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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ninety-two patients suffering from herpes zoster were enrolled in a double-blind controlled study aimed at evaluating the efficacy and tolerance of the drug neuramide. Neuramide (N) and placebo (P) were administered to patients intramuscularly twice daily for 28 days as follows: group N + N (patients always treated with neuramide); group N + P (patients treated with neuramide for 1 week, then with placebo); group P + N (patients treated with placebo for 1 week, then with neuramide); group P + P (patients always treated with placebo). During the first week, all patients were also treated with standardized doses of acyclovir. The presence and extent of clinical symptoms were evaluated during the first 4 weeks, while the appearance, degree and duration of postherpetic neuralgia were evaluated both during treatment and over a 6-month follow-up period. There were no significant differences between the four groups of patients when subjective parameters (such as pain and paresis at the lesion site) were examined. However, clinical examination at the end of treatment showed that treatment with neuramide was therapeutic. Indeed, the times for recovery and for regeneration of epithelium were significantly shorter when neuramide was administered for 3 weeks of the treatment period. Furthermore, the change from vesicles to crusts was significantly faster in the neuramide group than in the placebo group. Postherpetic neuritis occurred in the first months of follow-up. However, in groups N + P and P + P, the symptoms lasted throughout the 6-month observation period, while in the other groups this period was shorter. Indeed, there were significant differences (p < 0.05) in terms of the above complications between the following groups: N + N and N + P; N + N and P + P; N + P and P + N; P + N and P + P. No significant differences were observed between the N + N and P + N, or N + P and P + P groups. Taken together, these data demonstrate that neuramide treatment for at least 3 weeks significantly reduces the risk of postherpetic neuritis development.
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PMID:Evaluation of efficacy and tolerance of neuramide in the treatment of herpes zoster and postherpetic neuritis. 1195 78

Diagnosing and managing neuropathic pain with associated sensory aberrations can be aggravating and frustrating for both the dentist and the patient. The teeth and intraoral and extraoral tissues can be affected if neuritis is located in the maxillary or mandibular nerve branches. Dentists should be aware of a neuritic etiology for tooth pain because an incorrect diagnosis can lead to ineffective and unnecessary dental work.
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PMID:Neuritic toothache. 1200 98

Many techniques are available to the surgeon confronted with a patient with recurrent nerve entrapment/traction neuritis. The advantage of local muscle or fat flaps like the ADQ, pronator quadratus, and hypothenar fat flap is the ease at which each can be elevated. The size is very limited, however. Circumferential vein wrapping has been studied extensively and is efficacious despite the absence of vascularity, but length requirements may limit the indications to short nerve segments, as might be expected with recurrent carpal tunnel syndrome. Despite the increased complexity of a pedicled flap and free tissue transfer, the tissue availability, girth, and source of vascularity make these sophisticated techniques more attractive. Such flap transfers should be used only after the more simple techniques have been ruled out as options or failed and only if residual pain and hypersensitivity are due to localized neuritis as opposed to a more generalized dystrophic symptomatology.
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PMID:Recurrent carpal tunnel syndrome: treatment options. 1213 49

Cryoanalgesia (the use of cold to provide anesthesia or analgesia) is the oldest anesthetic and analgesic still in current clinical use. Its intraoperative use in providing postoperative analgesia for acute thoracic pain problems via an open thoracotomy is well described. The long-term efficacy of cryoanalgesia for the management of chronic thoracic pain due to intercostal neuralgia is less clear. We retrospectively examined the medical records of patients who received percutaneous cryoanalgesia following successful intercostal nerve blockade for chronic chest pain. Sixty percent of the patients (N = 43) reported significant pain relief immediately following their procedure. Three months following cryoanalgesia, 50% continued to report significant pain relief. There were no reports of neuritis or neuroma formation and only three patients had a pneumothorax. This work provides evidence that cryoanalgesia is a safe and efficacious method of providing analgesia for chronic thoracic pain due to intercostal neuralgia.
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PMID:The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. 1215 29

The authors present the case of a patient with recurrent trigeminal neuralgia, refractory to medical treatment and ablation of the trigeminal ganglion, who underwent three separate CT guided injections for pterygopalatine ganglion ablation over a two year period. Ablation of the pterygopalatine ganglion may be an effective technique for pain management in patients suffering from atypical facial pain syndrome, cluster headache, or neuritis. The technique used for CT guided ablation using alcohol or radiofrequency is described. The advantages and pitfalls of this technique are reviewed.
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PMID:[CT guided neurolysis of the sphenopalatine ganglion for management of refractory trigeminal neuralgia]. 1222 18

A variety of molecules released by inflammatory reactions in the dorsal root and dorsal root ganglion (DRG) may play important roles in the pathology of neuronal abnormalities in lumbar disc herniation. In order to elucidate the pathophysiological mechanisms of painful radiculopathy, secondary to lumbar disc herniation, we evaluated pain-related behavior and the change of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) expression in the DRG and dorsal root using a rat model of lumbar disc herniation. In the nucleus pulposus (NP) group, the left L4/5 nerve roots were exposed after hemilaminectomies and autologous intervertebral discs, which were obtained from coccygeal intervertebral discs, were implanted on each of the exposed nerve roots without mechanical compression. Rats in the NP group, but not the sham-operated rats, developed mechanical allodynia on the ipsilateral hind paw for 1 day after surgery and showed a significant increase in the number of NGF-immunoreactive (IR) cells in the nerve root and DRG. NGF-IR cells in the nerve root and DRG included macrophages and Schwann cells, because these cells were labeled for NGF and ED-1 or glial fibrillary acid protein by dual immunostaining. A significant increase in the percentage of BDNF-IR neurons in the DRG was observed in the NP group at 3 days after surgery and the increase in BDNF mRNA expression was confirmed using in situ hybridization histochemistry and reverse transcription-polymerase chain reaction. We also injected NGF into the endoneurial space of the normal rat spinal nerve root and found that the NGF injection produced dose-dependent mechanical allodynia on the ipsilateral hind paw at 1 day after surgery and an increase in the percentage of BDNF-IR neurons in the DRG at 3 days after surgery compared to the group receiving saline injection. These findings suggest that in the lumbar disc herniation model, i.e. neuritis of the nerve root, increased NGF produced by the inflammatory responses in the dorsal root and DRG tissues may affect the production of BDNF in the DRG and may play important roles in the modulation of the dorsal horn neurons. These changes in neurotrophic factors in the primary afferents may be involved in the pathophysiological mechanisms of neuropathic pain produced by lumbar disc herniation.
Pain 2002 Sep
PMID:Expression of neurotrophic factors in the dorsal root ganglion in a rat model of lumbar disc herniation. 1223 90

Wasp stings generally cause local reactions like pain, wheal, flare, edema and swelling, which are generally self-limiting. Multiple stings can lead to vomiting, diarrhea, generalized edema, dyspnea, hypotension, collapse, renal failure or death. Unusually, they may cause serum sickness, vasculitis, neuritis or encephalitis. We report a case of a 40 year old male who developed focal neurological deficit 10 hours following a wasp sting, which was confirmed to be ponto-cerebellar infarction on MRI scan, and recovered within five days.
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PMID:Wasp sting induced neurological manifestations. 1239 66

We assessed radiographic and functional outcome in 13 patients with a minimum of 5 years follow-up from a prospectively monitored series of 17 patients who underwent percutaneous vertebroplasty (PPV). A visual analogue scale (VAS) and the short McGill questionnaire (MPQ) were used to assess average symptoms. The VAS showed significant improvement after treatment: the initial score was 9.07+/-0.6 (mean+/-SD), falling to 2.07 (1.14) on the third day, 1.07 (1.07) by the third month and 2.15 (2.6) at 5 years. Pain reduction was statistically significant ( P<0.001). The MPQ showed a significant improvement after treatment ( P<0.001), but had worsened by the last follow-up. All patients were "very" or "somewhat satisfied" with the procedure. We saw no further collapse of the vertebrae injected or migration or changes in the shape of the cement. A new fracture was seen in three patients, affecting four vertebrae, only two of which were adjacent to the treated level. On CT following the procedure, there was cement in the epidural veins adjacent to the vertebra in 48% of cases, but only patient developed a transitory neuritis.
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PMID:Percutaneous vertebroplasty: long-term clinical and radiological outcome. 1242 34

Over the years patients with relatively minor compressive injuries seem to have a different morbidity, largely because of a constellation of neurologic findings, including dysesthesia and hyperesthesias. These are usually multifocal, and often extend far beyond the point of impact of the crushing force. Neuroischemia may play a role in the development of chronic pain after crush injuries to the foot, either through direct trauma to the peripheral nerves or by intraneural or extraneural fibrosis. This direct trauma to the nerve may cause chronic neuritis, which then triggers a sympathetically mediated pain syndrome. For the injured worker, these problems seem to be magnified. Early recognition of the extent of injury, the zone of injury, and the need for early soft tissue coverage is essential. With expeditious treatment, wound coverage, treatment of compartment syndromes, and early aggressive rehabilitation, many of the complications of these injuries, including chronic pain syndromes, can be minimized.
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PMID:Crush injuries of the foot in the industrial setting. 1246 15

The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.
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PMID:Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery. Report of two cases. 1250 91


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