Non-Surgical Management of a Painful Neuroma
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Neuromas are nerve tumors that often form at amputation sites as severed nerve ends regrow abnormally. Clinical diagnosis involves palpating areas of sensitivity, allodynia, or hyperalgesia and observing signs like Tinel's. Investigations may include diagnostic anesthesia, MRI, ultrasound, or nerve conduction studies. Treatment options include medications, patches, neuromodulation, radiofrequency ablation, or chemical neurolysis to manage symptoms palliatively or potentially cure the condition. Drugs commonly used include gabapentinoids, opiates, anti-epileptics, and antidepressants.
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Similar to Non-Surgical Management of a Painful Neuroma
Neuropathic Itch
Neuropathic itch is chronic itch caused by injury or dysfunction along the afferent itch pathway, resulting in a sensation to scratch. It affects 8-19% of patients with chronic pruritus. Diagnosis is challenging and involves ruling out dermatological and systemic causes. Neuropathic itch syndromes can affect the peripheral or central nervous systems. Treatment is also challenging and requires tailoring therapies like anticonvulsant medications or topical anesthetics.
Neuropathic Pain Presented At Primed 5.11.09
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THERAPEUTIC INTERVENTION OF NEUROPATHIC PAIN WITH INNOVATIVE TARGETS
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This document provides an overview of neurogenic pain management in the 21st century. It begins with definitions of pain and classifications of neurological pain. Nociceptive pain results from stimulation of peripheral nociceptors, while neuropathic pain results from dysfunction of the peripheral or central nervous system. Examples of each type are described. The physiology and generation of nociceptive pain is explained. Neuropathic pain results from injury to pain-conducting nerves and is described as burning, electric or tingling. Emerging trends in neuropathic pain treatment and potential descriptions of neuropathic pain are discussed. The effects of chronic pain, pathophysiology of peripheral and central sensitization, and the role of glutamate and calcium are outlined.
Neuropathic pain strategies to improve clinical outcome
This document discusses strategies for improving outcomes for patients with neuropathic pain. It begins by describing common conditions associated with neuropathic pain such as diabetes and shingles. It then discusses diagnostic approaches and distinguishing characteristics of neuropathic pain. Key points covered include the pathogenesis of neuropathic pain and new treatment options that modulate underlying mechanisms. Major forms of neuropathic pain like post-herpetic neuralgia and diabetic neuropathy are examined in depth. The document concludes by outlining a stepwise approach to managing neuropathic pain.
Pain and its treatment in psychiatric practice (2) (1)
This document discusses chronic pain from both a historical and medical perspective. It defines acute versus chronic pain and nociceptive versus neuropathic pain. It describes how chronic pain involves central sensitization and can become a way of life. The relationship between pain and conditions like depression is complex. The medicalization of chronic pain through drugs like aspirin changed views of chronic pain. Currently, there are controversies around balancing treating pain while reducing risks of prescription drug abuse and addiction. Serotonin-norepinephrine reuptake inhibitors have been approved to treat some chronic pain disorders.
Chronic pain management
This document discusses chronic pain management and focuses on neuropathic pain. It defines neuropathic pain as pain arising from damage or disease affecting the somatosensory nervous system. Neuropathic pain is estimated to affect 3.3-8.2% of the population and results from structural and molecular changes in the pain pathway. Common causes include diabetes, shingles, spinal injuries and strokes. The mechanisms of neuropathic pain involve increased neuronal excitability and hyperactivity of NMDA receptors. Symptoms vary based on the affected nerve fibers but include burning sensations, pins and needles, and electric shock-like pain. Treatment involves a stepped approach starting with gabapentin, tricyclic antidepressants or SNRIs and may include opioids if needed.
Prof. mridul m. panditrao's pain pathophysiology, management & role of anaest...
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This document discusses the history and treatment of pain management. It begins with a description of pain treatment in ancient times, which involved crude methods like partial strangulation. It then outlines major developments in pain relief, including the discovery of morphine in 1806, the introduction of nitrous oxide and ether for anesthesia, and the development of newer opioids and local anesthetics. The document also discusses the physiology of pain pathways in the body and classifications of pain. It emphasizes the anesthesiologist's role in acute and chronic pain management, including the use of various pharmacological therapies and procedures.Trigeminal neuralgia/TN/ NEURALGIA
The International Association for the Study of Pain (IASP)1 defines trigeminal neuralgia (TN) as a sudden, usually unilateral, severe brief stabbing recurrent pain in one or more branches of the fifth cranial nerve
synonyms
Idiopathic trigeminal neuralgia / Tic Doulourex.
Trifacial Neuralgia.
Fothergell’s disease.
In 1677 John Locke, a American physician and philosopher, accurately identified the major clinical features of TN
In 1756 the French physician Nicolaus Andre coined the term “Tic douloureux” to the condition.
The English physician John Fothergill in 1773 published detailed description of TN, since then, it has been referred to as ‘Fothergill’s disease’.
Peripheral injections
Long acting LA
Alcohol
Glycerol
Peripheral neurectomy/ nerve avulsion
Cryotherapy
Gasserian ganglion procedures
Percutaneous stereotactic radiofrequency thermal lesioning of the trigeminal ganglion and/or root (rfl)
percutaneous glycerol gangliolysis of the trigeminal ganglion
percutaneous balloon microcompression of the trigeminal ganglion
Intracranial procedures
MVD
Partial sensory rhizotomy
Gamma knife radiation to the trigeminal root entry zone GKR
Sue Barnes - Pain management and Multiple Sclerosis
This document provides an overview of pain management for patients with multiple sclerosis (MS). It defines different types of pain commonly experienced by MS patients, such as Lhermitte's sign and central neuropathic dysaesthesia. Neuropathic pain is discussed in more detail, including its pathophysiology and diagnosis. Common neuropathic pain medications for MS are presented, including amitriptyline, gabapentin, pregabalin, and opioids. National guidelines for treating neuropathic pain in MS are summarized. Specialist referral is recommended for complex pain or when first-line treatments are ineffective.
Dr liu fibromyalgia disease overview-1
Firmly palpates each of the 18 tender points with the thumb or finger, pressing into the muscle/fascia approximately 4 kg of pressure.
Patient: Rates pain on a scale of 0-3:
0 = No pain
1 = Mild pain (patient states "that's tender")
2 = Moderate pain (patient grimaces or withdraws)
3 = Severe pain (patient cries out)
*11/18 tender points must be rated 2/3 for diagnosis of FM per ACR criteria
Adapted from: Wolfe F, et al. Arthritis Rheum. 1990;33:160-172. 20
Diagnostic Criteria for FM
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This document provides an overview of pharmacology related to analgesic, antipyretic, and anti-inflammatory drugs. It discusses the nervous system and pain pathways, different types of pain including nociceptive and neuropathic pain, common pain-relieving medications like NSAIDs, acetaminophen, opioids, and neuropathic agents. It covers administration, patient education, and monitoring of pain treatment. Key points include the mechanisms and side effects of different drug classes, considerations for special populations, and the importance of the nurse's role in advocating for adequate pain relief.
Trigeminal neuralgia
Trigeminal neuralgia is a severe facial pain disorder affecting the trigeminal nerve, the largest nerve in the face. It causes sudden, severe, electric shock-like pain in the areas of the face served by the trigeminal nerve. Trigeminal neuralgia is often triggered by normal activities like eating or talking. It is treated initially with medications like carbamazepine, but patients may require surgical treatments like microvascular decompression if medications do not help. Nursing care focuses on preventing pain triggers and providing psychological support for patients suffering from this debilitating disorder.
Pain
This document defines pain and describes the physiology of pain. It states that pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is transmitted via nociceptors and travels along afferent nerve fibers to the spinal cord. The gate control theory proposes that pain transmission can be modulated by interactions between pain fibers and touch fibers at the spinal cord. Chronic pain may involve different nerve fibers and neurotransmitters than acute pain. Various brain regions are also involved in pain perception and modulation.
trigeminal-neuralgia-AIHS.ppsx
1) Trigeminal neuralgia is a disorder characterized by severe, sporadic facial pain affecting one or more divisions of the trigeminal nerve. It is often triggered by mild stimulation of the face like brushing teeth.
2) Treatment options include medications like carbamazepine, surgery such as microvascular decompression to separate compressing blood vessels from the trigeminal nerve, and interventional procedures like glycerol rhizolysis or gamma knife radiosurgery.
3) The document discusses the classification, diagnosis, differential diagnosis, medical management, interventional treatments and surgical treatment of trigeminal neuralgia. It provides details on evaluation, pharmacological options and technical aspects of various surgical and interventional
Orofacial pain
This document discusses the evaluation, classification, causes and treatment of orofacial pain. It defines orofacial pain as unpleasant sensation caused by noxious stimuli along nerve pathways to the central nervous system. The evaluation of orofacial pain patients involves medical history, pain characteristics, physical exam and diagnostic tests. Pain is classified as somatic, neurogenic or psychogenic based on origin. Common causes include local dental issues, neurological conditions like trigeminal neuralgia, and psychogenic factors. Treatment depends on diagnosis but may include medications, nerve blocks or surgery.
Pain pathways
Pain is a complex experience involving sensory and emotional components. It is initiated by noxious stimuli and transmitted along specialized pain pathways in the nervous system. There are different types of pain including nociceptive, inflammatory, neuropathic, and functional pain. Pain signals are transmitted via fast Aδ fibers and slow C fibers from receptors to the spinal cord and then to the brain. The transmission of pain can be modulated by descending pathways and inhibited using various pharmacological and surgical techniques. Managing pain involves understanding its underlying causes and mechanisms.
Trigeminal neuralgia in OMFS
Trigeminal neuralgia is a disorder causing severe facial pain. It affects branches of the trigeminal nerve, the largest cranial nerve. The pain is usually sudden, severe, and described as electric shock-like. It is commonly triggered by trivial stimuli like talking or brushing teeth. Treatment options include medications like carbamazepine or surgery to decompress the trigeminal nerve if medications do not provide relief from pain.
Neurology
1. Epilepsy is a chronic neurological disorder characterized by recurrent seizures from abnormal neuronal activity in the brain. Common symptoms include involuntary muscle contractions and shaking. Treatment was historically based on nervous system depressants, but now focuses on newer antiepileptic drugs.
2. Alzheimer's disease causes memory loss and cognitive impairment. Early symptoms are subtle memory loss worsening over time. Currently there is no cure, but medications can help control symptoms.
3. Parkinson's disease is a neurodegenerative process affecting motor pathways in the brain. Symptoms include tremors and impaired movement. Treatment focuses on medications to manage symptoms.
Trigeminal neuralgia 2_
Trigeminal neuralgia is a neuropathic facial pain condition caused by compression or irritation of the trigeminal nerve, resulting in intense electric shock-like pain. It typically affects those over 50 years old and treatment involves medications initially, with surgical options like microvascular decompression or rhizotomy considered if medications fail to control pain. The document discusses the anatomy, classification, symptoms, diagnosis, differential diagnosis, and treatment approaches for trigeminal neuralgia.
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- 1. NEUROMA NON-SURGICAL MANAGEMENT DR TONI HUNDLE
- 2. NEUROMA • Ancient Greek for nerve (neuro-) and tumour (suffix – oma) • plural neuromas, also neuromata • 1: a tumour or mass growing from a nerve and usually consisting of nerve fibres • 2: a mass of nerve tissue in an amputation stump resulting from abnormal regrowth of the stumps of severed nerves—called also stump neuroma
- 3. Acknowledgement to Stahl's essential psychopharmacology. 2008
- 4. • Acknowledgement to Stahl's essential psychopharmacology. 2008
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- 10. 1 week after high-dose topical capsaicin 1 week after control 10 0 μm
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