015
J. Devarajan, B. Minzter
{"title":"Ischemic Neuropathy","authors":"J. Devarajan, B. Minzter","doi":"10.1093/med/9780190298357.003.0015","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0015","url":null,"abstract":"This chapter discusses the subset of ischemic neuropathy which is due primarily to peripheral arterial disease. Peripheral arterial disease affects 5% of men and 2.5% of women and results in ischemic pain and claudication. Disease progression occurs in a small minority of patients to a stage of critical ischemia with rest pain and threatens limb survival. Ischemic neuropathy encompasses pain due to several stages of progression of tissue ischemia. Patients may have multiple comorbid conditions due to the same pathological process that affects coronary, cerebral, and other circulations. Diabetes mellitus is commonly associated with vascular ischemia and results in arterial occlusive diseases. Pathological changes involve demyelination, axonal loss, and disorderly remyelination. In addition to simple palpation of a pulse, Doppler flow estimation and angiography are used to determine the location and extent of the disease process. Ankle-brachial index, toe-brachial index, and digital flow estimations are more sensitive methods used for early identification. In addition to controlling risk factors and the management of comorbid conditions, medication and procedures to restore blood flow play a prominent role in management of ischemic neuropathy. Sympatholysis and spinal cord stimulation are effective methods to help manage chronic pain in advanced cases that are refractory to conventional treatment measures.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76550977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacological Treatment of Neuropathic Pain 神经性疼痛的药理治疗
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/MED/9780190298357.003.0006
R. Brewer, R. Shah, Elizabeth Casserly
{"title":"Pharmacological Treatment of Neuropathic Pain","authors":"R. Brewer, R. Shah, Elizabeth Casserly","doi":"10.1093/MED/9780190298357.003.0006","DOIUrl":"https://doi.org/10.1093/MED/9780190298357.003.0006","url":null,"abstract":"Neuropathic pain is a result of a somatosensory lesion or disease process, either centrally or peripherally. Prevalence is estimated to be in the millions and high as 8% in the general population. Neuropathic pain is often associated with depression, sleep disturbances, compromised physical and emotional functionality, and reduced productivity. Pharmacotherapy is a key component of a multidisciplinary approach to the management of neuropathic pain and is a treatment limited by analgesic efficacy and dose-related side effects. First-line medications for neuropathic pain include tricyclic antidepressants (TCAs), serotonin-noradrenaline reuptake inhibitors (SNRIs), calcium channel alpha2delta-1 ligands (gabapentin and pregabalin), topical lidocaine (lidocaine patch 5%), and topical capsaicin (capsaicin 8% patch). Tramadol is generally considered second-line medication. Sources for this chapter have come from randomized control trials, systematic reviews, meta-analysis, and the IASP NeuPSIG guidelines for the treatment of neuropathic pain.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74528438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolic, Endocrine, and Other Toxic Neuropathies 代谢性、内分泌性和其他毒性神经病
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/MED/9780190298357.003.0019
M. Carney, Mark R. Jones, Preya K. Jhita, Harold J. Campbell, M. Romain, M. Motejunas, A. Kaye
{"title":"Metabolic, Endocrine, and Other Toxic Neuropathies","authors":"M. Carney, Mark R. Jones, Preya K. Jhita, Harold J. Campbell, M. Romain, M. Motejunas, A. Kaye","doi":"10.1093/MED/9780190298357.003.0019","DOIUrl":"https://doi.org/10.1093/MED/9780190298357.003.0019","url":null,"abstract":"Neuropathic pain permeates a variety of disease processes and remains a consistent challenge for patient treatment at all levels. Diabetes continues to plague a distinct proportion of healthcare in the United States. Without proper preventative measures, these patients are at high risk for acquiring diabetic peripheral neuropathy (DPN). Similarly, rampant alcohol abuse can likely lead to chronic neuropathic sequelae. These issues increase in proportion with an aging population. There are a variety of malnutrition-based disorders, which can manifest into specific neurological issues. Specifically, vitamins B1, B12, and E and copper deficiencies can all lead to neuropathic disorders that become difficult to treat after prolonged periods of nutritional deprivation. Finally, various chemotherapeutic regimens have many known neuropathic complications. These conglomerations of disease manifestation make metabolic neuropathies a complex topic to fully categorize and understand, but certain pearls are vital in a foundational understanding of this topic.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"141 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74315983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Classification of Neuropathic Pain 神经性疼痛的分类
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0002
A. Kandil, D. Perret
{"title":"Classification of Neuropathic Pain","authors":"A. Kandil, D. Perret","doi":"10.1093/med/9780190298357.003.0002","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0002","url":null,"abstract":"Neuropathic pain encompasses a category of chronic pain conditions that are caused by disease or lesion of the somatosensory nervous system. Depending on the location of the lesion or disease, neuropathic pain can be categorized as peripheral, central, or mixed. Peripheral neuropathic pain includes such common pain conditions as painful diabetic neuropathy, postherpetic neuralgia, radiculopathies, post-amputation stump pain, various nerve entrapment syndromes, and neuropathies due to immune, hereditary, metabolic, and toxic factors. Central neuropathic pain is pain caused by stroke, spinal cord injury, spinal infarction, syringomyelia, multiple sclerosis, Parkinson disease, and phantom limb pain. In contrast, some conditions may cause pain through both central and peripheral mechanisms, such spinal stenosis, complex regional pain syndrome type II, Charcot-Marie-Tooth disease, fibromyalgia, and cancer pain. Classification of neuropathic may not only help guide the diagnosis and treatment of these chronic pain conditions but may also provide the framework for research of the mechanisms of generation of neuropathic pain.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77509764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
HIV Polyneuropathy 艾滋病毒多神经病
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0017
Hersimren Basi
{"title":"HIV Polyneuropathy","authors":"Hersimren Basi","doi":"10.1093/med/9780190298357.003.0017","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0017","url":null,"abstract":"HIV polyneuropathy has become increasingly common as a neurological disorder associated with AIDS over the recent years. Patients frequently experience paresthesias, pain, numbness, and dysesthesias. Direct and indirect neurotoxicity associated with the HIV virus may lead to painful neuropathy. There are six main types of HIV-associated polyneuropathies: distal symmetrical neuropathy, inflammatory demyelinating polyneuropathy, progressive polyradiculopathy, mononeuropathy multilplex, autonomic neuropathy and diffuse infiltrative lymphocytosis syndrome. This chapter discusses all six types, including their assessment, diagnosis, pathophysiology, and treatment.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91369503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Brain Infarction (Thalamus and Brainstem) 脑梗塞(丘脑和脑干)
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/MED/9780190298357.003.0021
Theodore G. Eckman, Jianguo Cheng
{"title":"Brain Infarction (Thalamus and Brainstem)","authors":"Theodore G. Eckman, Jianguo Cheng","doi":"10.1093/MED/9780190298357.003.0021","DOIUrl":"https://doi.org/10.1093/MED/9780190298357.003.0021","url":null,"abstract":"Central post-stroke pain (CPSP) is a central neuropathic pain condition resulting from lesions of a prior cerebrovascular accident (CVA) mainly affecting the spinothalamocortical tract. About 5%–10% of patients with CVAs develop CPSP. The pain is thought to be secondary to a complex interaction of central disinhibition, central sensitization, and an imbalance of stimuli, although the exact mechanism remains unknown. The pain is located within and associated with sensory dysfunction in a region affected by a prior CVA lesion. The pain is often described as burning, stabbing, and sharp. Allodynia, hyperalgesia, and evoked dysesthesia appear to be major clinical findings for this condition. There are no specific diagnostic criteria for CPSP, and treatment is often difficult. Medications such as tricyclic antidepressants and anticonvulsants are often used. Motor cortex stimulation and deep brain stimulation are active areas of research and offer hope that additional treatment modalities may be identified.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85439228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postsurgical Neuralgia 手术后的神经痛
Journal of neuropathic pain & symptom palliation Pub Date : 2018-12-01 DOI: 10.1093/med/9780190298357.003.0009
J. P. Kenny, Dalia Elmofty
{"title":"Postsurgical Neuralgia","authors":"J. P. Kenny, Dalia Elmofty","doi":"10.1093/med/9780190298357.003.0009","DOIUrl":"https://doi.org/10.1093/med/9780190298357.003.0009","url":null,"abstract":"The development of post-surgical neuralgia (PSN) is multi-factorial and many questions still remain unanswered. PSN results from traumatic nerve injury during a surgical procedure. Little is known about the correlation between the mechanism of injury and the clinical presentation. PSN is often unrecogonized and misdiagnosed. It can be severely debilitating. The consequences of postsurgical neuralgia not only affect a patient’s quality of life, but also have a profound impact on healthcare costs. Identifying predisposing risk factors, utilizing a preventative approach, proper and timely detection, enhancing awareness amongst physicians and early pain management referral are imperative steps in the treatment of PSN. Surgeons and anesthesiologist have a crucial role in the prevention of PSN. Identifying high risk patients and high risk surgery types along with collaborative efforts to implement a multimodal perioperative analgesic plan is recommended.","PeriodicalId":87440,"journal":{"name":"Journal of neuropathic pain & symptom palliation","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78287579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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