11/210. Using gabapentin to treat neuropathic pain.OBJECTIVE: To review use of gabapentin as an adjuvant agent to treat neuropathic pain. QUALITY OF EVIDENCE: medline was searched from 1995 to October 1998 for reports. There were approximately 20 citations. Additional articles from Pain and other medical journals were reviewed. No double-blind studies have examined gabapentin and its use as an analgesic adjuvant agent. MAIN MESSAGE: Gabapentin is an anticonvulsant medication used recently as an effective adjuvant agent for treating neuropathic pain. It is a structural analogue of gamma-aminobutyric acid (GABA), but its receptor and biochemical function remain unknown. Gabapentin has desirable pharmacokinetic properties and acceptable side effects, which simplify its use. There are very few interactions between gabapentin and other medications, and gabapentin is well tolerated. CONCLUSION: Gabapentin could be an effective adjuvant agent for many neuropathic pain states.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/210. Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing.A 71-year-old woman presented with a short history of episodes of severe left-sided orbital and temporal pain in paroxysms lasting 60 to 90 seconds, and accompanied by ipsilateral lacrimation of the eye, rhinorrhea, and conjunctival injection. Results of clinical examination and structural imaging were normal and a clinical diagnosis of SUNCT (short-lasting unilateral neuralgiform pains with conjunctival injection and tearing) was made. The patient had a BOLD contrast-magnetic resonance imaging study in which significant activation was seen in the region of the ipsilateral hypothalamic gray, comparing the pain to pain-free state. The region of activation was the same in this patient as has been reported in acute attacks of cluster headache.- - - - - - - - - - ranking = 0.61664681722846keywords = pain, headache (Clic here for more details about this article) |
13/210. Coincidental supraorbital neuralgia and sinusitis.Headache interpreted as treatment failure may be encountered after FESS or pharmacological treatment for chronic sinusitis. This persistent symptom may lead, even in the presence of minimal sinus disease, to frequent office visits, medical treatment, primary surgery, and revision procedures. A prospective study of patients with a documented history and imaging-verified sinus disease with persistent atypical refractory headache were evaluated. Diagnostic measures included injection of local anesthetic and response to carbamazepine. Severe neuralgia of the supraorbital nerve was identified in 11 patients with chronic sinusitis, treated either medically or surgically before inclusion in the study. Eight of the patients underwent surgery for sinus disease, and five of them had revision surgery because of persisting complaints. All patients responded favorably to the local injection, and eight were treated with carbamazepine. In certain cases, headache in sinusitis patients may be caused or aggravated by supraorbital neuralgia. Sinus disease is possibly a causative factor but conceivably plays the role of a "red herring." This readily diagnosed and treated coexistence may be more prevalent than recognized formerly.- - - - - - - - - - ranking = 0.018087298319954keywords = headache (Clic here for more details about this article) |
14/210. Glossopharyngeal neuralgia and MS.Glossopharyngeal neuralgia (GPN) is characterized by a severe lancing pain in the posterior pharynx, tonsillar fossa, and base of the tongue. It is induced frequently by swallowing and yawning. GPN has not been described previously in MS patients. The authors report four MS patients with GPN. Three responded to carbamazepine and one resolved during treatment with adrenocorticotrophin hormone (ACTH) and cyclophosphamide. Withdrawal of carbamazepine after 1 week in one patient resulted in recurrence of pain. GPN may be associated with MS and responds to carbamazepine.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
15/210. Bilateral median nerve compression at the level of Struthers' ligament. Case report.Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
16/210. herpes zoster in the elderly: issues related to geriatrics.This article reviews specific clinical and research issues of herpes zoster related to geriatric medicine. Salient epidemiological and clinical issues include the increasing probability of zoster and postherpetic neuralgia with aging, age-related decline in immunity to varicella-zoster virus, the functional and psychosocial impact of zoster on the quality of life of the elderly, illness behavior in elderly patients with zoster, and varicella-zoster virus transmission and control in the nursing home. The role of antiviral therapy, corticosteroids, and analgesics; the measurement and analysis of pain, health-related quality of life, and functional status; and development of the varicella vaccine in the management of zoster in the elderly are also emphasized. Fertile research opportunities exist within these areas for investigators interested in infectious diseases, geriatrics, and other zoster-related disciplines.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
17/210. Neurogenic pain.Effective preoperative communication and an awareness of the mechanisms and treatment of neurogenic pain by nursing staff directly influence the choice of intraoperative and postoperative pain management. This article describes the case study of a young woman with neurogenic pain and highlights the importance of having a working knowledge of this type of pain, its assessment, and treatment.- - - - - - - - - - ranking = 1.1428571428571keywords = pain (Clic here for more details about this article) |
18/210. Tonsillar pain mimicking glossopharyngeal neuralgia as a complication of vagus nerve stimulation: case report.An adolescent girl presented with severe, lancinating tonsillar pain exacerbated by swallowing 6 weeks after initiation of left vagus nerve stimulation for intractable epilepsy. Her symptoms mimicked those seen in glossopharyngeal neuralgia and were relieved by temporary cessation of stimulation. Gradual reinstitution of therapy with alteration in stimulus parameters resulted in improved seizure control as well as cessation of pain symptoms. Direct stimulation of the vagus nerve may result in vagoglossopharyngeal neuralgia, which, in this case, was amenable to stimulus modification.- - - - - - - - - - ranking = 0.85714285714286keywords = pain (Clic here for more details about this article) |
19/210. Gluteal neuralgia - unusual presentation in an adult with intrasacral meningocele: a case report and review of literature.A nineteen year old man with intrasacral meningocele is reported, who presented with long standing episodic gluteal pain and progressive muscle wasting. magnetic resonance imaging established the diagnosis. Surgical excision relieved the pain but muscle wasting persisted. Pertinent literature is reviewed.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
20/210. Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft.A case report of saphenous neuralgia following arthroscopically assisted anterior cruciate ligament reconstruction with hamstring tendons is presented. The patient complained of paresthesia in the anteromedial region of the lower leg and tenderness at the medial side of the knee without motor or reflex abnormalities. Because saphenous neuralgia can mimic disorders of the knee, peripheral vascular disease, and lumbar nerve root compression, diagnosis can be confirmed by anesthetic blockade. The patient underwent saphenous neurolysis. Six months after surgery, the patient had normal cutaneous sensation at the medial aspect of the lower leg and ankle and she no longer complained of any painful dysesthesia. To minimize the risk of damaging the saphenous nerve when harvesting hamstring tendons, the knee should be flexed and the hip external rotated.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
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