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Pain relief in headaches

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https://www.readbyqxmd.com/read/28072807/occipital-nerve-stimulation-for-refractory-chronic-migraine-results-of-a-long-term-prospective-study
#1
Dolores Rodrigo, Pilar Acin, Pedro Bermejo
BACKGROUND: Refractory chronic migraine affects approximately 4% of the population worldwide and results in severe pain, lifestyle limitations, and decreased quality of life. Occipital nerve stimulation (ONS) refers to the electric stimulation of the distal branches of greater and lesser occipital nerves; the surgical technique has previously been described and has demonstrated efficacy in the treatment of a wide variety of headache disorders. OBJECTIVES: The aim of this study is to evaluate the long-term efficacy and tolerability of ONS for medically intractable chronic migraine...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28067687/a-case-of-toxic-breast-feeding
#2
Megan L Schultz, Mark Kostic, Sigmund Kharasch
Opiates are frequently prescribed postpartum for pain relief after cesarean delivery, episiotomies, and headaches. It is estimated that greater than 30% of breast-feeding mothers in the United States are prescribed opiates for pain relief associated with childbirth. Many opiates are readily transferred to human milk, although life-threatening events are rare. We report a 6-day-old breast-feeding infant whose mother was taking hydromorphone for pain relief from a cesarean delivery and whose clinical course was suggestive of opiate toxicity...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27993418/comparison-of-intravenous-ketorolac-at-three-single-dose-regimens-for-treating-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#3
Sergey Motov, Matthew Yasavolian, Antonios Likourezos, Illya Pushkar, Rukhsana Hossain, Jefferson Drapkin, Victor Cohen, Nicholas Filk, Andrew Smith, Felix Huang, Bradley Rockoff, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Nonsteroidal anti-inflammatory drugs are used extensively for the management of acute and chronic pain, with ketorolac tromethamine being one of the most frequently used parenteral analgesics in the emergency department (ED). The drugs may commonly be used at doses above their analgesic ceiling, offering no incremental analgesic advantage while potentially adding risk of harm. We evaluate the analgesic efficacy of 3 doses of intravenous ketorolac in ED patients with acute pain...
December 16, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27990191/relief-of-lower-back-and-leg-pain-after-myelography
#4
Rui Guo, Toshihiko Sakakibara, Tetsutaro Mizuno, Koji Akeda, Tetsushi Kondo, Yuichi Kasai
INTRODUCTION: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. MATERIALS AND METHODS: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27861819/lacrimal-nerve-blocks-for-three-new-cases-of-lacrimal-neuralgia
#5
María-Luz Cuadrado, Álvaro Gutiérrez-Viedma, Lorenzo Silva-Hernández, Aida Orviz, Héctor García-Moreno
OBJECTIVE: Our aim was to report three new cases of lacrimal neuralgia and their response to superficial nerve blocks. BACKGROUND: Lacrimal neuralgia has been recently described as a pain in the territory supplied by the lacrimal nerve, at the lateral upper eyelid and/or the adjacent area of the temple. The pain is typically accompanied by tenderness on palpation of the lacrimal nerve at the superoexternal angle of the orbit. METHODS: Between January 2015 and June 2016, we prospective identified three cases of lacrimal neuralgia among the patients attending the Headache Unit in a tertiary hospital...
November 11, 2016: Headache
https://www.readbyqxmd.com/read/27855478/interventions-for-treating-burning-mouth-syndrome
#6
REVIEW
Roddy McMillan, Heli Forssell, John Ag Buchanan, Anne-Marie Glenny, Jo C Weldon, Joanna M Zakrzewska
BACKGROUND: Burning mouth syndrome (BMS) is a term used for oral mucosal pain (burning pain or discomfort in the tongue, lips or entire oral cavity) without identifiable cause. General population prevalence varies from 0.1% to 3.9%. Many BMS patients indicate anxiety, depression, personality disorders and impaired quality of life (QoL). This review updates the previous versions published in 2000 and 2005. OBJECTIVES: To determine the effectiveness and safety of any intervention versus placebo for symptom relief and changes in QoL, taste, and feeling of dryness in people with BMS...
18, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27826415/does-case-misclassification-threaten-the-validity-of-studies-investigating-the-relationship-between-neck-manipulation-and-vertebral-artery-dissection-stroke-no
#7
Donald R Murphy, Michael J Schneider, Stephen M Perle, Christopher G Bise, Michael Timko, Mitchell Haas
BACKGROUND: The purported relationship between cervical manipulative therapy (CMT) and stroke related to vertebral artery dissection (VAD) has been debated for several decades. A large number of publications, from case reports to case-control studies, have investigated this relationship. A recent article suggested that case misclassification in the case-control studies on this topic resulted in biased odds ratios in those studies. DISCUSSION: Given its rarity, the best epidemiologic research design for investigating the relationship between CMT and VAD is the case-control study...
2016: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/27803914/greater-occipital-nerve-blocks-in-the-treatment-of-refractory-chronic-migraine-an-observational-report-of-nine-cases
#8
Abdulkadir Koçer
AIM: To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine headache. METHODS: Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month (for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up...
October 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27781372/sufentanil-sublingual-tablet-30-mcg-for-the-management-of-pain-following-abdominal-surgery-a-randomized-placebo-controlled-phase-3-study
#9
Harold S Minkowitz, David Leiman, Timothy Melson, Neil Singla, Karen DiDonato, Pamela P Palmer
BACKGROUND: Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented. METHODS: Adults with American Society of Anesthesiologists status 1 - 3 scheduled to undergo abdominoplasty, open tension-free inguinal hernioplasty, or laparoscopic abdominal surgery under general or spinal anesthesia that did not include intrathecal opioids during the operation were eligible...
October 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27779368/safety-and-efficacy-of-occipital-nerves-stimulation-for-the-treatment-of-chronic-migraines-randomized-double-blind-controlled-single-center-experience
#10
Nagy A Mekhail, Emad Estemalik, Gerges Azer, Kristina Davis, Stuart J Tepper
BACKGROUND: A recent multicenter study presented 52-week safety and efficacy results from an open-label extension of a randomized, sham-controlled trial for patients with chronic migraine (CM) undergoing peripheral nerve stimulation of the occipital nerves. We present the data from a single center of 20 patients enrolled at the Cleveland Clinic's Pain Management Department. METHODS: In this single center, 20 patients were implanted with a neurostimulation system, randomized to an active or control group for 12 weeks, and received open-label treatment for an additional 40 weeks...
October 25, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27774361/application-of-the-harms-technique-to-treat-undiagnosed-intractable-c1-c2-unilateral-neck-pain-a-case-report
#11
Adnan Bashir Bhatti, Sunny Kim
A 79-year-old female presented with incapacitating chronic neck pain. The patient's pain which was greatest on the left side persisted for 18 months and was described as stabbing in nature (10/10 intensity). In addition to her neck pain, the patient described having frequent headaches. After six weeks of physical therapy and undergoing a rhizotomy procedure, she showed no prolonged improvement. An epidural steroid injection provided only temporary pain relief and was followed by a successful posterior fusion using the Harms technique with iliac crest autogenous bone grafting and placement of polyaxial screws in the C1 lateral masses and C2 pedicles...
September 21, 2016: Curēus
https://www.readbyqxmd.com/read/27737513/pharmacologic-interventions-for-treating-phantom-limb-pain
#12
REVIEW
Maria Jenelyn M Alviar, Tom Hale, Monalisa Dungca
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 12, 2011. Phantom limb pain (PLP) is pain that arises in the missing limb after amputation and can be severe, intractable, and disabling. Various medications have been studied in the treatment of phantom pain. There is currently uncertainty in the optimal pharmacologic management of PLP. OBJECTIVES: This review aimed to summarise the evidence of effectiveness of pharmacologic interventions in treating PLP...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27731896/predicting-inadequate-response-to-acute-migraine-medication-results-from-the-american-migraine-prevalence-and-prevention-ampp-study
#13
Richard B Lipton, Sagar Munjal, Dawn C Buse, Kristina M Fanning, Alix Bennett, Michael L Reed
BACKGROUND: Pain freedom at 2 hours and sustained pain response at 24 hours are important outcomes of acute migraine therapy. Some studies have examined rates and predictors of successful treatment outcomes for single attacks in clinical trials. However, little is known about predictors of typical response to acute treatment over multiple attacks in the population. OBJECTIVES: To identify sociodemographic features, headache characteristics, comorbidities and treatment-related factors that predict acute treatment success or failure at 2 hours and 24 hours post dose in a US population sample of persons with episodic migraine...
November 2016: Headache
https://www.readbyqxmd.com/read/27693247/value-of-targeted-epidural-blood-patch-and-management-of-subdural-hematoma-in-spontaneous-intracranial-hypotension
#14
Leigh A Rettenmaier, Brian J Park, Marshall T Holland, Youssef J Hamade, Shuchita Garg, Rahul Rastogi, Chandan G Reddy
Spontaneous intracranial hypotension (SIH) is a more common than previously noted condition (1-2.5 per 50,000) typically caused by cerebrospinal fluid (CSF) leakage. Initial treatment involves conservative therapies, but the mainstay of treatment for patients who fail conservative management is the epidural blood patch (EBP). Subdural hematoma (SDH) is a common complication occurring with SIH, but its management remains controversial. In this report, we discuss a 62-year-old female who presented with a 5-week history of orthostatic headaches associated with nausea, emesis, and neck pain...
September 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27687382/iterative-epidural-blood-patch-for-recurrent-spontaneous-intracranial-hypotension-during-pregnancy
#15
Joséphine Grange, Gilbert Lorre, Guillaume Ducarme
A 30-year-old woman at 28 weeks presented with sudden onset of intense headache, epigastric pain, hot flushes, nausea, vomiting, and stiff neck. Cerebral magnetic resonance imaging showed pathognonomic signs of spontaneous intracranial hypotension (SIH). Epidural blood patch was performed 2 times during pregnancy for symptoms relief in spite of medical treatments. No other recurrence was noted until the spontaneous delivery. SIH is a rare entity during pregnancy which may be diagnosed using magnetic resonance imaging...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687372/transnasal-sphenopalatine-ganglion-block-for-the-treatment-of-postdural-puncture-headache-in-obstetric-patients
#16
Sheffield Kent, Gregory Mehaffey
STUDY OBJECTIVE: To demonstrate a possible alternative treatment for postdural puncture headache (PDPH). DESIGN: Postdural puncture headache is a common complication associated with neuraxial anesthesia and unintentional dural puncture. Epidural blood patch (EBP) is the standard therapy for PDPH but has risks including pain, dural puncture, and infection. Transnasal sphenopalatine ganglion block (SPGB) has been successfully used to treat migraine, cluster headache, and trigeminal neuralgia...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27684803/cervicogenic-headache-alleviation-after-cervical-coblation-nucleoplasty-a-prospective-cohort-study
#17
Liangliang He, Jianning Yue, Liqiang Yang, Baishan Wu, Guoqing Cao, Yuna Guo, Guanghui Lai, Yuanzhang Tang, Jiaxiang Ni
A degenerative cervical disc is a pain generator for headaches, and headaches can benefit from cervical prolapse surgery. However, as an alternative intervention for open cervical surgery, no study has reported whether headaches can benefit from cervical nucleoplasty.The objective of this study was to evaluate the efficacy of cervical coblation nucleoplasty in the treatment of cervicogenic headaches.In a prospective cohort study performed between December 2013 and August 2015, 20 patients with cervicogenic headaches undergoing cervical nucleoplasty for shoulder-arm pain were recruited into group C, and 20 patients with cervicogenic headaches undergoing lumbar nucleoplasty for low back pain, matched for age and sex, were recruited into group L...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676681/radiofrequency-ablation-of-the-sphenopalatine-ganglion-using-cone-beam-computed-tomography-for-intractable-cluster-headache
#18
Vivek Loomba, Aman Upadhyay, Hirsh Kaveeshvar
UNLABELLED: Percutaneous radiofrequency ablation (RFA) of the sphenopalatine ganglion (SPG) has been shown to be an effective modality of treatment for patients with intractable chronic cluster headaches (CHs). While the use of fluoroscopy for RFA of the SPG is common, to our knowledge there are no documented cases of procedures using cone beam computed tomography (CBCT) for image guidance. We present a case report of a patient suffering from chronic intractable CH with complete long-lasting relief after RFA of the SPG using CBCT...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27676679/currently-recommended-ton-injectate-volumes-concomitantly-block-the-gon-clinical-implications-for-managing-cervicogenic-headache
#19
Sayed E Wahezi, Kyle Silva, Naum Shaparin, Andrew Lederman, Mohammed Emam, Nogah Haramati, Sherry A Downie
BACKGROUND: Headache (HA) is a significant cause of morbidity globally. Despite many available treatment options, HAs that are refractory to conservative management can be challenging to treat. Third occipital nerve (TON) and greater occipital nerve (GON) irritation are potential etiologic agents of primary and cervicogenic HAs that can be targeted using minimally invasive treatment options such as nerve blocks or radiofrequency ablation. However, a substantial number of patients that undergo radiofrequency ablation do not experience pain relief despite a positive diagnostic medial branch block (MBB)...
September 2016: Pain Physician
https://www.readbyqxmd.com/read/27676673/ultrasound-guided-intermediate-site-greater-occipital-nerve-infiltration-a-technical-feasibility-study
#20
Jonathan Zipfel, Adrian Kastler, Laurent Tatu, Julien Behr, Rachid Kechidi, Bruno Kastler
BACKGROUND: Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. OBJECTIVE: The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. STUDY DESIGN: Retrospective study...
September 2016: Pain Physician
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