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neuropathic itch

Carola Vogel, Roman Rukwied, Lenka Stockinger, Marcus Schley, Martin Schmelz, Wolfgang Schleinzer, Christoph Konrad
: At-level and above-level hypersensitivity was assessed in patients with chronic complete thoracic spinal cord injury (SCI). Patients were classified by somatosensory mapping (brush, cold, pinprick) and assigned into two groups, i.e. patients i) with at-level hypersensitivity (SCIHs, n=8) and ii) without at-level hypersensitivity (SCINHs, n=7). Gender and age-matched healthy subjects served as controls. Quantitative sensory testing (QST), electrically- and histamine-induced pain and itch, laser Doppler imaging and laser-evoked potentials (LEP) were recorded at-level and above-level in SCI-patients...
October 21, 2016: Journal of Pain: Official Journal of the American Pain Society
So Young Joo, Yoon Soo Cho, Sung-Rae Cho, Dohern Kym, Cheong Hoon Seo
PURPOSE: Pain Scrambler therapy is a patient-specific electrocutaneous nerve stimulation device. Burn pruritus is a common form of chronic and disabling neuropathic pain that is often difficult to treat effectively. Pruritus is mediated by histamines, which are effector molecules stored in mast cells and released locally during injury or inflammation. Burn pruritus may be accompanied by peripheral neuropathic pain, which may result from injury to sensory nerves that hampers conductance of neuronal messages along the large A and small C afferent fibers to the spinal cord...
October 15, 2016: Burns: Journal of the International Society for Burn Injuries
Janneke G J Hoeijmakers, Catharina G Faber, Carien J Miedema, Ingemar S J Merkies, Johan S H Vles
Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. The present article reports the cases of 2 adolescent girls diagnosed with SFN. The first patient (14 years of age) complained about painful itch and tingling in her legs, as well as dysautonomia symptoms for years. She also reported a red/purple-type discoloration of her legs aggravated by warmth and standing, compatible with erythromelalgia...
September 22, 2016: Pediatrics
Barth L Wilsey, Reena Deutsch, Emil Samara, Thomas D Marcotte, Allan J Barnes, Marilyn A Huestis, Danny Le
A randomized, placebo-controlled crossover trial utilizing vaporized cannabis containing placebo and 6.7% and 2.9% delta-9-tetrahydrocannabinol (THC) was performed in 42 subjects with central neuropathic pain related to spinal cord injury and disease. Subjects received two administrations of the study medication in a 4-hour interval. Blood samples for pharmacokinetic evaluation were collected, and pain assessment tests were performed immediately after the second administration and 3 hours later. Pharmacokinetic data, although limited, were consistent with literature reports, namely dose-dependent increase in systemic exposure followed by rapid disappearance of THC...
2016: Journal of Pain Research
Ekin Şavk
Neurologic itch is defined as pruritus resulting from any dysfunction of the nervous system. Itch arising due to a neuroanatomic pathology is seen to be neuropathic. Causes of neuropathic itch range from localized entrapment of a peripheral nerve to generalized degeneration of small nerve fibers. Antipruritic medications commonly used for other types of itch such as antihistamines and corticosteroids lack efficacy in neuropathic itch. Currently there are no therapeutic options that offer relief in all types of neuropathic pruritus, and treatment strategies vary according to etiology...
2016: Current Problems in Dermatology
Allison Scheetz, Richard J Ackermann
End-of-life care often involves management of pain. A patient's pain should be assessed using the Visual Analogue Scale, which uses a 0 to 10 score, with 0 indicating no pain and 10 the worst pain imaginable. Mild pain typically is managed with nonopioids (eg, acetaminophen, nonsteroidal anti-inflammatory drugs). More severe pain is managed with opioids. Opioid therapy should start with an immediate-release opioid to determine the dose needed to achieve pain control. This can be used to create a regimen with an extended-release formulation for daily pain management plus an immediate-release formulation for breakthrough pain...
August 2016: FP Essentials
Rachel Elizabeth Ward, Vindhya Lakshmi Veerula, Navid Ezra, Jeffrey B Travers, Nico Mousdicas
BACKGROUND: Chronic itch is a disruptive and disabling condition that can lead to psychological stress and depression. OBJECTIVE: We sought to describe an entity of generalized, symmetric, neuropathic pruritus, which we term "multilevel symmetric neuropathic pruritus," and offer possible explanations accounting for its pathogenesis. METHODS: A case series of 14 patients was evaluated at academic institutions from 2011 to 2015. RESULTS: All patients exhibited detectable degenerative vertebral changes, as seen by spinal x-ray or magnetic resonance imaging...
October 2016: Journal of the American Academy of Dermatology
Akitoshi Inoue, Hitoshi Uchida, Takanobu Nakazawa, Tadashi Yamamoto, Seiji Ito
Itch and pain are intimately related and may share similar peripheral and central mechanisms and pathways. However, it has been believed that synaptic glutamate release from a group of peripheral nociceptors is required to sense pain and suppress itch. Although we previously demonstrated that phosphorylation of GluN2B subunits of the NMDA receptor at Tyr1472 is important for central sensitization in a neuropathic pain model of mice with a knock-in mutation of the Tyr1472 site to phenylalanine of GluN2B (Y1472F-KI), the role of NMDA receptors in itch transmission remains unknown...
July 16, 2016: European Journal of Neuroscience
Carina M Grönhagen, Hong Liang Tey
No abstract text is available yet for this article.
June 2016: Annals of the Academy of Medicine, Singapore
Kazuki M Matsuda, Divya Sharma, Ariel R Schonfeld, Shawn G Kwatra
Chronic pruritus is a distressing symptom that is often refractory to treatment. Patients frequently fail topical therapies and oral over-the-counter antihistamines, prompting the clinician to consider alternative therapies such as neuroactive agents. Herein, the use of gabapentin and pregabalin, 2 medications well known for treating neuropathic pain and epilepsy that are occasionally used for relieving chronic pruritus is explored. The findings from original sources published to date to evaluate the use of gabapentin and pregabalin as antipruritic agents are explored...
September 2016: Journal of the American Academy of Dermatology
Roy E Strowd, Lindsay C Strowd, Jaishri O Blakeley
Skin findings are a rare but important aspect of the evaluation and management of patients with tumors of the nervous system. Skin findings have the highest prevalence in genetic tumor syndromes termed neuro-genodermatoses, which include neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and tuberous sclerosis. Skin changes are observed in patients with non-syndromic nervous system malignancy, often as a result of pharmacotherapy. The skin may also manifest findings in paraneoplastic conditions that affect the nervous system, providing an early indication of underlying neoplasm, including dermatomyosistis, neuropathic itch, and brachioradial pruritus...
June 2016: Seminars in Oncology
L Cunha-Miranda, A Santos, A Macedo
OBJECTIVE: Portuguese data concerning general population knowledge and prevalence about neuropathic pain (NeP) are sparse and many patients remain frequently undiagnosed as this disease is still under recognized among population. This study aimed to evaluate Portuguese perception about NeP and to characterize their knowledge and information sources. Additionally, the study had the exploratory objective of determining NeP prevalence. MATERIALS AND METHODS: Epidemiological, cross-sectional study of a representative sample of the Portuguese population aged 18 years old or more, by direct application of a structured questionnaire...
October 2015: Acta Reumatológica Portuguesa
Hjalte H Andersen, Carsten Sand, Jesper Elberling
Notalgia paresthetica (NP) is a focal neuropathic itch condition manifesting in intense chronic or recurrent episodic itch in a hyperpigmented, macular, uni- or bilateral skin area located below and/or medially to the scapulae. Achieving satisfactory relieve in NP patients is challenging. In this case-series three female NP patients were treated with 8% capsaicin patches following a spatial quantification of their alloknetic area with a von Frey filament. The use of a von Frey filament in order to delimit the precise area of itch sensitization and thus patch application, proved clinically feasible...
February 2016: Annals of Dermatology
Allan I Basbaum, João M Bráz
Among many mechanisms implicated in the development of neuropathic pain after nerve damage is a profound dysfunction of GABAergic inhibitory controls, manifested by ongoing pain, mechanical hypersensitivity, and thermal hyperalgesia. In some respects, neuropathic pain can be considered a "disease" of the nervous system, with features in common with trauma-induced seizures. Indeed, first-line management involves anticonvulsant therapy. An alternative to pharmacotherapy for neuropathic pain is an approach that reestablishes the inhibitory tone that is lost after nerve damage...
February 2016: Pain
Miguel Chuquilin, Yazan Alghalith, Kristen Heins Fernandez
Few sources of information exist regarding cutaneous innervation and how to apply this basic neurologic science to the clinical treatment of itch, as often performed on a daily basis by dermatologists. We address the types of nerve fibers that innervate the skin and their different components and discuss the similarities and differences between itch and pain. We hope that increased knowledge of this topic will improve the recognition and treatment of neuropathic itch.
February 2016: Journal of the American Academy of Dermatology
Monika Asplund, Susanna Calling, Anna Spirén, Cecilia Svedman
Prurigo nodularis is a pruritic condition characterized by skin noduli. Different treatment options have been used with limited success. Pregabalin is a drug licensed for treatment of neuropathic pain in adults. As prurigo nodularis involves suffering for the patients and is difficult to treat, the aim of this case report is to report the effect of pregabalin treatment in seven patients with prurigo nodularis, treated in the dermatology clinic in Malmö, Sweden. Four patients experienced good effect of pregabalin, though two patients had a transient effect...
2015: Läkartidningen
Javad Kiani, Saman Ahmad Nasrollahi, Farzaneh Esna-Ashari, Puyan Fallah, Firuzeh Sajedi
Because of less systemic side effects of topical medications in pain relief of the painful form of diabetic peripheral neuropathy, this study aimed to compare the effect of amitriptyline and capsaicin cream in relieving pain in this condition. In this randomized, double-blind and non -inferiority trial, 102 patients received amitriptyline 2% and capsaicin 0.75% creams 3 times a day for 12 weeks on the feet. Pain relief was measured by the visual analog scale (0-10). Treatment responding was considered as cure rate greater than 50% from baseline...
2015: Iranian Journal of Pharmaceutical Research: IJPR
Hans Verstraelen, Eline De Zutter, Martine De Muynck
The vulva is a particularly common locus of chronic pain with neuropathic characteristics that occurs in women of any age, though most women with neuropathic type chronic vulvar pain will remain undiagnosed even following multiple physician visits. Here, we report on an exemplary case of a middle-aged woman who was referred to the Vulvovaginal Disease Clinic with debilitating vulvar burning and itching over the right labium majus that had been persisting for 2 years and was considered intractable. Careful history taking and clinical examination, followed by electrophysiological assessment through somatosensory evoked potentials was consistent with genitofemoral neuralgia, for which no obvious cause could be identified...
2015: Journal of Pain Research
Elke Weisshaar, Melanie Weiss, Jutta Passlick-Deetjen, Ulrich Tschulena, Klaudia Maleki, Thomas Mettang
BACKGROUND: A representative cross-sectional study showed that chronic itch (lasting for a minimum of 6 weeks) affects 25.2 % (point prevalence) of hemodialysis (HD) patients. Pathophysiology and etiology of chronic itch (CI) in HD are still unclear. METHODS: We investigated 860 HD patients from a representative randomly selected cluster-sample considering the regional distributions of dialysis units in Germany. The current analyses report comorbidities, laboratory values and dialysis characteristics of HD patients in relation to CI...
2015: BMC Nephrology
Barbara Horváth, Ineke C Janse, Gary R Sibbald
Hidradenitis suppurativa (HS) is a chronic, relapsing, and painful inflammatory disease. HS patients' quality of life is severely impaired, and this impairment correlates strongly with their pain. Pain in HS can be acute or chronic and has both inflammatory and noninflammatory origins. The purpose of this review is to provide a summary of the existing literature regarding pain management in patients with HS. While there are no formal studies investigating pain management in HS, existing recommendations are based on general pain guidelines and expert opinion...
November 2015: Journal of the American Academy of Dermatology
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