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Treatment of post-herpetic neuralgia: antidepressants.

Five controlled clinical trials and extensive clinical experience have shown that amitriptyline and several other antidepressants reduce the severity of post-herpetic neuralgia. Studies in post-herpetic neuralgia and in painful diabetic neuropathy suggest that blockade of norepinephrine reuptake is the most important action accounting for pain relief; selective agents such as desipramine may be useful in patients unable to tolerate amitriptyline side effects. The selective serotonin reuptake inhibitors, zimelidine and paroxetine, have shown little effectiveness in neuropathic pain, but small s…

Постгерпетическая нейронгия: нынешние концепции и управление.

Постгерпетическая нейронгия (PHN) является наиболее осложнением герпеса зостера и остается одним из наиболее распространенных и трудноразрешимых хронических болевых расстройств. Последние данные пролили свет на возможные механизмы боли, а также на профилактические и лечебные подходы к ПХН. В этой статье рассматриваются нынешние концепции и методы управления ПХН.

Совпадение в аннотации оригинала
Postherpetic neuralgia (PHN) is the most feared complication of herpes zoster and remains one of the most common and intractable chronic pain disorders. Recent evidence has shed some light on the possible mechanisms of pain, and on the prophylactic and treatment approaches to PHN. This article reviews the current concepts and management of PHN.

Orofacial neuralgia. Diagnosis and treatment guidelines.

Patients with facial pain, without overt dental disease, are often seen in both medical and dental practice. The differential diagnosis incl … lthough frequent attacks are best suppressed by continuous propranolol or pizotifen; (c) trigeminal neuralgia, knifelike unilateral pains usually responsive to carbamazepine; and (d) temporal arteritis, a steadier pain very responsive to corticosteroids. There is no evidence that continuous 'idiopathic facial pain' is a result of malocclusion (i.e. the way …

[Neurosurgical treatment of essential facial neuralgia].

The authors describe the neurosurgical techniques currently available for the treatment of essential trigeminal neuralgia refractory to the usual medical treatments. They compare the advantages and disadvantages of percutaneous techniques (particularly thermocoagulation of the trigeminal ganglion) and open techniques (especially microsurgical treatment of neurovascular conflict in the cerebellopontine angle.

A mandibular fracture triggering trigeminal neuralgia.

The authors describe a case in which an elderly patient, who had previously been treated for trigeminal neuralgia, developed a subsequent fracture of the mandible at the site of a further trigger point. This presented difficulty in management of the case, and the necessary treatment is reviewed.

Angiographic observations in idiopathic trigeminal neuralgia.

Twenty-four patients with idiopathic trigeminal neuralgia were treated by neurovascular decompression surgery. All patients underwent preoperative vertebral angiography. After surgery, the vertebral angiograms of these patients were retrospectively reviewed. In 23 of the 24 patients, the superior cerebellar artery (SCA) and/or the anterior inferior cerebellar artery (AICA) compressed the trigeminal nerve. In the remaining case, no such compression by vessels was observed. On review of the angiograms, most of the compressing arteries, and the sites and numbers of compression points could be ide…

Post-herpetic neuralgia and topical capsaicin.

Topical 0.025% capsaicin was used to treat 33 patients with post-herpetic neuralgia (PHN). Thirty-nine percent of those entering the trial achieved at least a good result and 55% were improved or better. Fifty-six percent of the 23 patients completing the study had good or excellent pain relief after 4 weeks. Seventy-eight percent of the 23 noted at least some improvement in pain. Post-capsaicin burning was a common, untoward effect in most patients and in about one-third was so unbearable that the trial was terminated prematurely. This treatment appears to be a useful modality in PHN, particu…