The document discusses neuropathic pain, including its pathophysiology, symptoms, causes, assessment, and treatment approaches. It provides details on pharmacological and non-pharmacological treatment options for peripheral and central neuropathic pain, including guidelines on first-line therapies such as antidepressants, anticonvulsants, and topical lidocaine. Emerging treatments currently under investigation are also mentioned.
this presentation discusses pain pathways, definition and glossary of pain symptoms, classification of pain, pathogenesis, causes, diagnosis , types and treatment of neuropathic pain
illustrated with figures
this presentation discusses pain pathways, definition and glossary of pain symptoms, classification of pain, pathogenesis, causes, diagnosis , types and treatment of neuropathic pain
illustrated with figures
Phantom pain is pain caused by elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers after amputation or deafferentation
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
An update on the epidemiology and treatment of neuropathic pain. The slides were developed for a presentation in a departmental seminar at the Curtin University, Australia.
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
Phantom pain is pain caused by elimination or interruption of sensory nerve impulses by destroying or injuring the sensory nerve fibers after amputation or deafferentation
Amyotrophic lateral sclerosis (ALS), AKA "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed.
An update on the epidemiology and treatment of neuropathic pain. The slides were developed for a presentation in a departmental seminar at the Curtin University, Australia.
Pain definition, Pain pathways, pain modulation, the endorphin system, Types of Pain, current trend of Drugs used for pain management. New Drugs for pain
A disorder of the central nervous system that affects movement, often including tremors.
Nerve cell damage in the brain causes dopamine levels to drop, leading to the symptoms of Parkinson's.
Parkinson's often starts with a tremor in one hand. Other symptoms are slow movement, stiffness and loss of balance.
Treatment consists of medications to increase dopamine.
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
7. Likely causes of neuropathy according to speed of onset Acute onset Inflammatory Immunological Toxic Vascular Subacute onset over weeks or months Toxic Nutritional Systemic disease Chronic onset over many years Hereditary Metabolic disease
9. Goals of Neuropathic Pain Management Treat/prevent recurrence of pain-causing condition Reduce pain Improve physical/psychologic function Improve quality of life
10. Neuropathic Pain: Approach to Treatment Diagnosis Treat underlying condition/symptomatic treatment Reduce Pain Prevention (if applicable) Reduce psychological distress Improve physical functioning Improve overall quality of life
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13. Risk Continuum of Pain Therapy Level of Risk Most invasive Least invasive Interventional techniques Oral medications Topical medications Psychologic/ physical approaches Injections
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17. Pharmacological Treatments *: FDA approved in various neuropathic pain diseas +: FDA approved for use in severe chrnic pain
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19. APPROACHES TO THE MANAGEMENT OF NEUROPATHIC PAIN Monotherapy Combinations Additional Measures B. Second-line Capsaicin Physiotherapy Lidocaine patch Occupational therapy Tizanidine Paracetamol Clonidine TENS Baclofen Acupuncture Alternative antidepressant (e.g. duloxetine) Opioid tramadol, morphine, oxycodone Opioid with TCA or AE
20. APPROACHES TO THE MANAGEMENT OF NEUROPATHIC PAIN Monotherapy Combinations C. Third-line Alternative opioids Ketamine plus opioid Ketamine Intrathecal drug delivery Neuromodulation Additional Measures : Paracetamol, TENS, Acupuncture,Physiotherapy, Occupational therapy plus Psychological support
21. Peripheral neuropathic pain ALGORITHM FOR SEQUENCE OF DIFFERENT DRUG TREATMENTS IN PERIPHERAL NEUROPATHIC PAIN Lidocaine patch NO Post-herpetic neuralgia and focal neuropathy Pregabalin/ Gabapentin Tramadol, oxycodone TCA (SNRI) TCA (SNRI) Pregabalin/ Gabapentin YES YES NO YES NO TCA contraindication TCA contraindication
22. Algorithm for the management of neuropathic pain Consider nonpharmacologic treatments (e.g. physiotherapy, psychological interventions) and, in some cases, early referral for nerve blocks to facilitate rehabilitation (e.g., complex regional pain syndrome) First Step
23. Algorithm for the management of neuropathic pain If postherpetic neuralgia or focal neuropathy, initiate topical lidocaine treatment Ineffective, partial response or other diagnosis Second Step
24. Algorithm for the management of neuropathic pain Initiate first-line drug monotherapy (Pregabalin or Gabapentin OR TCA OR SNRI) Third Step
25. Algorithm for the management of neuropathic pain Switch to alternate first-line drug monotherapy (TCA or SNRI OR Gabapentin or Pregabalin) Ineffective or not tolerated/ TCA contraindication Partial treatment response Consider adding alternate first-line drug (TCA or SNRI OR gabapentin or pregabalin) Fourth Step
26. Algorithm for the management of neuropathic pain Initiate monotherapy with Tramadol or Oxycodone Ineffective or not tolerated Partial treatment response Consider adding Tramadol or Oxycodone Fifth Step
27. Algorithm for the management of neuropathic pain Refer patient to pain specialty clinic for consideration of third-line drugs, interventional treatments and pain rehabilitation programs Ineffective or not tolerated Sixth Step