Pain in Neurological Disease
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Several terms are commonly used to describe NP, some with overlapping meaning: Neurogenic pain refers to all neurological causes of pain and although differently defined in the past, to all intents and purposes it now has the same meaning as neuropathic pain in clinical practice.Neuralgia describes pain arising in the distribution of a nerve or nerves. It is usually restricted to describe NP due to a lesion of a single nerve, for example intercostal, sciatic, femoral or trigeminal, or a sensory spinal nerve root, in the case of postherpetic neuralgia.Central pain describes NP caused by lesions within the central nervous system – either spinal cord or brain.
The Nervous System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The names of many of the other diseases, syndromes, and symptoms affecting the nervous system are readily decipherable by those with an understanding of the basic terminology of the system. For example, a meningioma is simply a tumor (-oma) of the meninges, while a meningocele is a protrusion (-cele) of the meninges through an opening in the skull or spinal column. Myelitis is any inflammation of the spinal cord since myelo refers to the spinal cord; similarly, neuritis is an inflammation of a nerve. Using the same root, neuralgia is pain along the length of a nerve. From the same prefix, one can decipher the meanings of ataxia and aphasia as indicating a lack (a- means "without") of ability to properly perform a postural (-taxia) or speech (-phasia) function. Table 12.1 lists many of these terms.
Chronic pelvic pain
Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen in Clinical Pain Management, 2008
In some cases, with multiple trigger points in the vaginal wall, back, and abdominal wall, a series of abdominal nerve, caudal, pudendal or epidural blocks may prove to be more fruitful in treating the pain than multiple trigger point injections.10[III] Nerve blocks with local anesthetics may provide relief of neuralgia due to nerve injury. Prolonged partial pain relief may occur for weeks or months following one or more nerve blocks beyond the anticipated duration of the local anesthetic. The explanation for prolonged pain relief may be secondary to reduced capacity of the nerve to maintain repetitive impulses, decreased excitability of the nerve fiber, and systemic uptake of the anesthetic. Nerve blocks have also been used as a prerequisite for evaluating potential effectiveness prior to neurectomy.148[III] Superior hypogastric plexus block by CT guidance and at the time of microlaparoscopy may provide further evaluation and management in chronic pelvic pain.149, 150[III] CT guidance has also been found to be useful for needle guidance in pudendal nerve blocks.151[III]
Investigating the possible pain attenuating mechanisms of pregabalin in chronic constriction injury-induced neuropathic pain in rats
Published in International Journal of Neuroscience, 2019
Renuka Verma, Jasmine Sharma, Nirmal Singh, Amteshwar Singh Jaggi
Neuropathic pain is chronic pain in which a patient experiences severe pain those results from the dysfunction of the somatosensory nervous system [1, 2]. Neuropathic pain can be classified as central neuropathic pain or peripheral neuropathic pain, depending upon the site of injury [3, 4]. Peripheral neuropathic pain is triggered after damage to the peripheral nerves (sensory, motor and autonomic) and it is generally encountered in the patients who have cancer, AIDS, herpes disease, persistent diabetes, lumbar disc syndrome, thoracotomy, mastectomy and sternotomy [5]. Central neuropathic pain is caused due to the dysfunctioning of the central nervous system (the brain and the spinal cord) that may result from the injury of the spinal cord, multiple sclerosis and stroke [6]. The characteristic symptoms of neuropathic pain include hyperalgesia (increased sensitivity to pain stimulus), allodynia (decreased threshold, i.e. increased pain response to stimuli which generally do not provoke pain), dysesthesia (burning pain sensation) and neuralgia (shooting or stabbing pain; electric shock-like pain) [7, 8]. Regardless of the significant prevalence of neuropathic pain, there is still a lack of suitable pharmacological treatment for neuropathic pain. A few therapies available for the treatment of neuropathic pain include anti-epileptic agents including lamotrigine, calcium channel α2-δ ligands like gabapentin and pregabalin, sodium channel antagonists like carbamazepine and NMDA receptor antagonists, mexiletine and topical 5% lidocaine [3].
Preparation of uniform-sized GeXIVA[1,2]-loaded PLGA microspheres as long-effective release system with high encapsulation efficiency
Published in Drug Delivery, 2022
Lu Li, Zhiguo Li, Yongxin Guo, Kai Zhang, Weidong Mi, Jing Liu
Currently, the drug of choice for the clinical treatment of chronic neuralgia is opioids. However, opioids are accompanied by a series of adverse reactions such as tolerance and addiction, and they are frequently administered, resulting in poor patient compliance, and there are certain limitations in clinical treatment (Angst & Clark, 2006; Chou et al., 2015; Devereaux et al., 2018). Conotoxin αO-GeXIVA, a 28-amino acid polypeptide found in the marine animal conus in the South country Sea, can achieve an analgesic effect by specifically blocking the α9α10 nAChR receptor, which has attracted widespread attention (Yu et al., 2018; Xu et al., 2020; Wang et al., 2019). Its isomer GeXIVA[1,2] is by far the most active conotoxin (Yousuf et al., 2022), showing excellent analgesic effects in many disease models (Vincler & Mcintosh, 2007; Alsharari et al., 2020; Khan et al., 2002). Notably, no addictive or motor side effects were observed during the treatment period. Therefore, GeXIVA[1,2], as a novel polypeptide compound with unique pharmacological and analgesic effects, is expected to be used in the clinic to improve the therapeutic effect of chronic neuropathic pain.
Resolution of persistent traumatic supraorbital pain after neuroma excision
Published in Orbit, 2022
Matthew Tukel, Robert Beaulieu, Alon Kahana
For patients complaining of the aforementioned symptoms, the key differential diagnoses to consider are neuromas versus SO nerve compression versus primary SO neuralgia. Patients with a known history of facial injury or trauma overlying the anatomical path of the SO nerve, who complain of decreased forehead sensation, trigger points for pain located near the area of the SO nerve, and who experience pain relief from SO nerve block, the diagnosis is likely neuroma.1 A narrow supraorbital notch or foramen, or the presence of a tumor, can cause compression of the SO nerve as it emerges out of the orbit.7 If the history does not include trauma but the patient complains of painful trigger points in the area of the SO nerve, forehead hypoesthesia, and unilateral frontal headaches, compression should be considered a more likely etiology. In contrast, patients with idiopathic SO neuralgia typically lack sensory deficits and associated hypoesthesia, paresthesia, and allodynia that is common in post-traumatic or compressive cases.8
Related Knowledge Centers
- Brachial Plexus
- Glossopharyngeal Nerve
- Herpes
- Intercostal Nerves
- Occipital Neuralgia
- Postherpetic Neuralgia
- Sciatica
- Shingles
- Trigeminal Neuralgia
- Migraine