1. Several drugs are used to potentiate centrally acting analgesics like opioids for neuropathic pain, including anticholinergics, antispasmodics, and some antidepressants. 2. Dextromethorphan and some opioids like methadone have additional analgesic effects by acting on NMDA receptors. 3. In the past, high-alcohol liquor was used as a pain dulling agent due to ethanol's CNS depression, but it is now considered a primitive practice compared to modern analgesics.

1. Chapter 12 Kimberly Jackson July 13, 2011

2. Algesia Orphenadrine, cyclobenzaprine, scopolamine, atropine, gabapentin, first-generation antidepressants and other drugs possessing anticholinergic and/or antispasmodic properties are used in many cases along with analgesics to potentiate centrally acting analgesics such as opioids when used against pain especially of neuropathic origin and to modulate the effects of many other types of analgesics by action in the parasympathetic nervous system. Dextromethorphan has been noted to slow the development of tolerance to opioids and exert additional analgesia by acting upon the NMDA receptors; some analgesics such as methadone and ketobemidone and perhaps piritramide have intrinsic NMDA action.

3. Algesia High-alcohol liquor has been used in the past as an agent for dulling pain, due to the CNS depressant effects of ethylalcohol a notable example being the American Civil War. However, the ability of alcohol to "kill pain" may be inferior to many analgesics used today (e.g. morphine, codeine). As such, the idea of alcohol for analgesia is generally considered a primitive practice in virtually all industrialized countries today

4. Anagelsia An analgesic (also known as a painkiller) is any member of the group of drugs used to relieve pain (achieve analgesia). The word analgesic derives from Greek an- ("without") and algos ("pain"). Analgesic drugs act in various ways on the peripheral and central nervous systems; they include paracetamol (para-acetylaminophenol, also known in the US as acetaminophen), the non-steroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, and opioid drugs such as morphine and opium. They are distinct from anesthetics, which reversibly eliminate sensation.

5. Algesia In choosing analgesics, the severity and response to other medication determines the choice of agent; the WHO pain ladder, originally developed in cancer-related pain, is widely applied to find suitable drugs in a stepwise manner. The analgesic choice is also determined by the type of pain: for neuropathic pain traditional analgesics are less effective, and there is often benefit from classes of drugs that are not normally considered analgesics, such as tricyclic antidepressants and anticonvulsants

6. Taxia -Response whose direction is determined by the direction of the stimulus, so the organism will move away from (negative taxis) an unfavorable stimulus or towards (positive taxis) a favorable stimulus

7. Ataxia Childhood ataxia with central nervous system hypomyelination/vanishing white matter disease (CACH/VWM) is characterized by ataxia, spasticity, and variable optic atrophy. The phenotypes range from a prenatal/congenital form to a subacute infantile form (onset age <1 year), an early childhood-onset form (onset age 1-5 years), a late childhood-/juvenile-onset form (onset age 5-15 years), and an adult-onset form.

8. Ataxia The prenatal/congenital form is characterized by severe encephalopathy. In the later-onset forms initial motor and mental development is normal or mildly delayed followed by neurologic deterioration with a chronic progressive or subacute course. Chronic progressive decline can be exacerbated by rapid deterioration during febrile illnesses or following head trauma or major surgical procedures, or by acute psychological stresses such as extreme fright.