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Neuropathic Pain

Neuropathic Pain

The Neuropathic Pain Knowledge Centre is a unique resource containing a wealth of current information in this field of medicine.

The nervous system (central and peripheral) constantly receives and interprets information about the body's surroundings and the body's own functioning, responding by sending out messages to tissues and organs.

The Knowledge Centre addresses the two types of pain: nociceptive and clinical. Nocicpetive pain aims to protect individuals from harm. Clinical pain results from damage or inflammation of a part of the body and consists of both spontaneous pain that may arise with no apparent peripheral stimulus, and from hypersensitivity to peripheral stimuli1 due to peripheral and central sensitisations.

Neuropathic pain is often described as a shooting, stabbing or burning sensation. Estimates suggest that neuropathic pain may affect as much as 3% of the population.

Different types of neuropathic pain exist depending on their origin, details of which can be found in the Knowledge Centre: Painful Diabetic Neuropathy, Herpes Zoster and Post-Herpetic Neuralgia (PHN), HIV Associated-Neuropathy (HIV-AN), Cancer-related Neuropathic Pain, Post-surgical/Post-traumatic Neuropathic Pain.

In the clinic, the diagnosis of neuropathic pain relies on an accurate history and examination and some pain evaluation tools are used.

As Neuropathic pain doesn't respond to conventional therapy with analgesics, the different treatment regimens are antidepressants, anticonvulsants, opioids, topical agents and combination treatment.

To help physicians in the pharmacological management of this condition, recent guidelines are available.

Enter the Neuropathic Pain Knowledge Centre


References:

1. Ji R-R, et al. Central sensitization and LTP: Do pain and memory share similar mechanisms? Trends in Neuroscience 2003;26(12):696–705

Date of preparation: August 2012 PAIN/12/0003/EUd

Recent Drug Updates

Medical Journal Abstracts on Pain Management

Acupuncture for the Treatment of Vulvodynia

Wed 08 Oct 2014 -  Journal of Midwifery & Women’s Health

PurposeA randomized controlled pilot study was conducted to evaluate the effect of an acupuncture protocol for the treatment of vulvodyniaHypotheses1 Acupuncture reduces vulvar pain ...

OnabotulinumtoxinA (Botox) Nerve Blocks Provide Durable Pain Relief for Men with Chronic Scrotal Pain: A Pilot Open-Label Trial

Mon 06 Oct 2014 -  The Journal of Sexual Medicine

IntroductionChronic scrotal pain CSP is a common often debilitating condition affecting approximately 475 of men While nerve blocks using local anesthetics usually provide temporary pain ...

Clinical Guidelines

Guidelines on Penile Cancer

Apr 2014

The European Association of Urology (EAU) Guidelines Group on Penile Cancer has prepared this..

... guidelines document to assist medical professionals in the management of penile cancer. The guidelines aim to provide detailed, up-to-date information, based on recent developments in our understanding and management of penile squamous cell carcinoma (SCC). However, it must be emphasised that these guidelines provide an updated, but not yet standardised general approach to treatment and that they provide guidance and recommendations without legal implications.

Guidelines on Chronic Pelvic Pain

Apr 2014

The European Association of Urology (EAU) Guidelines Working Group for Chronic Pelvic Pain prepared..

... this guidelines document to assist urologists and medical professionals from associated specialties, such as gynaecologists, psychologists, gastroenterologists and sexologists, in assessing the evidence-based management of CPP and to incorporate evidence-based recommendations into their every-day clinical practice.

Clinical Trials

Botox Injection in Treatment of Chronic Migraine

03-10-2014

Cluster headache is an intense and powerful, one-sided headache accompanied by involuntary symptoms such as red eye, droopy eyelids, flow of tears, small pupils and one-sided facial sweating. The headache is believed to be the most intense of all..

... headaches and among many is totally disabling and of great personal and social consequences. For a small group of patients with episodic and most chronic form, drug therapy has little effect. For them, surgery may be a solution.

Neuroradiology has found evidence of a possible original activation of cluster headache from the portion of the brain called hypothalamus. In addition, an activation of the parasympathetic nervous system through the sphenopalatine ganglion may be involved, which may explain some of the one-sided involuntary symptoms in cluster headache. Injection of Botulinum toxin type A (BTA) inhibits secretion of synaptic acetylcholine resulting in nerve signals being blocked. The duration of such a blockade is believed to be 3-9 months.

The purpose of the present study is to develop and evaluate a new surgical procedure with injection of BTA for blocking of the sphenopalatine ganglion. The goal is to relieve the symptoms of refractory cluster headache with a minimal invasive procedure.

The main objective of the project is to determine the safety of BTA injection in the area of the sphenopalatine ganglion of refractory cluster headache and detect the adverse events. Secondary objective is to identify the changes of headache attacks by the method used.

Randomized Controlled Study of the Efficacy of Hypnosis Versus Relaxation and Control in Neuropathic Pain (PSYCNEP)

01-10-2014

A randomized double-blind controlled two centers study. The primary objective of this study will be to show a superiority of hypnosis over relaxation on pain intensity in patients with neuropathic pain.

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