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Chronic intractible pain

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https://www.readbyqxmd.com/read/28702333/cough-syncope-induced-by-post-nasal-drip-successfully-managed-by-gabapentin
#1
Hussein Algahtani, Bader Shirah
Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28670718/ketamine-infusion-combined-with-magnesium-as-a-therapy-for-intractable-chronic-cluster-headache-report-of-two-cases
#2
Xavier Moisset, Pierre Clavelou, Michel Lauxerois, Radhouane Dallel, Pascale Picard
BACKGROUND: Chronic cluster headache (CH) is a rare, highly disabling primary headache condition. As NMDA receptors are possibly overactive in CH, NMDA receptor antagonists, such as ketamine, could be of interest in patients with intractable CH. CASE REPORTS: Two Caucasian males, 28 and 45 years-old, with chronic intractable CH, received a single ketamine infusion (0.5 mg/kg over 2 h) combined with magnesium sulfate (3000 mg over 30 min) in an outpatient setting...
July 3, 2017: Headache
https://www.readbyqxmd.com/read/28647094/long-term-prognosis-of-hematogenous-vertebral-osteomyelitis-mortality-quality-of-life-and-pain
#3
Terufumi Kokabu, Masahiko Takahata, Nobuhisa Ishiguro, Norimasa Iwasaki
BACKGROUND: Hematogenous vertebral osteomyelitis (HVO) has a generally favorable prognosis if appropriate treatment is initiated in its early phase; however, some intractable cases with HVO can develop neurological impairment as well as spinal deformity during the course of treatment and these sequelae may lead to impaired quality of life (QOL). In this study, we aimed to evaluate the long-term relapse rate, mortality, and QOL of patients with HVO. METHODS: In this retrospective case series study, medical records of 60 patients with HVO with a mean follow-up period of 8 years (5-23 years) were reviewed to assess demographic data, details of infection, and clinical course...
June 21, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28632962/a-novel-minimally-invasive-wireless-technology-for-neuromodulation-via-percutaneous-intercostal-nerve-stimulation-pns-for-post-herpetic-neuralgia-a-case-report-with-short-term-follow-up
#4
Bart Billet, Roel Wynendaele, Niek E Vanquathem
BACKGROUND: Peripheral nerve stimulation (PNS) of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. OBJECTIVE: To assess analgesic effects of a minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. CASE SUMMARY: A 78-year-old man presented with severe intractable post herpetic neuralgic pain...
June 20, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28631871/efficacy-of-percutaneous-endoscopic-gastro-jejunostomy-peg-j-decompression-therapy-for-patients-with-chronic-intestinal-pseudo-obstruction-cipo
#5
H Ohkubo, A Fuyuki, J Arimoto, T Higurashi, T Nonaka, Y Inoh, H Iida, M Inamori, T Kaneda, A Nakajima
BACKGROUNDS: Chronic intestinal pseudo-obstruction (CIPO) is an intractable rare digestive disease manifesting persistent small bowel distension without any mechanical cause. Intestinal decompression is a key treatment, but conventional method including a trans-nasal small intestinal tube is invasive and painful. Therefore, a less invasive and tolerable new decompression method is urgently desired. We conducted a pilot study and assessed the efficacy and safety of percutaneous endoscopic gastro-jejunostomy (PEG-J) decompression therapy in CIPO patients...
June 20, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28579820/cannabis-and-intractable-chronic-pain-an-explorative-retrospective-analysis-of-italian-cohort-of-614-patients
#6
Guido Fanelli, Giuliano De Carolis, Claudio Leonardi, Adele Longobardi, Ennio Sarli, Massimo Allegri, Michael E Schatman
BACKGROUND: Despite growing interest in the therapeutic use of cannabis to manage chronic pain, only limited data that address these issues are available. In recent years, a number of nations have introduced specific laws to allow patients to use cannabis preparations to treat a variety of medical conditions. In 2015, the Italian government authorized the use of cannabis to treat several diseases, including chronic pain generally, spasticity in multiple sclerosis, cachexia and anorexia among AIDS and cancer patients, glaucoma, Tourette syndrome, and certain types of epilepsy...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28567456/surgery-for-intractable-pain-in-a-patient-with-chronic-pancreatitis-complicated-with-biliary-obstruction-portal-vein-stenosis-and-mesenteric-venous-collaterals
#7
Cuneyt Kayaalp, Murat Sait Dogan, Veysel Ersan
Pancreatic head resection for chronic pancreatitis is a challenging procedure, in the presence of venous collaterals, cavernous transformation, extensive fibrosis or porto-mesenteric stenosis or thrombosis. We present a surgically treated patient for the intractable pain of chronic pancreatitis. Complications with biliary obstruction and portal vein stenosis/thrombosis resulted in cavernous transformation. A pancreaticoduodenectomy combined with portal vein resection was intended in a 51 year-old male, but the procedure was terminated due to the high risk associated with intraoperative bleeding...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28535555/paresthesia-independence-an-assessment-of-technical-factors-related-to-10-khz-paresthesia-free-spinal-cord-stimulation
#8
MULTICENTER STUDY
Giuliano De Carolis, Mery Paroli, Lara Tollapi, Matthew W Doust, Abram H Burgher, Cong Yu, Thomas Yang, Donna M Morgan, Kasra Amirdelfan, Leonardo Kapural, B Todd Sitzman, Richard Bundschu, Ricardo Vallejo, Ramsin M Benyamin, Thomas L Yearwood, Bradford E Gliner, Ashley A Powell, Kerry Bradley
BACKGROUND: Spinal cord stimulation (SCS) has been successfully used to treat chronic intractable pain for over 40 years. Successful clinical application of SCS is presumed to be generally dependent on maximizing paresthesia-pain overlap; critical to achieving this is positioning of the stimulation field at the physiologic midline. Recently, the necessity of paresthesia for achieving effective relief in SCS has been challenged by the introduction of 10 kHz paresthesia-free stimulation...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28527055/cluster-headache-present-and-future-therapy
#9
Massimo Leone, Alessandro Giustiniani, Alberto Proietti Cecchini
Cluster headache is characterized by severe, unilateral headache attacks of orbital, supraorbital or temporal pain lasting 15-180 min accompanied by ipsilateral lacrimation, rhinorrhea and other cranial autonomic manifestations. Cluster headache attacks need fast-acting abortive agents because the pain peaks very quickly; sumatriptan injection is the gold standard acute treatment. First-line preventative drugs include verapamil and carbolithium. Other drugs demonstrated effective in open trials include topiramate, valproic acid, gabapentin and others...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28522185/orofacial-complex-regional-pain-syndrome-pathophysiologic-mechanisms-and-functional-mri
#10
Yeon-Hee Lee, Kyung Mi Lee, Hyug-Gi Kim, Soo-Kyung Kang, Q-Schick Auh, Jyung-Pyo Hong, Yang-Hyun Chun
Complex regional pain syndrome (CRPS) is one of the most challenging chronic pain conditions and is characterized by burning pain, allodynia, hyperalgesia, autonomic changes, trophic changes, edema, and functional loss involving mainly the extremities. Until recently, very few reports have been published concerning CRPS involving the orofacial area. We report on a 50-year-old female patient who presented with unbearable pain in all of her teeth and hypersensitivity of the facial skin. She also reported intractable pain in both extremities accompanied by temperature changes and orofacial pain that increased when the other pains were aggravated...
March 14, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28521018/stereotactic-radiosurgery-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#11
Dustin G Roberts, Nader Pouratian
BACKGROUND: Since the advent of neuromodulation, the role and efficacy of stereotactic radiosurgery (SRS) for chronic pain has not been carefully scrutinized. OBJECTIVE: To perform a systematic review to evaluate the clinical efficacy, both short- and long-term, of SRS for the treatment of chronic intractable pain. METHODS: A systematic search in PubMed, Web of Science, and PsycINFO was performed using keywords and controlled vocabulary. The search included peer-reviewed articles reporting clinical outcomes of SRS for chronic pain with a minimum 3-mo follow-up for nonmalignant and 1 mo for malignant pain...
May 17, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28501595/corticolimbic-circuitry-in-the-modulation-of-chronic-pain-and-substance-abuse
#12
REVIEW
Anna M W Taylor
The transition from acute to chronic pain is accompanied by increased engagement of emotional and motivational circuits. Adaptations within this corticolimbic circuitry contribute to the cellular and behavioral maladaptations associated with chronic pain. Central regions within the corticolimbic brain include the mesolimbic dopamine system, the amygdala, and the medial prefrontal cortex. The evidence reviewed herein supports the notion that chronic pain induces significant changes within these corticolimbic regions that contribute to the chronicity and intractability of pain...
May 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28486758/stimulation-of-the-l2-l3-dorsal-root-ganglia-induces-effective-pain-relief-in-the-low-back
#13
Frank Huygen, Liong Liem, William Cusack, Jeffery Kramer
INTRODUCTION: Chronic low back pain affects millions of people worldwide and can arise through a variety of clinical origins. In the case of Failed Back Surgery Syndrome (FBSS), previous surgical procedures can contribute to low back pain that is often unresponsive to intervention. Although spinal cord stimulation can be an effective treatment modality, it does not provide sufficient pain relief for some intractable cases. Recently, alternative neuromodulation options have been developed, including dorsal root ganglion (DRG) stimulation...
May 9, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28479215/local-injection-to-sciatic-nerve-of-dexmedetomidine-reduces-pain-behaviors-sgcs-activation-ngf-expression-and-sympathetic-sprouting-in-cci-rats
#14
Jing-Ru Wu, Hui Chen, Ying-Ying Yao, Ming-Ming Zhang, Kai Jiang, Bo Zhou, Deng-Xin Zhang, Jie Wang
Neuropathic pain has become an intractable health threat, with its profound effect on quality of life. Dorsal root ganglia (DRG) is evidenced to play a crucial role in neuropathic pain. The peripheral nociceptive afferents seem to be essential not only to initiate the process of neuropathic pain, but also to maintain and modulate it. Dexmedetomidine (DEX), a highly selective agonist of α2-adrenergic receptor (α2-AR), has provided significant analgesia in neuropathic pain. In the present study, we found that local injection to sciatic nerve of DEX alleviated heat hypersensitivity induced by chronic constriction injury (CCI)...
June 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#15
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#16
Peter S Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction, and lack of efficacy...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28399549/cost-effectiveness-data-regarding-spinal-cord-stimulation-for-low-back-pain
#17
Christian Hoelscher, Jonathan Riley, Chengyuan Wu, Ashwini Sharan
STUDY DESIGN: Review of published literature pertaining to spinal cord stimulation (SCS) cost data analysis. OBJECTIVE: To acquire, organize, and succinctly summarize the available literature regarding the costs associated with, and the cost-effectiveness of, SCS. SUMMARY OF BACKGROUND DATA: Chronic back and limb pain is a pervasive complaint in modern society, with estimated annual costs of medical care greater than $100 billion. The traditional standard medical management with or without intermittent surgical decompression/fusion has been plagued by high costs and inconsistent results, leading to poor patient satisfaction and functional outcome, and questions from policy makers regarding use of limited healthcare resources...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28370989/specialty-based-variations-in-spinal-cord-stimulation-success-rates-for-treatment-of-chronic-pain
#18
Syed Mohammed Qasim Hussaini, Kelly Ryan Murphy, Jing L Han, Aladine A Elsamadicy, Siyun Yang, Alykhan Premji, Beth Parente, Jichun Xie, Promila Pagadala, Shivanand P Lad
OBJECTIVES: Spinal cord stimulation (SCS) has emerged as an appropriate modality of treatment for intractable chronic pain. The present study examines variations in SCS trial-to-permanent conversion rates based on provider types performing the procedure. MATERIALS AND METHODS: We designed a large, retrospective analysis using the Truven MarketScan data base analyzing adult SCS patients with provider information available, with or without IPG implantation from the years 2007-2012...
June 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28368982/spinal-cord-stimulation-in-chronic-pain-mode-of-action
#19
Ricardo Vallejo, Kerry Bradley, Leonardo Kapural
STUDY DESIGN: Literature review. OBJECTIVE: A review of the literature that presents a perspective on mechanisms of actions behind spinal cord stimulation (SCS) therapy for chronic pain. SUMMARY OF BACKGROUND DATA: SCS is an effective therapeutic alternative for the treatment of intractable chronic pain. Its application has been mostly based on the gate control theory of pain. Computational models have been fundamental on the understanding of clinical observations and the design of therapies that provide optimal neuromodulation...
July 15, 2017: Spine
https://www.readbyqxmd.com/read/28327190/primary-pain-generator-identification-by-ct-spect-in-a-patient-with-low-back-pain-a-case-report
#20
Gabriel Tender, Adriana Constantinescu, Andrew Conger, Anthony DiGiorgio
BACKGROUND: Chronic low back pain is one of the most common conditions encountered in the middle-age population. Identifying the primary pain generator is notoriously difficult. The computed tomography-single-photon emission computed tomography (CT-SPECT) is emerging as a new diagnostic modality for this purpose. CASE PRESENTATION: This 68-year-old Caucasian male presented with intractable low back pain refractory to maximal conservative treatment, including medication and extensive physical therapy...
March 21, 2017: BMC Research Notes
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