• Title/Summary/Keyword: Neuropathic Pain

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The Long-Term Safety and Efficacy of Intrathecal Therapy Using Sufentanil in Chronic Intractable Non-Malignant Pain

  • Monsivais, Jose Jesus;Monsivais, Diane Burn
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.297-300
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    • 2014
  • This report describes the long term safety and efficacy of intrathecal therapy using Sufentanil for the management of chronic intractable neuropathic pain in 12 chronic pain patients. Standardized psychological screening was used to determine treatment suitability. Evaluation data included the Visual Analog Scale (VAS), Wong-Baker Faces Scale, Brief Pain Inventory (BPI), Disability of Arm, Shoulder, and Hand (DASH), McGill Quality of Life Questionnaire, and complications (granulomas, toxicity, withdrawal, or deaths). SPSS version 18 was used for data analysis. Pre- and post- treatment BPI measures and pain scale scores showed a statistically significant difference. There were no complications directly related to drug toxicity, nor drug withdrawals, granulomas, or deaths. Intrathecal therapy with Sufentanil therapy offers a good treatment alternative for those cases that have failed both surgery and standard pain treatment. Strict patient selection based on psychological screening, control of co-morbidities, a proper pain management may contribute to successful outcome.

Development of Neuropathic Pain Behavior and Expression of CCL2/CCR2 and CX3CL1/CX3CR1 after Spinal Cord Hemisection

  • Park, Hea-Woon;Son, Jo-Young;Cho, Yun-Woo;Hwang, Se-Jin;Kim, Su-Jeong;Ahn, Sang-Ho;Jang, Sung-Ho;Jung, Yong-Jae
    • The Journal of Korean Physical Therapy
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    • v.22 no.3
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    • pp.99-105
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    • 2010
  • Purpose: The purpose of this study was to evaluate the development of pain behavior and the expression of CCL2/CCR2 and CX3CL1/CX3CR1 at above and below the level of hemisection of the spinal cord in a rat model. Methods: Spinal cords of adult female Sprague-Dawley rats (n= 16, 200~250 g, 6~8 weeks old) were hemisected at T13 on the right side to develop the spinal hemisection injury model. We compared behavioral responses of the hemisection and of a sham surgery group. Behavioral tests for motor function (by the BBB locomotor scale), and for pain response for mechanical and cold allodynia were assessed postoperatively (PO) for 21 days. Expression of mRNA for chemokines and their receptors (CCL2/CCR2 and CX3CL1/CX3CR1) below and above the level of the spinal cord dissection were examined by RT-PCR. Results: We observed gradual motor improvement and the development of mechanical and cold allodynia on the ipsilateral hindpaw after spinal hemisection injury. We also found upregulation of mRNA expression of CCL2/CCR2 both above and below the level of spinal cord dissection but CX3CL1/CX3CR1 mRNA expression. Conclusion: Upregulation of CCL2/CCR2 is associated with neuropathic pain after spinal hemisection injury. CCL2/CCR2 may play an important role in the development of neuropathic pain after SCI as well as of peripheral neuropathic pain. These findings may improve understanding of the pathophysiological mechanism of neuropathic pain after SCI.

Analgesic Effects of Sokyungwhalhyul-tang on Constriction Nerve Injury-Induced Neuropathic Pain in Rats (말초 신경병증성 통증 모델에서 소경활혈탕의 진통 효과)

  • Kim, Kyung-Yoon;Jeong, Hyun-Woo;Choi, Chan-Hun;Kim, Hyung-Woo;Kim, Gi-Do;Sim, Ki-Cheol;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.2
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    • pp.195-201
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    • 2011
  • Nardostachys chinensis;Anti-proliferation;Cell cycle arrest;Differentiation;U937 cells; This study was conducted to determine the analgesic effect of Sokyungwhalhyul-tang(SKWHT) using the model of peripheral neuropathic pain model. A model of neuropathic pain was made by ligating left 5th lumbar spinal nerve of rats. After 1 days, the extract of SKWHT was orally administered daily. Rats were divided into four groups; (1) Control group(n=6), (2) Experimental group I(SKWHT-OA1, 100 mg/kg, n=6), (3) Experimental group II(SKWHT-OA2, 300 mg/kg, n=6), (4) Experimental group III(SKWHT-OA3, 500 mg/kg, n=6). After that, we examined the withdrawl response of neuropathic rats legs by von Frey filament and Hot plate at pre, $1^{th}$, $4^{th}$, $7^{th}$, $14^{th}$, $21^{th}$ days after the induction of neuropathic pain. And also we examined c-fos, GOT, GPT and histological study of Liver at 21th days. von Frey filament and Hot plate were increase in experimental group I, II, III than Con. especially group III was most significantly analgesic effect than the other groups at $14^{th}$, $21^{th}$ days. In c-fos protein expression on spinal cord, group III was most significantly reduction immunoreactivity at $21^{th}$ days and in blood serum GOT & GPT levels and histologic finding of Liver in all experimental groups were no significant difference with Con at $21^{th}$ days. According to the above results, SKWHT(500 mg/kg) may have a significant analgesic effect on the neuropathic pain.

Neuropathic Pain Behaviors and the Change of Spinal Neuropeptides following Peripheral Nerve Injury in Neonatal Rats

  • Yoon, Young-Sul;Back, Seung-Keun;Kim, Hee-Jin;Na, Heung-Sik
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.52-57
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    • 2006
  • Objective : It has been suggested that the occurrence of persistent pain signal during the early postnatal period may alter an individual's response to pain later in life. The aim of this study is to assess whether neonatal nerve injury resulted in long-lasting consequences on nociceptive system in the rat. Methods : We examined whether neuropathic pain behaviors and the changes of spinal neuropeptides [SP, CGRP, VIP and VIP] induced by peripheral nerve injury within 1 day after birth [Neonate group] were different from those at 8 weeks after birth [Mature group]. Results : The Neonate group showed more robust and long-lasting pain behaviors than the Mature group. Immunohistochemical findings demonstrated that spinal SP- & CGRP-immunoreactivities[ir] of the ipsilateral to the contralateral side increased in the Neonate group, whereas those decreased in the Mature group. In addition, increase in spinal VIP- & NPY-ir of the ipsilateral to the contralateral side was more robust in the Mature group than in the Neonate group. Conclusion : These results suggest that peripheral nerve injury in the early postnatal period may result in long-lasting and potentially detrimental alterations in nociceptive pathways.

Clinical Experiences on the Effect of Scrambler Therapy for Patients with Postherpetic Neuralgia

  • Ko, Young Kwon;Lee, Ho Young;Lee, Wang Yong
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.98-101
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    • 2013
  • Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster, especially in elderly and comorbid patients. Unfortunately, the currently available treatments have shown limited efficacy and some adverse events that are poorly tolerated in elderly patients. Scrambler Therapy, proposed as an alternative treatment for chronic neuropathic pain recently, is a noninvasive approach to relieve pain by changing pain perception at the brain level. Here, we report our clinical experiences on the effect of Scrambler Therapy for three patients with PHN refractory to conventional treatment.

Altered synaptic connections and inhibitory network of the primary somatosensory cortex in chronic pain

  • Kim, Yoo Rim;Kim, Sang Jeong
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.2
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    • pp.69-75
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    • 2022
  • Chronic pain is induced by tissue or nerve damage and is accompanied by pain hypersensitivity (i.e., allodynia and hyperalgesia). Previous studies using in vivo two-photon microscopy have shown functional and structural changes in the primary somatosensory (S1) cortex at the cellular and synaptic levels in inflammatory and neuropathic chronic pain. Furthermore, alterations in local cortical circuits were revealed during the development of chronic pain. In this review, we summarize recent findings regarding functional and structural plastic changes of the S1 cortex and alteration of the S1 inhibitory network in chronic pain. Finally, we discuss potential neuromodulators driving modified cortical circuits and suggest further studies to understand the cortical mechanisms that induce pain hypersensitivity.

Peripheral nerve blocks for acute trigeminal neuralgia involving maxillary and mandibular branches: a case report

  • Ricardo Luiz de Barreto Aranha;Renata Goncalves Resende;Fernando Antonio de Souza
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.357-362
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    • 2023
  • Trigeminal neuralgia (TN) is neuropathic pain that affects the trigeminal nerve branches. Facial pain experienced by patients with TN is typically intense and excruciating. The second and third branches (maxillary and mandibular) are commonly affected. This case report focuses on the potential treatment options for acute TN attacks involving these branches. The proposed approach involves extra-oral peripheral blocks using local anesthetics. Pain levels were measured using a visual numeric scale (VNS) with potential side effects and other relevant documented information. The patients showed responses from high pain levels to almost complete remission (from 8 to 2 and from 10 to 2 on the final VNS), with no significant side effects. This technique provides immediate pain relief and complements oral medications by offering comfort and confidence until the desired drug effect is achieved.