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

In a model of peripheral mononeuropathy produced by 4 ligatures around the sciatic nerve, we investigated the effects of various i.v. doses of morphine on the vocalization thresholds elicited by paw pressure and compared the effects obtained with the same doses in normal rats. In neuropathic rats, morphine (0.1 and 0.3 mg/kg) produced a significant analgesic effect on the lesioned hind paw, maximum at 15 min post injection with a recovery at 20-25 min. For doses of 0.6 and 1 mg/kg, a modification of the kinetics was observed, with maximum effect at 20-30 min post injection and a recovery at 50-80 min. An analgesic effect was also observed on the unlesioned side, significantly less potent than that observed on the lesioned paw. The effect of 1 mg/kg morphine was almost totally reversed by a 0.1 mg/kg dose of systemic naloxone. The effects induced by the successive doses of morphine on the lesioned paw appeared higher than in normal rats (maximum vocalization thresholds (% of control) following 1 mg/kg morphine (N = 12) were 193.92 +/- 6.57% versus 154 +/- 3.5% in normal rats N = 3), whereas they were comparable to those obtained from the sham-operated paw. The present data clearly show that morphine induces potent antinociceptive effects in a rat model of neuropathy, which seems to contradict the classical view that neuropathic pain is opioid resistant. Some possible pathophysiological mechanisms are discussed.
Pain 1991 Oct
PMID:Behavioural evidence that systemic morphine may modulate a phasic pain-related behaviour in a rat model of peripheral mononeuropathy. 166 27

Chronic foot pain developed in a 43-year-old woman after taking methysergide, a potent vasoconstrictor. The etiology was believed to be ischemic monomelic neuropathy, which results from the compromise of blood flow to an extremity. The patient eventually required a surgical sympathectomy after lumbar sympathetic blocks failed to provide permanent relief.
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PMID:Chronic pain after methysergide: a new cause of ischemic monomelic neuropathy. 166 89

Adolescent patellofemoral disorders which are associated with recognizable change in the articular cartilage of the patella are called chondromalacia patellae. This is a clinical syndrome characterized by persistent retropatellar pain, but not always associated with histopathological changes of the articular cartilage. When lateral retinacular release is performed in such patients, pain is frequently eased even though lateral release does not always cause an appreciable change in patellofemoral contact pressure. This suggests that pain, at times, may emanate from the peripatellar retinacular supports themselves. Thirty-five knees of 22 patients suffering from anterior knee pain (with or without an unstable patella) were investigated histologically. Pathological changes in nerves were graded on a 0 to 3 + scale of severity. There was severe degenerative neuropathy in nine knees, moderate change in nine, and slight change in 11; the remaining six knees were normal. Histological investigation of the resected lateral retinaculum suggested that pain originated in the lateral retinaculum in many patients, and that degenerative changes in the nerves of the lateral retinaculum may be an important cause of pain in patients with patellofemoral disorders.
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PMID:Lateral retinaculum release in adolescent patellofemoral disorders: its relationship to peripheral nerve injury in the lateral retinaculum. 166 10

Diabetic neuropathy may have a metabolic or an ischemic origin, and the pattern of nerve damage varies by cause. Treatment should address the underlying cause. Patient reassurance, relaxation techniques, glucose control, use of tricyclic antidepressants or anticonvulsants, and surgical decompression for entrapment neuropathy are currently the mainstays of treatment. Physicians must reassure these patients that neuropathic pain is temporary.
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PMID:Diabetic neuropathy. Helping patients cope with their pain. 168 27

Taxol is a promising new antitumor drug with therapeutic use that is limited by a toxic sensory neuropathy. Taxol is also cytotoxic to dorsal root ganglion neurons in vitro, but this effect is prevented by cotreatment with the trophic protein, nerve growth factor. We sought to develop an animal model and then to determine whether nerve growth factor can prevent taxol neuropathy in vivo. Administration of taxol to mice resulted in a profound sensory neuropathy characterized by decreases in dorsal root ganglion content of the peptide neurotransmitter, substance P, elevated threshold to thermally induced pain, and diminished amplitude of the compound action potential in the caudal nerve. Coadministration of nerve growth factor prevented all of these signs of neurotoxicity. These findings suggest that administration of nerve growth factor may prevent certain toxic sensory neuropathies.
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PMID:Nerve growth factor prevents toxic neuropathy in mice. 170 9

Iloprost, a stable prostacyclin analog, was evaluated clinically for its ability to ameliorate the symptoms of peripheral neuropathy associated with diabetes. In an open, nonrandomized trial, 13 diabetic patients with neuropathy but without proliferative retinopathy received an intravenous infusion of Iloprost at a dose of 10 micrograms, at a rate of 0.1 micrograms/kg/h, twice daily for two weeks. The administration of Iloprost relieved the majority of such subjective symptoms as pain, numbness or sensation of cold and to a lesser extent, such autonomic symptoms as dizziness. In contrast, there was little evidence of objective improvement, e.g., in motor nerve conduction velocity. Iloprost treatment significantly inhibited the platelet aggregation rate stimulated by collagen in vitro. In the one patient tested, thermography revealed an increase in skin temperature by more than 2 degrees C. Side effects associated with Iloprost included headache (3 patients) or aggravation of pain in the extremities (2 patients) and could be ameliorated by slowing the infusion rate or by discontinuing the drug (one patient). Iloprost appears to be safe and effective for relieving the symptoms of diabetic neuropathy. Our results provide the rationale for a double-blind, clinical trial in larger populations of diabetics with peripheral neuropathy.
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PMID:Clinical efficacy of a stable prostacyclin analog, iloprost, in diabetic neuropathy. 170 9

A 41-year-old man with PPP since in 1982 was admitted in May, 1987, because of the progressive asymmetric sensory disturbance in the hands and feet over 4 months, accompanied by an exacerbation of PPP. On admission, eruptions of PPP were observed in the palms and soles. Asymmetric and mildly decreased sensations of touch and pain were present in the distal part of the four extremities as well as in his trunk, accompanied by paresthesia and dysesthesia. Mild to moderate weakness was noted in the hand muscles, and slight muscular atrophy was present in the right lower leg. A work-up for collagen vascular disease was within normal limits. T lymphocyte subset showed a decreased ratio of OKT 4/OKT 8. Left sural nerve biopsy showed axonal degeneration and moderate decrease of myelinated fibers, and the vasculitis was not found. The neurological signs and symptoms as well as the skin eruptions improved with methylprednisolone 40 mg/day. A causal relationship between the multiple mononeuropathy and PPP of our patient was indicated by the almost simultaneous onset of the neuropathy and the exacerbation of PPP as well as the improvement of these two conditions with corticosteroid therapy. Such combination of multiple mononeuropathy and PPP has not so far been reported.
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PMID:[A case of multiple mononeuropathy associated with pustulosis palmaris et plantaris (PPP)]. 176 52

Vibration and thermal detection threshold and heat pain threshold were determined in 34 diabetics scrutinized for clinical neuropathy using a standardized questionnaire and examination form. On the basis of the clinical grading patients were classified as having either no neuropathy or a neuropathy of increasing severity. As expected thermal and vibratory detection threshold increased with increasing severity of neuropathy. Comparison between diabetics without symptoms and signs of neuropathy and a corresponding non-diabetic control group showed that a warm sensibility index (WSI = the range in which non-noxious heat is perceived) was significantly lower on feet in diabetics than in their matched non-diabetic controls. The findings show that quantitative assessment of thermal sensitivity may be of value to detect early small nerve fiber dysfunction even in patients without symptoms or signs of a clinical neuropathy.
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PMID:Vibratory and thermal thresholds in diabetics with and without clinical neuropathy. 177 6

A clinical analysis of 8 patients with brachial plexus neuropathy is presented. The disease may involve the upper, the lower, or the entire plexus. There is a higher incidence in men than in women. The syndrome is not uncommon but is frequently diagnosed incorrectly. The fairly typical pattern of symptoms and signs includes sudden onset with severe pain along one side of the shoulder girdle, followed in a few hours or days by atrophic paralysis of muscles over the affected shoulder. The disorder is occasionally bilateral. The paresis persists for months or even years. The overall prognosis is excellent despite the severity and extent of the lesion. The etiology is unknown, but decreased physical resistance is a predisposing factor.
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PMID:The syndrome of Parsonage and Turner. Discussion of clinical features with a review of 8 cases. 177 18

The activity of cisplatin and a 120-hour continuous infusion of 5-fluorouracil (5-FU) was evaluated in 25 patients with metastatic nasopharyngeal carcinoma. Cisplatin 100 mg/m2 and 5-FU 1000 mg/m2/day by continuous infusion for 120 hours were given via an implanted venous access device and ambulatory infusion pump. Eighteen (72%) patients had multiple sites of metastases and seven (28%) patients had only bony metastases. Subjective responses in terms of pain relief and improvement in performance status were seen in 21 (84%) patients. Overall objective response was seen in 19 (76%) patients with two complete remissions (CR) and 17 partial remissions (PR). Locoregional disease responded more completely and rapidly than bony or visceral metastases. Toxicities included nausea, vomiting, neuropathy and one septic death. Cisplatin and 5-FU by continuous infusion represent an effective treatment for metastatic nasopharyngeal carcinoma.
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PMID:Cisplatin and 5-fluorouracil continuous infusion for metastatic nasopharyngeal carcinoma. 178 42


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