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Central pain syndrome

Panna Gajdos, Adrien Rigó
Irritable bowel syndrome is a chronic functional gastrointestinal disorder with a prevalence of 7-21%. It has a negative impact on health-related quality of life and work productivity and it is associated with increased psychological distress and mental comorbidity, like major depression disorder and generalised anxiety disorder. Due to biopsychosocial factors and the brain-gut axis playing a key role in the aetiology of the disease, the use of psychological treatments has great importance in the therapy of irritable bowel syndrome...
December 2018: Orvosi Hetilap
César Calvo-Lobo, Roi Painceira-Villar, Daniel López-López, Vanesa García-Paz, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Patricia Palomo-López
Background: Based on changes in lung function and musculoskeletal disorders in patients with asthma, this study aimed to compare the tarsal tunnel and fibular bone pressure pain thresholds (PPTs) of patients with asthma and healthy matched-paired controls. Methods: A case-control study was performed. One hundred participants were recruited: 50 asthma patients and 50 healthy matched-paired controls. Bilaterally, tarsal tunnel and fibula bone PPTs were registered. Results: Statistically significant differences ( p < 0...
December 12, 2018: Journal of Clinical Medicine
Louis H Poppler, Susan E Mackinnon
Pain is a frequent cause of physician visits. Many physicians find these patients challenging because they often have complicated histories, emotional comorbidities, confusing examinations, difficult problems to fix, and the possibility of factitious complaints for attention or narcotic pain medications. As a result, many patients are lumped into the category of chronic, centralized pain and relegated to pain management. However, recent literature suggests that surgical management of carefully diagnosed generators of pain can greatly reduce patients' pain and narcotic requirements...
December 12, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Roger Pack, Randy Gilliland, Alisha Mecham
Chronic pain affects 1.7 million children in the United States, and its effects often linger into adulthood. Unfortunately, chronic pediatric pain is often undertreated. The current case report discusses the use of pain neuroscience education (PNE) combined with progressive exposure to activity to treat persistent pain in a 13-year-old female diagnosed with central sensitization syndrome. Prior to the diagnosis, the patient underwent two unsuccessful episodes of physical therapy that focused on musculoskeletal sources of pain...
December 12, 2018: Physiotherapy Theory and Practice
Zafer Gunendi, Musa Polat, Doga Vuralli, Bulent Cengiz
OBJECTIVE: Fibromyalgia is the prototypical central sensitivity syndrome which is associated with increased sensitivity to pain and other stimuli. In this study, we aimed to evaluate whether somatosensory temporal discrimination ability, which provides information about central processing of sensory stimuli, was impaired in patients with fibromyalgia. METHODS: Fifteen patients with fibromyalgia and 15 healthy subjects participated in the study. Demographic characteristics of participants and severity for fatigue, sleep quality, cognitive symptoms, somatic symptoms and health-related quality of life in fibromyalgia patients were recorded...
October 24, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Michael Camilleri
Irritable bowel syndrome (IBS) is associated with diverse pathophysiologic mechanisms. These mechanisms include increased abnormal colonic motility or transit, intestinal or colorectal sensation, increased colonic bile acid concentration, and superficial colonic mucosal inflammation, as well as epithelial barrier dysfunction, neurohormonal up-regulation, and activation of secretory processes in the epithelial layer. Novel approaches to treatment include lifestyle modification, changes in diet, probiotics, and pharmacotherapy directed to the motility, sensation, and intraluminal milieu of patients with IBS...
December 2018: Mayo Clinic Proceedings
Gwang-Ho Choi, L Susan Wieland, Hyangsook Lee, Hoseob Sim, Myeong Soo Lee, Byung-Cheul Shin
BACKGROUND: Carpal tunnel syndrome (CTS) is a compressive neuropathic disorder at the level of the wrist. Acupuncture and other methods that stimulate acupuncture points, such as electroacupuncture, auricular acupuncture, laser acupuncture, moxibustion, and acupressure, are used in treating CTS. Acupuncture has been recommended as a potentially useful treatment for CTS, but its effectiveness remains uncertain. We used Cochrane methodology to assess the evidence from randomised and quasi-randomised trials of acupuncture for symptoms in people with CTS...
December 2, 2018: Cochrane Database of Systematic Reviews
Ye-Ha Jung, Hyeonjin Kim, So Yeon Jeon, Jeong Min Kwon, Yong Chul Kim, Won Joon Lee, Dasom Lee, Jun-Young Lee, Jee Youn Moon, Do-Hyung Kang
The aim of this study was to investigate distinct neurometabolites in the right and left thalamus and insula of patients with complex regional pain syndrome (CRPS) compared with healthy controls using proton magnetic resonance spectroscopy. Levels of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), myo-inositol (ml), glutamine (Gln), glycerophosphocholine (GPC), glutathione (GSH), and alanine (Ala) relative to total creatine (tCr) levels, including creatine and phosphocreatine, were determined in the right and left thalamus and insula in 12 patients with CRPS compared with 11 healthy controls using magnetic resonance spectroscopy...
November 29, 2018: Neuroreport
Xuhui Chen, Zuofan Li, Bo Zhang, Rong Hu, Jiayan Li, Miaomiao Feng, Wenlong Yao, Chuanhan Zhang, Li Wan, Yue Zhang
Central post-stroke pain (CPSP) is a neuropathic pain syndrome arising after lesion of the central nervous system (CNS) due to cerebrovascular insult. Impaired daily activities and reduced quality of life in people suffering from CPSP justify the need for improved treatment. The detailed mechanism of CPSP is not well understood but central disinhibition has been suggested. Recent reports indicated that epoxyeicosatrienoic acids (EETs), the cytochrome P450 metabolites of arachidonic acid, promoted neuronal survival after stroke, displayed antinociception in peripheral inflammatory pain and reduced neuronal excitability in seizure model...
November 27, 2018: Journal of Pain: Official Journal of the American Pain Society
Jiann-Her Lin, Chih-Hsien Hung, Der-Sheng Han, Shih-Ting Chen, Cheng-Han Lee, Wei-Zen Sun, Chih-Cheng Chen
BACKGROUND: Sensing tissue acidosis is an important function of the somatosensory nervous system to response to noxious stimuli. MAIN BODY: In the pain clinic, acid or soreness sensation is a characteristic sensory phenotype of various acute and chronic pain syndromes, such as delayed onset muscle soreness, fibromyalgia, and radicular pain. However, soreness sensation is a sign of successful analgesia for acupuncture and noxipoint therapy. Thus, the nature of acid or soreness sensation is not always nociceptive (or painful) and could be anti-nociceptive...
November 29, 2018: Journal of Biomedical Science
Asad Ali, Nouman Safdar Ali, Muhammad Bilal Malik, Zohaib Sayyed, Malik Qistas Ahmad
Our article will discuss bladder pain syndrome (BPS), which is the presence of chronic suprapubic pain to bladder filling accompanied by other urinary symptoms, such as frequency, urgency, discomfort with filling, and relief with emptying of the bladder in the absence of infections or other pathology. It is mostly seen in females and occurs in 0.06%-30% of the population. Some of the proposed mechanisms causing BPS include damage to the bladder lining, a problem manifesting in the pelvic musculature, endocrine, neurological, allergic, autoimmune system, and inflammatory system; however, a definite cause has not been yet identified...
September 17, 2018: Curēus
Nicola Oehler, Tim Rolvien, Tobias Schmidt, Sebastian Butscheidt, Ralf Oheim, Florian Barvencik, Haider Mussawy
In the course of complex regional pain syndrome (CRPS), local osteopenia in the subchondral/subcortical areas of the affected limb represents a central manifestation. Mechanistic aspects of CRPS-associated pathologies remain unclear, and knowledge about bone morphology in CRPS-affected areas is rare. The aim of this study was to assess trabecular and cortical bone microstructure in patients with CRPS of the distal tibiae. We retrospectively analysed 14 women diagnosed with unilateral CRPS type I of the lower limb whose affected and unaffected distal tibiae were examined by high-resolution peripheral quantitative computed tomography (HR-pQCT)...
November 21, 2018: Journal of Bone and Mineral Metabolism
Tone Kristin Bergersen, Lars Walløe
The term acral coldness is used to describe physiologic or pathologic situations in humans where the fingers and toes are exceptionally cold in spite of normal central body temperature. In the thermoneutral zone, the blood flow to acral skin normally shows large fluctuations between high and low values, with a frequency of about 3 cycles per minute. At an acral skin temperature of about 21°C, finger blood flow is constantly low. At lower temperatures the fingers and toes become painful. This is a normal physiologic reaction, probably because of ischemia...
2018: Handbook of Clinical Neurology
Piotr Tederko, Marek Krasuski, Beata Tarnacka
OBJECTIVES: To present a synopsis of evidence on the efficacy of rehabilitation after cervical disk surgery performed for neck pain and radiculopathy. DATA SOURCES: The databases of Medline, EMBASE, and Cochrane Central were searched for studies reporting effects of rehabilitation interventions in patients undergoing surgery due to cervical disk disease with pain and radicular syndrome, published before 31 August 2018. REVIEW METHODS: Project was registered with PROSPERO database (number CRD42018085937)...
November 21, 2018: Clinical Rehabilitation
Benjamin Peterson, Andrea Coda, Verity Pacey, Fiona Hawke
Background: Hypermobility Spectrum Disorder and Hypermobile Ehlers Danlos Syndrome are two common heritable genetic disorders of connective tissue. Both conditions are characterised by excessive joint range of motion and the presence of musculoskeletal symptoms, and are associated with joint instability, motion incoordination, decreased joint position sense, and musculoskeletal pain. Hypermobility Spectrum Disorder is the new classification for what was previously known as Joint Hypermobility Syndrome...
2018: Journal of Foot and Ankle Research
Giulia Magni, Alessandra Marinelli, Daniele Riccio, Davide Lecca, Chiara Tonelli, Maria P Abbracchio, Katia Petroni, Stefania Ceruti
Natural products have attracted interest in the search for new and effective analgesics and coadjuvant approaches to several types of pain. It is in fact well known that many of their active ingredients, such as anthocyanins (ACNs) and polyphenols, can exert potent anti-inflammatory actions. Nevertheless, their potential beneficial effects in orofacial painful syndromes have not been assessed yet. Here, we have evaluated the preventive effect of an ACN-enriched purple corn extract against the development of orofacial allodynia, in comparison with isogenic yellow corn extract containing only polyphenols...
2018: Frontiers in Cellular Neuroscience
Madhulika A Gupta, Daiana R Pur, Branka Vujcic, Aditya K Gupta
Several antiepileptic drugs (AEDs) are approved by the US Food and Drug Administration for the treatment of bipolar disorder (valproic acid, divalproex, lamotrigine, carbamazepine) and some cutaneous neuropathic pain syndromes (carbamazepine, gabapentin, pregabalin). The AEDs may be effective in the management of (1) chronic pruritus, including pruritus due systemic disease, including uremia, neuropathic pain, neuropathic pruritus, and complex cutaneous sensory syndromes, especially where central nervous system (CNS) sensitization plays a role; (2) management of emotional dysregulation and the resultant repetitive self-excoriation or other cutaneous self-injury in patients who repetitively stimulate or manipulate their integument to regulate emotions (prurigo nodularis, lichen simplex chronicus, skin picking disorder, trichotillomania); (3) management of dermatologic clinical manifestations associated with autonomic nervous system activation (hyperhidrosis, urticaria, flushing; these often occur in conjunction with psychiatric disorders with prominent autonomic activation and dysregulation, eg, social anxiety disorder, posttraumatic stress disorder); and (4) when certain anticonvulsants have a direct therapeutic effect (eg, in psoriasis); currently the use of AEDs for such cases is largely experimental...
November 2018: Clinics in Dermatology
Dervla O'Malley
NEW FINDINGS: Pathophysiological changes linked to Irritable Bowel Syndrome (IBS) include stress and immune activation, changes in gastrointestinal microbial and bile acids profiles and sensitisation of extrinsic and intrinsic gut neurons. This review explores the potential role for L-cells in these pathophysiological changes. L-cells, which secrete glucagon-like peptide-1 (GLP-1) in response to nutrients, microbial factors, bile acids and short-chain fatty acids, may sense IBS-related changes in the luminal environment...
November 16, 2018: Experimental Physiology
Mathew Wooster, Blake Fernandez, Kelli L Summers, Karl A Illig
BACKGROUND: Subclavian vein stenosis or occlusion at the thoracic outlet is a problem associated with certain anatomic and environmental stresses (venous thoracic outlet syndrome [VTOS]), the presence of central venous catheters, and the high flows associated with arteriovenous (AV) access in the limb. We describe our experience with open and endovascular techniques for restoring patency in highly symptomatic patients. METHODS: A prospectively collected database of patients was queried for patients treated for central venous obstructive disease in the setting of highly symptomatic VTOS and ipsilateral AV access from October 2011 to August 2016...
November 12, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Miroslav Sikora, Željko Verzak, Marko Matijević, Aleksandar Včev, Stjepan Siber, Larisa Musić, Andreja Carek
BACKGROUND: Burning mouth syndrome is a condition of unknown etiology, characterized by burning symptoms on the otherwise clinically healthy oral mucosa. Central and/or peripheral neuropathy is one of the proposed causes for this condition. Psychological component in these patients is also very present, as it is known that BMS patients exhibit high levels of pain, anxiety, and depression. The aim of this study was to evaluate anxiety and depression among patients with burning mouth syndrome and a control group...
December 2018: Psychiatria Danubina
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