NEURALGIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
ii
ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Neuralgia: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84527-1 1. Neuralgia-Popular works. I. Title.
iii
Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail:
[email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.
iv
Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on neuralgia. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
v
About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
vi
About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
vii
Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON NEURALGIA .............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Neuralgia ...................................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 21 The National Library of Medicine: PubMed ................................................................................ 22 CHAPTER 2. NUTRITION AND NEURALGIA .................................................................................... 65 Overview...................................................................................................................................... 65 Finding Nutrition Studies on Neuralgia ..................................................................................... 65 Federal Resources on Nutrition ................................................................................................... 67 Additional Web Resources ........................................................................................................... 68 CHAPTER 3. ALTERNATIVE MEDICINE AND NEURALGIA .............................................................. 69 Overview...................................................................................................................................... 69 National Center for Complementary and Alternative Medicine.................................................. 69 Additional Web Resources ........................................................................................................... 78 General References ....................................................................................................................... 81 CHAPTER 4. CLINICAL TRIALS AND NEURALGIA ........................................................................... 83 Overview...................................................................................................................................... 83 Recent Trials on Neuralgia .......................................................................................................... 83 Keeping Current on Clinical Trials ............................................................................................. 87 CHAPTER 5. PATENTS ON NEURALGIA ........................................................................................... 89 Overview...................................................................................................................................... 89 Patents on Neuralgia ................................................................................................................... 89 Patent Applications on Neuralgia................................................................................................ 97 Keeping Current ........................................................................................................................ 110 CHAPTER 6. BOOKS ON NEURALGIA............................................................................................. 111 Overview.................................................................................................................................... 111 Book Summaries: Federal Agencies............................................................................................ 111 Book Summaries: Online Booksellers......................................................................................... 112 Chapters on Neuralgia ............................................................................................................... 113 CHAPTER 7. PERIODICALS AND NEWS ON NEURALGIA ............................................................... 117 Overview.................................................................................................................................... 117 News Services and Press Releases.............................................................................................. 117 Newsletter Articles .................................................................................................................... 119 Academic Periodicals covering Neuralgia.................................................................................. 120 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 123 Overview.................................................................................................................................... 123 U.S. Pharmacopeia..................................................................................................................... 123 Commercial Databases ............................................................................................................... 124 Researching Orphan Drugs ....................................................................................................... 125 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 129 Overview.................................................................................................................................... 129 NIH Guidelines.......................................................................................................................... 129 NIH Databases........................................................................................................................... 131 Other Commercial Databases..................................................................................................... 133 The Genome Project and Neuralgia ........................................................................................... 133 APPENDIX B. PATIENT RESOURCES ............................................................................................... 137 Overview.................................................................................................................................... 137 Patient Guideline Sources.......................................................................................................... 137 Associations and Neuralgia ....................................................................................................... 158
Contents
viii
Finding Associations.................................................................................................................. 158 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 161 Overview.................................................................................................................................... 161 Preparation................................................................................................................................. 161 Finding a Local Medical Library................................................................................................ 161 Medical Libraries in the U.S. and Canada ................................................................................. 161 ONLINE GLOSSARIES................................................................................................................ 167 Online Dictionary Directories ................................................................................................... 168 NEURALGIA DICTIONARY ...................................................................................................... 169 INDEX .............................................................................................................................................. 239
1
FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with neuralgia is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about neuralgia, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to neuralgia, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on neuralgia. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to neuralgia, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on neuralgia. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
3
CHAPTER 1. STUDIES ON NEURALGIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on neuralgia.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and neuralgia, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “neuralgia” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Unilateral Trismus in a Patient with Trigeminal Neuralgia Due to Microvascular Compression of the Trigeminal Motor Root Source: Journal of Oral and Maxillofacial Surgery. 57(1): 90-92. January 1999. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 628239, Orlando, FL 32862-8239. (800) 654-2452. Summary: In this article, the authors report a case of unilateral trismus (difficulty opening the mouth) associated with typical trigeminal neuralgia (facial nerve pain), refractory to medical therapy, alleviated by microvascular decompression. The case study is of a 33 year old right handed woman with a significant medical history of hypertension, asthma, depression, and beta thalassemia who presented with a 14 month history of intermittent right ear pain, followed by right masseter muscle spasm with jaw
4
Neuralgia
deviation to the left. There was no history of trauma, joint noises, or episodes of closed or open lock of the mandible. The patient subsequently developed intermittent, sharp, lancinating, right facial pain in the second and third dermatomes of the trigeminal nerve. The patient's facial and ear pain was sharp, intermittent, and nonpositional, triggered by touching the face, eating, cold temperatures, and wind. The authors describe the drug management of the patient and the move to a surgical microvascular decompression of the trigeminal nerve. The authors discuss the relevant anatomy of the trigeminal nerve, along with the pathophysiology and differential diagnosis. Postoperatively, the patient remained off all medications. She noted some preauricular (in front of the ear) hints of trigeminal neuralgia, but this was minimal. 3 figures. 13 references. •
Trigeminal Neuralgia: A Dental Diagnosis Challenge Source: Northwest Dentistry. 78(3): 19-24. May-June 2000. Contact: Available from Minnesota Dental Association. 2236 Marshall Avenue, St. Paul, MN 55104. (800) 950-3368 or (651) 646-7454. Fax (651) 646-8246. E-mail:
[email protected]. Website: mndental.org/nwdentistry.html. Summary: Perhaps one of the most perplexing diagnostic and treatment challenges facing the dental practitioner today is the situation presented by a patient complaining of toothache or sinusitis without any dental abnormality as its origin. This article reviews trigeminal neuralgia, focusing on its sometimes difficult diagnosis. The author notes that misdiagnosis and incorrect management of the trigeminal neuralgia (TN) patient can result in invasive dental therapies such as extensive endodontic (root canal) procedures, multiple extractions, TMJ (temporomandibular joint) surgery, etc., quite often resulting in no resolution of the patient's pain and, in many cases, making the problem worse. Topics include the onset and early development of TN, management options, dental management of the TN patient, a TN overview for patients and their families, defining TN, diagnostic methods, the causes of TN, epidemiology, and the medical and surgical treatments for TN. Drug that may be used to treat TN include carbamazepine (Tegretol), phenytoin (Dilantin), gabapentin (Neurotonin), and baclofen (Lioresal). Surgical options include radiofrequency rhizotomy (percutaneous needle used to heat the nerve and destroy the pain fibers), glycerol rhizotomy (glycerol injected to damage the pain fibers), balloon compression (used to compress the nerve and damage the pain fibers), microvascular decompression (a surgical procedure done under general anesthesia), and stereotactic radiosurgery. The article concludes with a list of the major goals and purposes of the Trigeminal Neuralgia Association (TNA). 1 figure. 23 references.
•
Trigeminal Neuralgia: Review of Etiologies and Treatments Source: Compendium of Continuing Education in Dentistry. 14(10): 1256, 1258-1262. October 1993. Summary: This article discusses the currently accepted etiologies of trigeminal neuralgia, their respective treatments, and similar orofacial pain disorders. Topics covered include the central and peripheral etiologies of trigeminal neuralgia; the clinical features of trigeminal neuralgia and how it is distinguished from other related orofacial pain disorders; and the surgical and conservative treatment strategies and their potential side effects used to treat this condition. 40 references. (AA-M).
Studies
•
5
Felbamate Relieved Trigeminal Neuralgia: Case Report Source: Clinical Journal of Pain. 11(2): 139-142. June 1995. Contact: Available from Raven Press, Ltd. 1185 Avenue of the Americas, New York, NY 10036. (800) 77-Raven (72836). Summary: This article presents a case report demonstrating the analgesic efficacy of the novel anticonvulsant felbamate in trigeminal neuralgia. The author reports on a trial offered in a tertiary referral center to three outpatients with severe pain who had exhausted other medical options, yet did not wish to undergo surgery. Felbamate was prescribed as the sole analgesic for approximately 1 month. Felbamate potently diminished the severe pain of trigeminal neuralgia and was well tolerated. The drug was withdrawn because of subsequent reports elsewhere of aplastic anemia and hepatic failure associated with it when used for epilepsy. The author concludes that preliminary evidence suggested that felbamate was effective in relieving trigeminal neuralgia; however, significant potential risks preclude further use of felbamate in the management of nonmalignant pain. 1 figure. 16 references. (AA-M).
•
Trigeminal Neuralgia Due to an Acoustic Neuroma in the Cerebellopontine Angle Source: Journal of Orofacial Pain. 14(2): 147-151. Spring 2000. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. Website: www.quintpub.com. Summary: This case report first reviews the intracranial tumors associated with symptoms of trigeminal neuralgia (TN). Among patients with TN like symptoms, 6 to 16 percent are variously reported to have intracranial tumors. The most common cerebellopontine angle (CPA) tumor to cause TN like symptoms is a benign tumor called an acoustic neuroma. The reported clinical symptoms of the acoustic neuroma are hearing deficits (60 to 97 percent), tinnitus (50 to 66 percent), vestibular disturbances (46 to 59 percent), numbness or tingling in the face (33 percent), headache (19 to 29 percent), dizziness (23 percent), facial paresis (17 percent), and trigeminal nerve disturbances (12 to 45 percent). Magnetic resonance imaging (MRI) or computed tomography (CT) are used to detect intracranial tumors. The authors then report a rare case of a young female patient who was mistakenly diagnosed and treated for a temporomandibular disorder (TMD) but who was subsequently found to have an acoustic neuroma located in the CPA. 2 figures. 23 references.
•
Peripheral Glycerol Injections in the Treatment of Idiopathic Trigeminal Neuralgia: Retrospective Analysis of 157 Cases Source: Journal of Oral and Maxillofacial Surgery. 59(10): 1176-1179. October 2001. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 629239, Orlando, FL 32862-8239. (800) 654-2452. Summary: This study presents the results of peripheral glycerol injections in patients with idiopathic trigeminal neuralgia. The patients who either failed to respond to drug therapy for their neuralgia or who developed serious side effects were treated by means of glycerol injections. Medical records and questionnaires on 157 patients treated between 1983 and 1996 were evaluated. The minimum follow up period for each patient was 4 years. The study population included 65 males and 92 females. The right side (112 patients, 71 percent) was affected more commonly than the left. The most common
6
Neuralgia
distribution was in the second and the third trigeminal divisions. The initial success rate was 98 percent. Pain recurred in 60 patients and was most frequently recorded between 25 and 36 months postinjection (28 of the 60 recurrences). These patients were successfully reinjected. At the end of 4 years, complete or almost complete pain relief was obtained in 154 patients. The authors conclude that peripheral glycerol injection is a minimally invasive and useful technique to manage trigeminal neuralgia, with a high success rate and a low incidence of morbidity. 6 tables. 25 references. •
Percutaneous Stereotactic Differential Radiofrequency Thermal Rhizotomy for the Treatment of Trigeminal Neuralgia Source: Journal of Oral and Maxillofacial Surgery. 57(2): 104-111. February 1999. Contact: Available from W.B. Saunders Company. Periodicals Department, P.O. Box 628239, Orlando, FL 32862-8239. (800) 654-2452. Summary: Trigeminal neuralgia (also called tic douloureux) is a painful and debilitating craniofacial pain disorder, characterized by paroxysms of severe, lancinating bouts of pain. This article reports on a study undertaken to evaluate the effectiveness of radiofrequency thermal rhizotomy (RTR) for trigeminal neuralgia, after failure of drug therapy. The study evaluated 215 patients who underwent RTR from 1991 to 1996. RTR is a technique of controlled thermal ablation of nerve fibers in the trigeminal ganglion or nerve root, producing loss of pain with relative preservation of touch and more complex facial sensations. Patients were evaluated for pain relief, recurrence requiring or not requiring reoperation, and the type and rate of complications. At early followup (immediate postoperative to 6 months), pain relief of excellent or good quality occurred in 198 or 215 patients (92 percent). Fair or poor or no pain relief occurred in 17 (8 percent). At long term followup (longer than 6 months to a high limit of 68 months), recurrence of pain that required reoperation occurred in 24 patients (11 percent) and recurrence of pain that did not require operation (medically managed) occurred in 34 patients (16 percent). Dysesthesia (numbness) developed in 18 patients (8 percent); seven patients had dysesthesia alone (medically managed) and 11 patients had dysesthesia with recurrence of pain (medically or surgically managed). At long term followup, 83 percent of patients had good to excellent pain relief. There were no mortalities, no significant morbidity, and a low rate of minor complications. The authors conclude that, with the use of a specific diagnostic approach and management algorithm, patients with trigeminal neuralgia can be successfully managed. 2 figures. 4 tables. 36 references. (AA-M).
Federally Funded Research on Neuralgia The U.S. Government supports a variety of research studies relating to neuralgia. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions.
2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
Studies
7
Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to neuralgia. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore neuralgia. The following is typical of the type of information found when searching the CRISP database for neuralgia: •
Project Title: ALTERNATIVES TO OPIOIDS FOR CHRONIC PAIN -PART III Principal Investigator & Institution: Deleo, Joyce A.; Associate Professor; Anesthesiology; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 15-JUL-1997; Project End 31-MAY-2005 Summary: The pain that follows nerve injury is chronic and consistently refractory to available analgesics. These neuropathic pain syndromes include deafferentation pain, diabetic, cancer and ischemic neuropathies, phantom limb pain, trigeminal neuralgia, postherpetic neuralgias and nerve injury caused by surgery or trauma. Neuropathic pain is not only chronic and intractable, it is debilitating and causes extreme physical, psychological and social distress. The broad, long- term objective pf our research is to elucidate spinal neuroimmune mechanisms responsible for the generation and maintenance of neuropathic pain. This knowledge will enable development of new medications to treat neuropathic pain without the added liability of drug abuse. Research completed in the previous funding period provides substantial data to support the role of central nervous system (CNC) cytokines in persistent neuropathic pain states. We propose to extend our studies to address the unifying hypothesis that chronic pain following peripheral nerve injury is maintained by central neuroimmune/neuroinflammatory mechanisms. The central hypothesis is that peripheral nerve injury causes an inappropriate CNS expression of Major Histocompatibility Complex (MHC) Class II and cellular adhesion molecules which leads to an imbalance of proinflammatory cytokines and immune mediators that manifests as persistent neuropathic pain. This hypothesis will be tested using the following Specific Aims: 1) Assess the role of spinal MHC Class II and cellular adhesion molecule expression in nerve injury and acute inflammatory animal models; 2) Determine whether activated T-cells or macrophages are recruited into the CNS in response to a peripheral nerve injury; 3) Continue to evaluate the potential for global or specific immunosuppressive therapy yo alter sensory nociceptive processing; 4) Determine the effect of the above immunosuppressive therapy on spinal proinflammatory cytokines, MHC Class II and CAM expression. Immunocytochemistry, in situ hybridiazation, ELISA, RNS protection assays, specific pharmacological agents and noncieptive behavioral assays will be used to resolve these specific aims. When completed, these studies will provide: a) Information o the kinetics of spinal MHC class II and CAM expression following peripheral nerve injury and acute intraplantar inflammation, b) Data on the recruitment of immune cells into the CNS in response to nerve injury; c) Preliminary data to support new pharmacological approaches to the treatment of clinical neuropathic pain; d) a foundation for further understanding the neuroimmune response of nerve injury and the relationship to other central nervous systems inflammatory disease states e) Data to guide future studies that evaluate the role of cytokines and neuroimmune activation in chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
8
•
Neuralgia
Project Title: AMITRYPTILINE VS MORPHINE IN THERAPY OF NEURALGIA Principal Investigator & Institution: Campbell, James N.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: The purpose of this research is to determine the effectiveness of two medications, tricyclic antidepressants (TCA) and opioids, compared to a placebo in the treatment of Post-Herpetic Neuralgia. The specific aims are to compare the effects of opioids and TCA against placebo on pain, altered skin sensitivity, and affective and cognitive function. In addition, the study will determine if the therapy with opioids or TCA affects cognitive function that may limit their usefulness in the treatment of PHN. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEURALGIA
ANALGESIA
IN
HERPES
ZOSTER
AND
POSTHERPETIC
Principal Investigator & Institution: Dworkin, Robert H.; Professor; Anesthesiology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Herpes zoster is a common and painful neurological disease that is caused by reactivation of the varicella-zoster virus. Herpes zoster pain that persists after healing of the acute infection is termed postherpetic neuralgia (PHN), a chronic pain syndrome that is often refractory to all treatment. The prevalence of PHN is expected to increase substantially in the coming decades because the incidence of herpes zoster and the risk of PHN will both increase as the population ages. Although research to improve treatment is continuing, as many as half of all patients do not currently obtain relief. For this reason, the development of interventions that prevent PHN would lead to major reductions in disability, distress, and use of health care resources. On the basis of the results of research on risk factors for PHN and its pathophysiologic mechanisms, it can be hypothesized that combined antiviral and analgesic treatment begun as soon as possible after the -onset of herpes zoster will reduce the risk of PHN. The specific aim of this planning grant is to develop the protocol and procedures for a clinical trial to test this hypothesis. The proposed trial will have the following major objectives: The primary aim will be to test the hypothesis that the risk of PHN is reduced by half in herpes zoster patients treated with an antiviral agent and an opioid analgesic compared with patients treated with the antiviral agent and matching placebo. Support for this hypothesis would have a major impact on the treatment of patients with herpes zoster and lead to a substantial reduction in the prevalence of PHN. A second major aim that will be accomplished by the proposed trial is determining whether the initiation of central mechanisms of chronic neuropathic pain can be prevented by attenuating acute pain. The answer to this question will provide important information about mechanisms of prolonged pain and have major implications for its prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANIMAL MODELS TO DESIGN & EVALUATE IMPROVED VZV VACCINES Principal Investigator & Institution: Gray, Wayne L.; Associate Professor; Microbiology and Immunology; University of Arkansas Med Scis Ltl Rock Little Rock, Ar 72205 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2007
Studies
9
Summary: (provided by applicant): Varicella zoster virus (VZV) causes varicella (chickenpox), a common disease of childhood. Following resolution of the acute disease, VZV establishes latent infection in neural ganglia. The virus may reactivate later in life to cause herpes zoster (shingles) and postherpetic neuralgia. VZV infections cause significant morbidity, especially in children, the elderly, and immunosuppressed patients. The VZV Oka vaccine is safe and effective for immunization of healthy children and susceptible adults. However, this live attenuated vaccine is not generally recommended for some patients including immunocompromised individuals. In addition, the vaccine establishes latent infection in ganglia of the host and may reactivate to cause herpes zoster. Studies to assess VZV antiviral therapies and vaccines are limited due to the need for suitable animal models. The overall goal of this proposal is to develop animal models for evaluation of improved VZV vaccines. The specific aims are: * To evaluate the ability of the VZV Oka vaccine to effectively immunize nonhuman primates and to protect against varicella following subsequent challenge with simian varicella virus. * To evaluate the ability of the VZV vaccine virus to establish latent infection and express latency associated transcripts (LATs) in ganglia of immunized monkeys. * To develop a recombinant VZV vaccine that expresses the simian immunodeficiency virus (SlV) gp120 and nef antigens and to evaluate the ability of the VZV-SlVenv/nef recombinant vaccine to immunize and protect monkeys against varicella and simian AIDS. The findings may lead to improved VZV vaccines that effectively protect against varicella, but do not establish latent infection or reactivate to cause herpes zoster and postherpetic neuralgia. The study may also provide support for use of the VZV vaccine as a recombinant vector for immunization against other infectious agents, particularly human immunodeficiency virus (HIV). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANTIGENIC DETERMINANTS OF VARICELLA VIRUS Principal Investigator & Institution: Grose, Charles F.; Professor; Pediatrics; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-SEP-1985; Project End 30-APR-2007 Summary: (provided by applicant): Varicella-zoster virus (VZV) is the cause of chickenpox and herpes zoster. VZV infection is a recurrent problem in both transplant and cancer patients. Herpes zoster and post herpetic neuralgia are also major medical problems in the elderly population. The VZV genome encodes about 70 open reading frames. The predominant VZV glycoprotein complex, in contrast to other alphaherpesviruses, is gE:gI. The long-term goal of this project is an in depth understanding of the role of VZV gE glycoprotein, an essential gene product which has many attributes of a cell surface receptor. For example, gE has endocytosis signals and both serine/threonine and tyrosine phosphorylation motifs in its cytoplasmic tail. The endocytosis of gE is clathrin mediated; subsequent gE trafficking is dependent on a casein kinase II phosphorylation sequence and the association of PACS-1. Analyses with a recombinant biologically active VZV ORF47 protein serine kinase led to the discovery that the viral kinase has a similar phosphorylation consensus motif to that of casein kinase II. Therefore, the hypothesis states that the ORF47 protein kinase and casein kinase II will act as team players to modify the acidic gE consensus site and in the process determine the gE trafficking pathways. The Specific Aims include the following: 1) Characterize the phosphorylation of gE by ORF47 kinase and document differences from casein kinase II phosphorylation, 2) Investigate the trafficking of gE in the presence and absence of ORF47 kinase, 3) Characterize the tyrosine phosphorylation sites on gE and the cellular site of tyrosine phosphorylation, and 4) Investigate the interaction of gI
10
Neuralgia
with gE during the phosphorylation and trafficking events, and the interaction of the gE:gl complex with PACS-l. Phosphorylation analyses will include both in vitro kinase assays and 2-D phosphopeptide gels. The trafficking experiments will include both transfection studies with wild type and mutant gE and gI glycoproteins, as well as infection studies with recombinant viruses containing mutated gE and ORF47 proteins. Endocytosis and trafficking data with labeled viral and cellular proteins will be analyzed by confocal microscopy followed by digital image analysis to obtain a pixel quantification. Preliminary data with wild type and mutant VZV suggested that gE trafficking was redirected in cells infected with an ORF47 mutant virus, namely, gE did not travel to the trans Golgi. Thus, this latter experiment provided strong evidence of an inter-relationship between virus-specific phosphorylation and directed trafficking of the gE glycoprotein. In turn, the cumulative data suggest that VZV gE trafficking occurs in two phosphorylation dependent pathways: one pathway not directed to the TGN may facilitate cell spread while the other pathway directed to the TGN may facilitate glycoprotein incorporation into virions. These proposed VZV studies will provide further insight into the multiple functions of gE and the gE:gI complex. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAIN STEM MECHANISMS MEDIATING THE NOCICEPTIVE PRESSOR RESPONSE Principal Investigator & Institution: Felder, Robert B.; Professor; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2002 Summary: The goal of this proposal is to determine the role of the lateral parabrachial nucleus (LPBN) in mediating the cardiovascular responses to pain. Noxious stimulation typically elicits increases in arterial blood pressure and heart rate. These responses are mediated by nociceptive and cardiovascular centers in the brain stem. Recent anatomical and electrophysiological studies point to the LPBN as the major projection site for nociceptive inputs from lamina I and lamina II neurons in the spinal cord and the spinal trigeminal sensory nucleus in medulla. Moreover calcitonin gene-related peptide (CGRP) and substance P (SP), neuropeptides prominently involved in sensory afferent and nociceptive pathways, are present in LPBN and have been implicated in ascending pain pathways. These studies will use single cell electrophysiological recording techniques, recordings of arterial pressure, heart rate and sympathetic nerve activity, and functional neuroanatomy (c-fos) to determine the role of the LPBN in mediating the nociceptive pressor response by stimulating the trigeminal afferent system which has a discrete termination site in caudal medulla and well defined projection pathways to LPBN. The influence of the solitary tract nucleus (NTS) will also be examined, though existing data suggest a secondary role for NTS in this process. Finally, the interactions of baroreceptor afferent signals with noxious inputs will be determined at LPBN and at the rostral ventrolateral medulla (RVLM), the medullary sympathetic outflow site for the pressor response. The trigeminal afferent system mediates a number of important clinical pain syndromes, including migraine headache, the headache of arachnoid hemorrhage, trigeminal neuralgia, temporal mandibular joint pain and corneal and oral cavity pain. Thus, a better understanding of the central neural mechanisms mediating cardiovascular responses to noxious trigeminal stimulation may ultimately lead to new management strategies for patients with these clinical syndromes. In addition, these findings will contribute to the basic understanding of the central link between nociceptive afferent signals and cardiovascular regulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies
•
11
Project Title: CA CHANNELS IN TRIGEMINAL NEUROPATHIC PLASTICITY & PAIN Principal Investigator & Institution: Westenbroek, Ruth E.; Pharmacology; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 30-JUN-2004 Summary: (adapted from applicant's abstract): Peripheral tissue damage or nerve injury to somatosensory neurons in rats results in functional and cytochemical changes in sensory neurons and pain behaviors that resemble clinical neuropathic states. The longterm objectives of our research are to understand the role of voltage-gated calcium channels in the peripheral and central mechanisms associated with neuropathic pain. The proposed studies offer several unique opportunities. First, the studies will examine the normal pattern of expression and localization of voltage-gated calcium channels in the trigeminal ganglion and in teeth. Second, changes in the expression of these channels will be assessed in two models of neuropathic pain. The first model is coronal pulp exposure, which leads to pulpal necrosis and chronic inflammation and the second model is unilateral inferior alveolar nerve crush. Use of these two models will allow comparisons to be made between tissue and nerve damage. Each experiment will also assess changes in calcium channels compared to terminal marker proteins (syntaxin and synaptotagmen) as well as several neuropeptides (substance P and calcitonin generelated peptide) at various post-operative time points. Our hypotheses are that discrete changes in calcium channels will occur and will differ for the two models. Behavior tests will allow us to determine whether or not those changes have behavioral correlates. The trigeminal system provides an ideal model system in which to investigate these changes since its somatotopic organization is well known and changes which are known to occur following lesions of the trigeminal system differ from those of injured segmental nerves. The studies outlined in this proposal will lead to a greater understanding of the changes in calcium channels that occur after trigeminal sensory nerve injury and will have important implications for future drug therapies for inflammatory and neuropathic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: HERPES ZOSTER AND MEDICATIONS IN THE ELDERLY Principal Investigator & Institution: Schmader, Kenneth E.; Medicine; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-MAY-2006 Summary: (Applicant s abstract) The overall purpose of this award application is to support the patient-oriented research and mentoring program of an academic geriatrician in order to further develop his research and mentoring skills, generate new knowledge in clinical geriatrics and develop other clinical investigators in geriatrics. The candidate is a mid-career clinician and investigator at Duke University and Durham VA Medical Centers with a strong commitment, funding and publication record in patientoriented research in herpes zoster and medications in the elderly and a history of mentoring house staff and junior faculty in clinical research. The research plan is structured along two complementary areas of investigation involving zoster and medications in the elderly. The objectives of his zoster research program are the optimal management of zoster and postherpetic neuralgia in the elderly. A series of studies is proposed that is centered around his work in the Shingles Prevention Study, a large multicenter clinical trial to determine whether immunization with live attenuated varicella-zoster vaccine can reduce the incidence and/or severity of zoster and PHN in
12
Neuralgia
the elderly. Additional research opportunities are available in treatment trials of zoster and studies of genetics and zoster. The objectives of his drug-related research program is to optimize pharmacotherapy in the elderly by reducing polypharmacy, inappropriate prescribing and adverse drug reactions. The basis for a program of drug-related studies is the GEM Drug Study, a multicenter trial to determine if Geriatric Evaluation and Management (GEM) care reduces adverse drug reactions and inappropriate prescribing in the elderly compared to usual care. The candidate will recruit and select advisees from a rich pool of beginning clinical investigators at Duke University Medical Center and mentor them in the context of the above research projects using one-one teaching, the Duke Clinical Research Training Program (CRTP) and other research educational experiences at Duke. The Duke CRTP and Faculty Development Programs will provide opportunities for the candidate s research, mentoring and leadership career development. The award will allow the candidate to devote additional time to patientoriented research and mentoring by relieving the candidate of clinical and administrative responsibilities in the Division of Geriatrics, the Duke Geriatric Evaluation and Treatment Clinic and Durham VAMC. The award fits into past and future career development by providing a bridge from earlier academic activities to the expansion of mentoring and research skills and to program leadership in geriatrics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AUSTRALIA
INTERNATIONAL
HERPESVIRUS
WORKSHOP,
CAIRNS,
Principal Investigator & Institution: Nelson, Jay A.; Director & Professor; Molecular Microbiology and Immunology; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 17-JUL-2002; Project End 30-JUN-2003 Summary: (provided by applicant): This proposal requests funds to enable young investigators to attend the 27th International Herpesvirus Workshop at the Cairns Convention Center, Australia, July 20-26, 2002. The International Herpesvirus Workshop is the premier scientific meeting for herpesvirus researchers, and the only meeting with an interdisciplinary focus on all the major subfamilies ofherpesviruses and all aspects of research from molecular biology to clinical studies. The strength of the Workshop rests on the cross-fertilization that results from comparison of different herpesviruses, different approaches to key questions and on the support and participation of leading researchers in the field, most significantlyincluding promising young investigators and students in training. Moreover, the forum is truly international, with broad- based world-wide attendance. The medical importance of this meeting is clearly indicated from the wide variety of diseases caused by the now recognized eight human herpesviruses. These include skin and eye ulcerations (HSV-1), genital lesions (HSV-2), meningitis and encephalitis (HSV-1 and HSV-2), infectious mononucleosis (EBV), chicken pox and shingles (VZV). CMV is a major cause of birth defects including mental retardation, blindness and deafness due to congenital transmission but aisc) a significant opportunistic pathogen in AIDS patients and organ transplant recipients. More recently, CMV and HSV have been implicated as pathogenic contributors in the development of atherosclerosis. Cancer has also been associated with herpesvirus infections. EBV is associated with Burkitt's lymphoma, other B cell neoplasias and nasopharyngeal carcinoma. The most recent human herpesvirus discovered (HHV-8 or KSHV) is associated with Kaposi's sarcoma in AIDS patients and other immunosupressed persons and in other groups. All of the herpesviruses persist for life and therefore pose significant problems in the treatment of immunologically
Studies
13
compromised persons. Diseases caused by reactivation of most human herpesviruseses are a significant cause of morbidity and mortality in various immune patient populations. Shingles and post-herpetic neuralgia are problems in the elderly. Animal herpes significant economic importance to the poultry (Marek's and others), swine (pseudorabies virus), cattle (several bovine herpesviruses) and horses (several equine herpesviruses). In addition, these animal herpes serve as Important model systems for studying herpesvirus pathogenesis. Finally, recombinant DNA technology permits the design of novel vaccines for controlling the spread of animal herpesvirus infection and the design of herpesvirus vectors for gene therapy. Workshop sessions will take an interdisciplinary approach to the following topics: virus structure, mechanism of virus entry and cell-cell spread, membrane proteins, pathogenesis and latency, DNA replication, vaccination and the immune response, transcriptional control, regulation of gene expression, chemotherapeutic targets, and virus gene therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIDOCAINE GEL FOR PAINFUL PERIPHERAL NEUROPATHY IN HIV Principal Investigator & Institution: Mcarthur, Justin C.; Professor of Neurology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: The purpose of this study is to determine the safety, tolerability and efficacy of pain relief of lidoderm 5% gel for HIV-associated neuropathy. Painful peripheral neuropathies represent the most common neurological complication in patients infected with HIV. Painful distal sensory polyneuropathy (DSP) is the most common peripheral neuropathy in AIDS patients, occurring in about 20% to 35% of patients. The signs and symptoms of DSP include pain primarily in the feet, diminished primary sensory modalities in the feet, and decreased ankle reflexes with minimal foot weakness. The mechanism of DSP in AIDS is unknown. The incidence of DSP increases with advancing immunosuppression in later stages in the course of AIDS. The effectiveness of the new topical lidocaine formulations in the treatment of post-herpetic neuralgia pain suggest that these agents might be useful in treating the pain of HIV DSP. Because topical application of lidocaine has a very low potential for side effects or addiction, this type of treatment could become one of choice for a large number of patients. Lidocaine is an amide-type local anesthetic and is known to stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Lidoderm preparations, when applied to intact skin in post-herpetic neuralgia provides dermal analgesia through analgesic modulation of abnormally functioning fibers, rather than interfering with normal nerve fiber function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: LUNG IMAGING: MRI OF HYPERPOLARIZED NOBLE GASES Principal Investigator & Institution: Dimitrov, Ivan E.; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002 Summary: This study is an exploration of the human brain processing of pain using functional MRI on humans. The goal is to develop objective quantitative assay of pain. The subjects will be patients with a specific type of pain, postherpetic neuralgia, an aftermath of herpes zoster. Such patients have pain is localized to the nerve affected by the herpes zoster and is always unilateral. The severity of the pain increases greatly
14
Neuralgia
when the localized area of the nerve is touched with external stimuli such as brushing. We will examine brain activation pattern in response to painful stimulation. Stimulation on contralateral non-painful site will be used as control. Normal subjects will also serve as controls. A stimulating apparatus for use in magnet bore has been constructed, which allows a mechanical stimulus on patient body surface area with a controlled amount of force. We are starting to collect data with the exerted force varied, and oberve the change in intensity in the brain images. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NERVE GROWTH FACTOR AND OROFACIAL NEUROPATHIC PAIN Principal Investigator & Institution: Anderson, Leigh C.; Anatomy; University of the Pacific-Stockton 3601 Pacific Ave Stockton, Ca 95211 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 31-JUL-2004 Summary: (Adapted from the investigator's Abstract): Partial injury to somatosensory nerves in rats results in functional and cytochemical alterations in sensory neurons and in pain-associated behaviors that closely resemble human clinical neuropathic pain states. The long-term objectives of this research are to further clarify the peripheral and central mechanisms that contribute to the development and pathophysiology of neuropathic pain, and to characterize and evaluate the roles of nerve growth factor (NGF), other neurotrophins and sympathetic nerves in these processes. A standard model for trigeminal neuropathic injury in adult rats (unilateral infraorbital nerve constriction) will be used, but the proposed studies offer several unique opportunities. First, an autoimmune model of NGF depletion will be used to investigate the role of NGF in the development of neuropathic pain. Second, each experiment will assess changes in free ranging behavior, behavioral reactions to orofacial stimulation (von Frey stimulation), electrophysiological response properties of trigeminal ganglion neurons (receptive field and fiber type, spontaneous activity, evoked activity and conduction velocity), and ganglionic cytochemistry (CGRP, tyrosine hydroxylase, c-jun, glial fibrillary acidic protein, p75 and trkA NGF receptors and brain derived neurotrophic factor) in the ipsilateral and contralateral sensory neurons and their support cells in the same animal. Third, the somatotopic organization of the trigeminal ganglion is well known, and will allow the discrimination of those effects directly attributable to nerve injury, per se, from those that are centrally mediated, or that result from intraganglionic mechanisms. Finally, clinical studies suggest that lesions of the trigeminal nerve lead to chronic pain conditions that differ from those of segmental nerves (e.g., sciatic), due in part to the anatomical-physiological organization of the trigeminal system. The studies outlined in this proposal will lead to a greater understanding of the behavioral, physiological and cytochemical alterations that occur after trigeminal sensory nerve injury, and as a consequence will have important implications for the clinical management of neuropathic pain in the orofacial region. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: NEURITE DENSITY IN SKIN AS A MARKER FOR NEUROPATHIC PAIN Principal Investigator & Institution: Oaklander, Anne L.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2006
Studies
15
Summary: (provided by applicant): Chronic pain has been recognized as an underserved area of medicine. Clinical care and research are hampered by the lack of objective correlates for the subjective complaint of pain. This is especially a problem for neuropathic pain patients, where the pain is caused by malfunction of the pain-sensing neurons, rather than injury to the area where the pain is felt. In this translational project we will evaluate two types of objective evidence of neural damage to see whether they correlate with the complaint of pain. We will investigate the usefulness of these methods in adults with one of two common neuropathic pain conditions, postherpetic neuralgia (PHN) after shingles (herpes zoster), or painful neuropathy in the lower legs from diabetes mellitus, and in rat models of these conditions. Data from individuals with and without pain will be compared. We will evaluate the usefulness of tests of specific sensory functions, using standardized quantitative sensory stimuli, for predicting who does or does not have pain from shingles or diabetes. We will also evaluate the usefulness of a new technique, counting the density of pain-sensing (nociceptive) nerve endings within the epiderrnal layer of small skin punch biopsies. Surprisingly, work by our group and others show that neuropathic pain patients usually have fewer nociceptive nerve endings in painful skin. When the amount of signal coming in from the periphery decreases, pain-processing neurons in the brain and spinal cord become hyperactive. The result can be pain in the absence of tissue injury. This is similar to the development of tinnitus (ringing in the ears) when people lose hearing. Our data suggests that after shingles, PEN pain is felt by only those patients whose density of nociceptive nerve endings has been reduced below a threshold value (650 neurites/mm2 skin surface area). In Specific Aim I, we will study patients about 6 weeks after onset of shingles with quantitative sensory testing and skin biopsies, and repeat them 6 months later. We will evaluate whether data from the first set of tests, or changes between the two test sessions, can provide a marker for those who recover from pain or not. In Specific Aim II we will compare sensory testing and skin biopsy data from normal people and diabetics with and without pain to see whether there is evidence for a threshold value separating individuals with and without pain, and whether we can identify a presymptomatic state. In Specific Aim III, we plan to evaluate sensory function of the paw in rat models of pain after sciatic nerve injury. At sacrifice, biopsies will be taken from the bottom of the rat's paws as well as from the injured nerves to see whether changes in the density of nociceptive nerve endings in the foot correlate with severity of damage in the nerve and with the rat's behavior during sensory testing. The goal of this research is to improve medical care for patients with chronic neuropathic pain, and facilitate research by identifying "biomarkers" that can be used as surrogate measures for the presence of neuropathic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROPHYSIOLOGY OF TRIGEMINAL NEURALGIA Principal Investigator & Institution: Baumann, Thomas K.; Neurological Surgery; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 05-DEC-1998; Project End 31-MAY-2004 Summary: Trigeminal neuralgia is a severe, recurrent (episodic, but otherwise chronic) facial pain syndrome which affects chiefly older patients. The pain of trigeminal neuralgia is unique in its paroxysmal nature, excruciating intensity, lancinating quality, and confinement to the trigeminal nervous system. Various medical and surgical treatments are available for this disorder, but none is uniformly and permanently effective. It appears that a substantial improvement in the long-term treatment of trigeminal neuralgia may be hindered by the lack of basic understanding of the
16
Neuralgia
neurological basis of this disorder. Theories involving abnormal sensory input from the peripheral nervous system and/or alteration of synaptic processing in the central nervous system have been invoked in the past, but thus far there is no direct experimental evidence to support them. In the absence of an adequate animal model of trigeminal neuralgia, theories of genesis have to be tested in symptomatic human patients. The goal of this research proposal is to apply a novel micro-neurographic recording technique to study directly the neurophysiological characteristics of trigeminal ganglion neurons in patients with trigeminal neuralgia. The technique, which we have developed, allows intra-operative microelectrode recordings in the trigeminal ganglion before the patients undergo percutaneous gangliolysis for treatment of the pain. The proposed study will examine if light mechanical stimulation of the trigger zone elicits abnormal (self-sustained) action potential discharge in trigeminal primary afferent neurons. Electrical stimulation of the axons will be used to detect autorhythmic activity in the roots or somata of trigeminal ganglion neurons. Finally, an attempt will be made to identify action potential discharges which may occur in trigeminal gang!ion neurons concurrent with patient's experience of trigeminal neuralgic pain. It is anticipated that intra-operative recordings will provide, for the first time, direct evidence that trigeminal neuralgia is associated with abnormal sensory input from the peripheral nervous system. Choral made observations of impulse traffic in the nerve or ganglion during paroxysms of pain should greatly illuminate the neural mechanism of trigeminal neuralgia, allow for modelling of the syndrome in experimental animals, and direct research toward better medical and surgical treatment of pain paroxysms in this and other neuropathic pain disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOCICEPTION
NORADRENERGIC
MODULATION
OF
TRIGEMINAL
Principal Investigator & Institution: Mokha, Sukhbir S.; Professor; Meharry Medical College 1005-D B Todd Blvd Nashville, Tn 37208 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2007 Summary: The long-term objective of the proposed research is to enhance our understanding of pain mechanisms and their control in the dorsal horn of the medulla (trigeminal nucleus caudalis), a region closely associated with many clinical pain conditions such as migraine, toothache, trigeminal neuralgia and temporomandibular joint related disorders. Specifically, the proposed research will elucidate the sex-related differences in the control ofnociceptive information originating from oro-facial tissues particularly the tooth pulp. The specific aims of the investigation are to determine that, a) activation of alpha2-adrenoceptors (alpha2-ARs) and descending noradrenergic pathway from the Kolliker Fuse nucleus (KF = A7) produce sex-specific modulation of trigeminal nociception through the participation of gonadal steroids, and b) the sexspecific modulation is mediated by gonadal hormone-induced, particularly estrogeninduced, genomic and non-genomic mechanisms The proposed studies will be carried out using electrophysiological, behavioral, molecular (in-situ hybridization) and cellular (in-vitro intracellular) techniques in male, proestrous female, ovariectomized, estradiol treated ovariectomized females, castrated males, testosterone treated castrated males and sham operated animals. Single unit activity of tooth pulp specific (TPS), nociceptive specific (NS) and wide dynamic range (WDR) neurons including trigeminothalamic neurons will be recorded in the superficial and deeper dorsal horn of the medulla in anesthetized male and female rats. Effects of microiontophoretically applied alpha2-AR agonists and antagonists will be tested on the responses evoked by, a) electrical
Studies
17
stimulation of the tooth pulp, b) noxious stimuli, and c) activation of N-methyl-Daspartic acid (NMDA) receptors. Nociceptive scratching behavior will be elicited by microinjection of NMDA through a cannula implanted dorsal to the medullary dorsal horn. Effects of alpha2-AR agonists and antagonists microinjected through the same cannula, and stimulation in KF will be investigated on the NMDA-induced nociceptive scratching behavior in males and females. Contribution of gonadal steroid-induced genomic and non-genomic changes in generating sex-related differences will be investigated by examining whether, a) estrogen and testosterone alter the expression of the alpha2A-AR gone in the dorsal horn of the medulla, b) the estrogen receptor is colocalized in alpha2A-AR containing neurons, and c) estrogen alters the coupling of alpha2-ARs to potassium channels. The proposed studies will deepen our understanding of sex-related differences in the modulation of trigeminal nociception and lead to the development of better pain control strategies in males and females. The new information may also help in the development of analgesics that are free of the abuse potential and side effects associated with narcotics such as morphine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL ANESTHETIC NOCICEPTORS
MECHANISMS
THAT
DESENSITIZE
Principal Investigator & Institution: Liu, Lieju; Anesthesiology; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 05-MAR-2002; Project End 28-FEB-2007 Summary: Pain is a major clinical problem and its alleviation by any method is beneficial to patients and society. The sensation of pain is usually initiated by the activation of peripheral sensory neurons, called nociceptors. Chemical stimuli may sensitize nociceptors resulting in allodynia and/or hyperalgesia whereas their desensitization will result in hypoalgesia or a diminution of pain. Topical applications of capsaicin, the pungent compound in hot pepper, is used clinically to reduce pain arising from arthritis, oral facial pain, and even chronic pain. The mechanism by which proinflammatory mediators can sensitize nociceptors is relatively well known. What is not known, and which is the primary topic of this proposal, is how pungent vanilloid receptor activators like capsaicin and its non-pungent analogue, olvanil, can selectively desensitize (or anesthetize) nociceptors in mammalian trigeminal neurons. The interactions between vanilloid receptors and voltage-gated ion channels that cause desensitization in nociceptors are not understood. The mechanisms by which olvanil can depolarize nociceptors without causing excitation is also unknown and is obviously important in developing novel types of anesthetics. Olvanil also activates cannabinoid CB1 receptors, so the endogenous pathways that lead nociceptor desensitization via the dual activation of vanilloid and CB1 receptors will be determined by investigating their effects on voltage-gated sodium (VGSC) and potassium (VGPC) channels. These experiments will determine whether only neurons having vanilloid and or CB1 receptors will be desensitized by capsaicin or olvanil and the intracellular pathways that modulate VGSCs (TTX-s, TTX-r) and VGPCs (IK and IA). Electrophysiological measurements quantifying the efficacy of capsaicin and olvanil to inhibit VGSC and VGPCs will be combined with single cell RT-PCR of the various subunits of VGSC and VGPCs, with IB4 labeling, and with enzyme immunoassay measurements. This information will lead to novel anesthetic mechanisms that involve the reversible desensitization of nociceptors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
18
•
Neuralgia
Project Title: PAIN & NEURAL DYSFUNCTION FROM ACUTE HERPES ZOSTER Principal Investigator & Institution: Petersen, Karin L.; Neurology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 01-FEB-2000; Project End 31-JAN-2005 Summary: Pain, nerve trunk inflammation, and neuronal injury are hallmarks of acute herpes zoster (AHZ or 'shingles'). The majority of patients with AHZ recover uneventfully, but a minority develop enduring neuropathic pain - in the form of postherpetic neuralgia (PHN). Age, initial pain severity, and psychosocial factors have been established as risk factors for PHN in longitudinal studies, but evolution of neural dysfunction and deafferentation, the hallmarks of the chronic neuropathic pain of PHN, have received little study. We hypothesize that the development of post-herpetic neuralgia strongly depends on two factors: 1) the severity of the initial neural injury and 2) the ability to recover from the initial neural injury. To test this hypothesis, we will prospectively follow 200 patients with AHZ at high risk for development of PHN. Study participants will be followed closely from 2 weeks after the onset of AHZ to 6 months post-zoster, a time when PHN is well established and unlikely to remit spontaneously. Evolution of pain and neural injury will be evaluated at 2 weeks, 1 month, 3 months, and 6 months after the onset of AHZ. At study visits, assessments will include ratings of pain intensity, mood, quality of life, allodynia severity, mapping the extent of skin affected by lesions, pain, and allodynia, quantitative tests of sensory function, and response to controlled applications of capsaicin. Loss and possible recovery of cutaneous nerve fibers will be documented through serial skin punch biopsies stained for the axonal marker PGP 9.5 in affected and normal skin. Abnormal neural function in remaining fibers will be evident as allodynia, hyperalgesia to mechanical and thermal stimuli, and hyperalgesia to capsaicin application. Signs of loss of primary afferent nociceptor function will be evident as inability to perceive noxious heat and capsaicin. The importance of neural dysfunction and neuronal loss as risk factors for PHN will be compared to risk factors found in other studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: POST HERPETIC NEURALGIA/AMITRYPTILINE VS MORPHINE IN PATIENT MANAGEMENT Principal Investigator & Institution: Raja, Srinivasa N.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002 Summary: The purpose of this research is to determine the effectiveness of two medications, tricyclic antitidepressants (TCA) and opioids, compared to a placebo in the treatment of postherpetic neuralgia. The specific aims are to compare the effects of opioids and TCA against placebo on pain, altered skin sensitivity, and affective and cognitive function. In addition, the study will determine if the presence of psychiatric co- morbidity, particularly depression, predicts the outcome of treatment with opioids, TCA, and placebo. We have studied the relationships between ongoing pain, alterations in thermal sensibility, and allodynia to mechanical and thermal stimuli of patients with, PHN to determine the role of peripheral and/or central mechanisms, in PHN. Ongoing pain ratings were obtained using a verbal score (0-10). Sensory tests were performed within the affected site, and the corresponding, contralateral, normal site. The area of mechanical allodynia was mapped with a cotton swab and pain, evoked by mechanical stimuli (soft hair brush, brass probe, von Frey hairs) was rated on a verbal scale of 1-10. Thermal thresholds to warm, cold, heat pain, and cold pain were determined using a
Studies
19
Peltier device and a modified Marstock technique. To date, fifty-nine patients (33 F, 26 M) with PHN of 3-216 months duration (median = 19 months) have been studied. The average rating of ongoing pain was 7.3 + 2 (M + SD). The majority of patients (80%) had allodynia to dynamic (hair brush), static (brass probe) or punctate (von Frey) mechanical stimuli (Z > 5.01, p<.0001). No significant correlation was observed between the intensity of ongoing pain and mechanical allodynia. As a group, the patients demonstrated hypoesthesia to cold and warm detection, and hypoalgesia to heat pain and cold pain. There were no significant correlations between ongoing pain intensity and the degree of sensory alterations (between the unaffected and affected sites) in warm, cold, heat pain, and cold pain detection thresholds. Hence, the role of primary afferent input in tlie mechanism of PHN is uncertain. The presence of allodynia/hyperalgesia to mechanical stimuli, but the relative absence of hyperalgesia to thermal stimuli in most patients in this group suggests that central sensitization in PHN is not generalized for all modalities of sensation. It has been observed that patients with chronic pain have high rates of psychiatric conditions. Controversy has existed as to whether these conditions are uniquely related to chronic pain or simply the result of ongoing suffering from a chronic physical symptom. Patients completed a structured interview (DIS-III-A) for Major Depression, Dysthymic Disorder, Generalized Anxiety Disorder and Somatization Disorder and completed the Somatization and Anxiety subscales of the SCL-90-R. Our results in PHN patients are consistent with the existing literature. PHN patients compared to patients with chronic and distressing but nonpain physical symptoms also reported higher numbers of depression symptoms as well as other medically unexplained physical symptoms. These findings suggest that depression and higher levels of somatic focus are more than secondary complications of experiencing chronic symptoms and are uniquely related to chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GANGLIA
RECOMBINANT
HERPES
INJECTION
INTO
TRIGEMINAL
Principal Investigator & Institution: Yeomans, David C.; Assistant Professor; Anesthesia; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Head cancer pain, trigeminal neuralgia, migraine headache, dental pain and temporomandibular joint pain are all examples of pain syndromes that are unique to the trigeminal system. In many instances, these pain types are hard to treat clinically, with last-line opiates working only marginally well in some instances, and not at all in others. In addition, the tolerance and addiction potential of strong, systemic opioids sometimes limit the duration over which they can be used effectively. Thus, there is a need for novel approaches to the treatment of trigeminal pain. We have previously demonstrated the potential of using replication-defective herpes viral constructs to alter the function of pain-sensing nerve cells, such that we have been able to produce robust, highly localized analgesia for months after a single application. In doing this we have applied the virus locally to targeted tissues, such as skin. Doing so, we have observed a very long-lasting (> 20 weeks) attenuation of pain responses limited to those areas treated with the virus. In many trigeminal syndromes however, pain is relatively diffuse or multicentered. Applications of vectors to peripheral tissues may be of limited utility in these cases, as a more widely distributed analgesic effect is desirable. One method that has not yet been investigated would be to inject vectors directly into the trigeminal ganglia, the grouping of neurons that make up the cell bodies of the sensory nerves of the trigeminal. In doing this, we would expect to
20
Neuralgia
introduce recombinant vectors over a wide distribution of trigeminal neurons, and thus, potentially, producing a widespread analgesic effect. The experiments described here will provide evidence as to whether direct trigeminal injection of recombinant herpes vectors, encoding genes for analgesic peptides, will alter the sensitivity to nociceptive stimulation of tissue innervated by the trigeminal. In so doing, we hope to provide initial support for what may be a new long-lasting treatment for trigeminal nerverelated pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SOMATOSENSORY CHANNEL INTERACTIONS IN TRIGEMINAL NERVE-INJURED PATIENTS Principal Investigator & Institution: Essick, G K.; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: TRIGEMINAL NEUROPATHIC PAIN MECHANISMS Principal Investigator & Institution: Henry, Michael A.; Surgical Dentistry; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Chronic neuropathic pain can be a devastating disease and the management is often inadequate. A recent focus of pain research is examining changes in the expression of sodium channels that follow nerve injury since these changes may contribute to neuronal hyperexcitability and the development of neuropathic pain. This proposal will investigate the distributions of Nav1.1, Nav1.2, Nav1.3, Nav1.6, Nav1.7, Nav1.8 and Nav1.9 sodium channel isoforms at both the light and electron microscopic levels in normal rat trigeminal primary afferents (infraorbital nerve, trigeminal ganglion/root entry zone and trigeminal sensory nucleus) and in intrinsic neurons in the trigeminal sensory nucleus. Once the normal expression is determined for each isoform, then changes in this expression will be evaluated in the same regions following a chromic suture injury to; 1) infraorbital nerve, or 2) trigeminal root entry zone, combined with behavioral testing for altered nociception. The hypothesis is that there will be a change in the normal distribution of the sodium channel isoforms following injury that correlates with behavioral evidence for altered nociception, the changes may depend on the site of the injury (peripheral vs. central), these changes contribute to neuronal hyperactivity of both primary afferents and intrinsic neurons seen following lesions, and the reduction of hyperexcitability with sodium channel blocking drugs. The trigeminal system represents an excellent model system to evaluate differences in sodium channel expression following either peripheral nerve or central root injury since distinct clinical entities are seen in humans following these different injuries. Trigeminal neuralgia may result from a root entry zone injury, while peripheral trigeminal neuropathy follows damage to peripheral nerves. There may be a difference in the expression of sodium channels following peripheral and central injury, since patients with trigeminal neuralgia usually respond to carbamazepine, while patients with peripheral trigeminal neuropathy rarely obtain significant relief with only carbamazepine. A differential expression of sodium channels in different fiber types may also be responsible for the different clinical characteristics of pain seen following peripheral and central injury. Identification of specific sodium
Studies
21
channel alterations after injury may help develop more selective treatments for neuropathic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VARICELLA ZOSTER VACCINE FOR PREVENTION OF HERPES ZOSTER/COMPLICATIONS Principal Investigator & Institution: Smith, Jean; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2002 Summary: This study addresses the lack of therapy for post-herpetic neuralgia. It proposes that Varicella vaccine will significantly reduce the burden of illness due to herpes zoster and will protect against neuralgia. Enrolled subjects, all over the age of 60, will receive either vaccine or placebo (double-blinded) and then followed for three years or until 360 cases of herpes zoster have occurred. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “neuralgia” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for neuralgia in the PubMed Central database: •
Acyclovir for Treatment of Postherpetic Neuralgia: Efficacy and Pharmacokinetics. by Acosta EP, Balfour HH Jr.; 2001 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90729
•
Expression of varicella-zoster virus in blood mononuclear cells of patients with postherpetic neuralgia. by Vafai A, Wellish M, Gilden DH.; 1988 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=280080
•
Intravenous immunoglobulin in the treatment of primary trigeminal neuralgia refractory to carbamazepine: a study protocol[ISRCTN33042138]. by Goebel A, Moore A, Weatherall R, Roewer N, Schedel R, Sprotte G.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149450
•
Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. by Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA.; 2000 Sep 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27491
3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
22
•
Neuralgia
The PINE study: rationale and design of a randomised comparison of epidural injection of local anaesthetics and steroids versus care-as-usual to prevent postherpetic neuralgia in the elderly [ISRCTN32866390]. by Opstelten W, van Wijck AJ, van Essen GA, Buskens E, Bak AA, Kalkman CJ, Verheij TJ, Moons KG.; 2004; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=341453
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with neuralgia, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “neuralgia” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for neuralgia (hyperlinks lead to article summaries): •
A case of trigeminal-vagal neuralgia relieved by peripheral self-stimulation. Author(s): Bonicalzi V, Canavero S. Source: Acta Neurol Belg. 2002 December; 102(4): 188-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12534247
•
A giant internal carotid-posterior communicating artery aneurysm presenting with atypical trigeminal neuralgia and facial nerve palsy in a patient with autosomal dominant polycystic kidney disease: a case report. Author(s): Terao S, Hara K, Yoshida K, Ohira T, Kawase T. Source: Surgical Neurology. 2001 August; 56(2): 127-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11580955
•
A method for intraoperative microneurographic recording of unitary activity in the trigeminal ganglion of patients with trigeminal neuralgia. Author(s): Baumann TK, Burchiel KJ. Source: Journal of Neuroscience Methods. 2004 January 15; 132(1): 19-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14687671
6
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
Studies
23
•
A new treatment for postherpetic neuralgia. Author(s): Watson CP. Source: The New England Journal of Medicine. 2000 November 23; 343(21): 1563-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11087888
•
A novel treatment of postherpetic neuralgia using peppermint oil. Author(s): Davies SJ, Harding LM, Baranowski AP. Source: The Clinical Journal of Pain. 2002 May-June; 18(3): 200-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048423
•
A population-based estimate of the prevalence of postherpetic neuralgia after herpes zoster. Author(s): Bigby M. Source: Archives of Dermatology. 2001 June; 137(6): 789-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11405773
•
A randomized parallel trial of topical aspirin-moisturizer solution vs. oral aspirin for acute herpetic neuralgia. Author(s): Balakrishnan S, Bhushan K, Bhargava VK, Pandhi P. Source: International Journal of Dermatology. 2001 August; 40(8): 535-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11703529
•
A randomized, controlled trial of high-dose dextromethorphan in facial neuralgias. Author(s): Gilron I, Booher SL, Rowan MS, Smoller MS, Max MB. Source: Neurology. 2000 October 10; 55(7): 964-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11061252
•
A simple cure for Morton's neuralgia. Author(s): Hirschberg GG. Source: Journal of the American Podiatric Medical Association. 2000 February; 90(2): 100-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10697976
•
A study of shingles and the development of postherpetic neuralgia in East London. Author(s): Scott FT, Leedham-Green ME, Barrett-Muir WY, Hawrami K, Gallagher WJ, Johnson R, Breuer J. Source: Journal of Medical Virology. 2003; 70 Suppl 1: S24-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12627483
24
Neuralgia
•
A trial of intravenous lidocaine on the pain and allodynia of postherpetic neuralgia. Author(s): Baranowski AP, De Courcey J, Bonello E. Source: Journal of Pain and Symptom Management. 1999 June; 17(6): 429-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10388248
•
A trigeminal neuralgia-like paroxysmal pain condition presumably due to buccal nerve compression in the temporalis muscle. Author(s): Maeda S, Miyawaki T, Kuboki T, Shimada M. Source: Cranio. 2001 January; 19(1): 56-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11842842
•
Acute herpes zoster neuralgia: retrospective analysis of clinical aspects and therapeutic responsiveness. Author(s): Haas N, Holle E, Hermes B, Henz BM. Source: Dermatology (Basel, Switzerland). 2001; 202(4): 302-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11455141
•
Acute herpetic neuralgia and postherpetic neuralgia in the head and neck: response to gabapentin in five cases. Author(s): Filadora VA 2nd, Sist TC, Lema MJ. Source: Regional Anesthesia and Pain Medicine. 1999 March-April; 24(2): 170-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10204905
•
Acyclovir for treatment of postherpetic neuralgia: efficacy and pharmacokinetics. Author(s): Acosta EP, Balfour HH Jr. Source: Antimicrobial Agents and Chemotherapy. 2001 October; 45(10): 2771-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11557467
•
Affected side and risk of pain recurrence after surgery for trigeminal neuralgia. Author(s): Cucchiara B, Messe S. Source: Archives of Neurology. 2003 August; 60(8): 1169-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12925379
•
Allodynia and pinprick hypesthesia in acute herpes zoster, and the development of postherpetic neuralgia. Author(s): Haanpaa M, Laippala P, Nurmikko T. Source: Journal of Pain and Symptom Management. 2000 July; 20(1): 50-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10946169
•
Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia. Author(s): Graff-Radford SB, Shaw LR, Naliboff BN. Source: The Clinical Journal of Pain. 2000 September; 16(3): 188-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11014390
Studies
25
•
An investigation of eye lens dose for gamma knife treatments of trigeminal neuralgia. Author(s): Ma L, Chin L, Sarfaraz M, Shepard D, Yu C. Source: Journal of Applied Clinical Medical Physics [electronic Resource] / American College of Medical Physics. 2000 Autumn; 1(4): 116-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11674826
•
An unusual case of stabbing eye pain: a case report and review of trigeminal neuralgia. Author(s): Dufour SK. Source: Optometry. 2002 October; 73(10): 626-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12408549
•
Analgesic effects of flecainide on postherpetic neuralgia. Author(s): Ichimata M, Ikebe H, Yoshitake S, Hattori S, Iwasaka H, Noguchi T. Source: Int J Clin Pharmacol Res. 2001; 21(1): 15-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11708571
•
Anatomical observations during microvascular decompression for idiopathic trigeminal neuralgia (with correlations between topography of pain and site of the neurovascular conflict). Prospective study in a series of 579 patients. Author(s): Sindou M, Howeidy T, Acevedo G. Source: Acta Neurochirurgica. 2002 January; 144(1): 1-12; Discussion 12-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11807642
•
Anterior crural neuralgia as a presenting manifestation of lymphocele. Author(s): Gonzalez-Gay MA, Garcia-Porrua C, Pulpeiro JR, Branas F, Mateo-Cambon L, Hernandez T. Source: Arthritis and Rheumatism. 2000 May; 43(5): 1183-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10817573
•
Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic neuralgia: a quantitative systematic review. Author(s): Collins SL, Moore RA, McQuayHJ, Wiffen P. Source: Journal of Pain and Symptom Management. 2000 December; 20(6): 449-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11131263
•
Antiepileptic drugs in the management of cluster headache and trigeminal neuralgia. Author(s): Rozen TD. Source: Headache. 2001 November-December; 41 Suppl 1: S25-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903537
26
Neuralgia
•
Are latent, immediate-early genes of herpes simplex virus-1 essential in causing trigeminal neuralgia? Author(s): Ecker AD, Smith JE. Source: Medical Hypotheses. 2002 November; 59(5): 603-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12376087
•
Arnold Chiari Type I malformation presenting as a trigeminal neuralgia: case report. Author(s): Rosetti P, Ben Taib NO, Brotchi J, De Witte O. Source: Neurosurgery. 1999 May; 44(5): 1122-3; Discussion 1123-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10232547
•
Association between paroxysmal trigeminal neuralgia and atypical facial pain. Author(s): Juniper RP, Glynn CJ. Source: The British Journal of Oral & Maxillofacial Surgery. 1999 December; 37(6): 444-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10687903
•
Association of HLA-A*3303-B*4403-DRB1*1302 haplotype, but not of TNFA promoter and NKp30 polymorphism, with postherpetic neuralgia (PHN) in the Japanese population. Author(s): Sato M, Ohashi J, Tsuchiya N, Kashiwase K, Ishikawa Y, Arita H, Hanaoka K, Tokunaga K, Yabe T. Source: Genes and Immunity. 2002 December; 3(8): 477-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12486606
•
Balloon compression of the Gasserian ganglion for the treatment of trigeminal neuralgia. Author(s): Correa CF, Teixeira MJ. Source: Stereotactic and Functional Neurosurgery. 1998; 71(2): 83-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10087472
•
Bilateral trigeminal neuralgia: a therapeutic dilemma. Author(s): Tacconi L, Miles JB. Source: British Journal of Neurosurgery. 2000 February; 14(1): 33-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10884882
•
Bilateral trigeminal neuralgia: a therapeutic dilemma. Author(s): Berk C. Source: British Journal of Neurosurgery. 2001 April; 15(2): 198. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11360396
Studies
27
•
Capsaicin evoked pain and allodynia in post-herpetic neuralgia. Author(s): Petersen KL, Fields HL, Brennum J, Sandroni P, Rowbotham MC. Source: Pain. 2000 November; 88(2): 125-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11050367
•
Cavernous angioma in the brachium pontis presenting with trigeminal neuralgia: a case report. Author(s): Vitek L, Tettenborn B. Source: European Neurology. 2002; 48(4): 226-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12422074
•
Cerebellopontine angle cysticercus and concurrent vascular compression in a case of trigeminal neuralgia. Author(s): Revuelta R, Soto-Hernandez JL, Vales LO, Gonzalez RH. Source: Clinical Neurology and Neurosurgery. 2003 December; 106(1): 19-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14643911
•
Cerebrospinal fluid interleukin 8 concentrations and the subsequent development of postherpetic neuralgia. Author(s): Kotani N, Kudo R, Sakurai Y, Sawamura D, Sessler DI, Okada H, Nakayama H, Yamagata T, Yasujima M, Matsuki A. Source: The American Journal of Medicine. 2004 March 1; 116(5): 318-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14984817
•
Challenging the neuralgia-inducing cavitational osteonecrosis concept. Author(s): Zuniga JR. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2000 September; 58(9): 1021-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10981982
•
Chiari Type I malformation presenting as glossopharyngeal neuralgia: case report. Author(s): Kanpolat Y, Unlu A, Savas A, Tan F. Source: Neurosurgery. 2001 January; 48(1): 226-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11152353
•
Chiari type I presenting as left glossopharyngeal neuralgia with cardiac syncope. Author(s): Aguiar PH, Tella OI Jr, Pereira CU, Godinho F, Simm R. Source: Neurosurgical Review. 2002 March; 25(1-2): 99-102. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11954773
28
Neuralgia
•
Chronic varicella-zoster virus ganglionitis--a possible cause of postherpetic neuralgia. Author(s): Gilden DH, Cohrs RJ, Hayward AR, Wellish M, Mahalingam R. Source: Journal of Neurovirology. 2003 June; 9(3): 404-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12775423
•
Classic trigeminal neuralgia: a surgical perspective. Author(s): Filipchuk D. Source: The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses. 2003 April; 35(2): 82-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12795034
•
Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia. Author(s): Maesawa S, Salame C, Flickinger JC, Pirris S, Kondziolka D, Lunsford LD. Source: Journal of Neurosurgery. 2001 January; 94(1): 14-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147887
•
Clinical profile of headache and cranial neuralgias. Author(s): Shah PA, Nafee A. Source: J Assoc Physicians India. 1999 November; 47(11): 1072-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10862316
•
Coincidental supraorbital neuralgia and sinusitis. Author(s): Talmi YP, Finkelstein Y, Wolf M, Ben-Shoshan Y, Kronenberg J. Source: American Journal of Rhinology. 1999 November-December; 13(6): 463-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10631403
•
Combined transhorizontal-supracerebellar approach for microvascular decompression of trigeminal neuralgia. Author(s): Fujimaki T, Kirino T. Source: British Journal of Neurosurgery. 2000 December; 14(6): 531-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11272030
•
Comment on Rice ASC, Maton S, the Postherpetic Neuralgia Study Group (UK), gabapentin in postherpetic neuralgia: a randomized, double blind, placebo-controlled study. Author(s): Gehling M, Tryba M. Source: Pain. 2002 April; 96(3): 410-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11973022
Studies
29
•
Comment on Rice ASC, Maton S, the Postherpetic Neuralgia Study Group (UK), gabapentin in postherpetic neuralgia: a randomized, double blind, placebo-controlled study. Author(s): Bowsher D. Source: Pain. 2002 April; 96(3): 409-10; Author Reply 411-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11973021
•
Comparative therapeutic evaluation of intrathecal versus epidural methylprednisolone for long-term analgesia in patients with intractable postherpetic neuralgia. Author(s): Kikuchi A, Kotani N, Sato T, Takamura K, Sakai I, Matsuki A. Source: Regional Anesthesia and Pain Medicine. 1999 July-August; 24(4): 287-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10445766
•
Comparison of percutaneous trigeminal ganglion compression and microvascular decompression for the management of trigeminal neuralgia. Author(s): Chen JF, Lee ST. Source: Clinical Neurology and Neurosurgery. 2003 July; 105(3): 203-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12860515
•
Complex salvage procedures for severe lower extremity nerve pain. Author(s): Schon LC, Lam PW, Easley ME, Anderson CD, Lumsden DB, Shanker J, Levin GB. Source: Clinical Orthopaedics and Related Research. 2001 October; (391): 171-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11603666
•
Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia. Author(s): Uchino A, Sawada A, Hirakawa N, Totoki T, Kudo S. Source: European Radiology. 2002 September; 12(9): 2339-42. Epub 2002 January 19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12195492
•
Consumer views on management of trigeminal neuralgia. Author(s): Zakrzewska JM. Source: Headache. 2001 April; 41(4): 369-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11318883
•
Cranial root injury in glossopharyngeal neuralgia: electron microscopic observations. Case report. Author(s): Devor M, Govrin-Lippmann R, Rappaport ZH, Tasker RR, Dostrovsky JO. Source: Journal of Neurosurgery. 2002 March; 96(3): 603-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11883848
30
Neuralgia
•
Cryosurgical treatment of genuine trigeminal neuralgia. Author(s): Pradel W, Hlawitschka M, Eckelt U, Herzog R, Koch K. Source: The British Journal of Oral & Maxillofacial Surgery. 2002 June; 40(3): 244-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12054718
•
Cryotherapy in the management of trigeminal neuralgia: a review of the literature and report of three cases. Author(s): Poon CY. Source: Singapore Dent J. 2000 December; 23(1 Suppl): 49-55. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11699364
•
CSNS Resident Award: the economics of trigeminal neuralgia surgery. Author(s): Ecker RD, Pollock BE. Source: Clin Neurosurg. 2003; 50: 387-95. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14677455
•
Dedicated linear accelerator radiosurgery for the treatment of trigeminal neuralgia. Author(s): Smith ZA, De Salles AA, Frighetto L, Goss B, Lee SP, Selch M, Wallace RE, Cabatan-Awang C, Solberg T. Source: Journal of Neurosurgery. 2003 September; 99(3): 511-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12959439
•
Demonstration of neurovascular compression in trigeminal neuralgia and hemifacial spasm with magnetic resonance imaging: comparison with surgical findings in 60 consecutive cases. Author(s): Fukuda H, Ishikawa M, Okumura R. Source: Surgical Neurology. 2003 February; 59(2): 93-9; Discussion 99-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12648904
•
Design issues for studies into prevention of chronic pain: lessons from post-herpetic neuralgia. Author(s): Opstelten W, van Wijck AJ, Moons KG. Source: Anaesthesia. 2004 March; 59(3): 213-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14984516
•
Dextromethorphan and memantine in painful diabetic neuropathy and postherpetic neuralgia: efficacy and dose-response trials. Author(s): Sang CN, Booher S, Gilron I, Parada S, Max MB. Source: Anesthesiology. 2002 May; 96(5): 1053-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981142
Studies
31
•
Diagnosis and differential diagnosis of trigeminal neuralgia. Author(s): Zakrzewska JM. Source: The Clinical Journal of Pain. 2002 January-February; 18(1): 14-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11803298
•
Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia. Author(s): Sato J, Saitoh T, Notani K, Fukuda H, Kaneyama K, Segami N. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2004 January; 97(1): 18-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14716252
•
Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? A prospective double-blind, randomized study. Author(s): Flickinger JC, Pollock BE, Kondziolka D, Phuong LK, Foote RL, Stafford SL, Lunsford LD. Source: International Journal of Radiation Oncology, Biology, Physics. 2001 October 1; 51(2): 449-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11567820
•
Does the presence of a pontine trigeminal lesion represent an absolute contraindication for microvascular decompression in drug resistant trigeminal neuralgia? Author(s): Ferroli P, Franzini A, Farina L, La Mantia L, Broggi G. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2002 January; 72(1): 122-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11784841
•
Does treatment of acute herpes zoster prevent or shorten postherpetic neuralgia? Author(s): Alper BS, Lewis PR. Source: The Journal of Family Practice. 2000 March; 49(3): 255-64. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10735485
•
Effective pain management of post-herpetic neuralgia. Author(s): Johnson L. Source: Nurs Times. 2003 March 11-17; 99(10): 32-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12677936
•
Effects of single and repeated applications of a eutectic mixture of local anaesthetics (EMLA) cream on spontaneous and evoked pain in post-herpetic neuralgia. Author(s): Attal N, Brasseur L, Chauvin M, Bouhassira D. Source: Pain. 1999 May; 81(1-2): 203-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10353509
32
Neuralgia
•
Electrical stimulation of the trigeminal tract in chronic, intractable facial neuralgia. Author(s): Holsheimer J. Source: Archives of Physiology and Biochemistry. 2001 October; 109(4): 304-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11935364
•
Endoscopy as a tool in minimally invasive trigeminal neuralgia surgery. Author(s): El-Garem HF, Badr-El-Dine M, Talaat AM, Magnan J. Source: Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2002 March; 23(2): 132-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11875338
•
Endoscopy during neurotomy of the nervus intermedius for geniculate neuralgia. Author(s): Alcaraz N, King WA, Wackym PA. Source: Otolaryngology and Head and Neck Surgery. 1999 September; 121(3): 334-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10471888
•
Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Author(s): Schmader KE. Source: The Clinical Journal of Pain. 2002 November-December; 18(6): 350-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12441828
•
Epileptic seizures, cranial neuralgias and paroxysmal symptoms in remitting and progressive multiple sclerosis. Author(s): Eriksson M, Ben-Menachem E, Andersen O. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2002 December; 8(6): 495-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12474990
•
Evaluation of analgesic effect of low-power He:Ne laser on postherpetic neuralgia using VAS and modified McGill pain questionnaire. Author(s): Iijima K, Shimoyama N, Shimoyama M, Mizuguchi T. Source: Journal of Clinical Laser Medicine & Surgery. 1991 April; 9(2): 121-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10149452
•
Evaluation of surgical procedures for trigeminal neuralgia. Author(s): Ong KS, Keng SB. Source: Anesthesia Progress. 2003; 50(4): 181-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14959906
Studies
33
•
Experience in acupuncture treatment of occipital neuralgia. Author(s): Wang H, Chen H, Jiang H. Source: J Tradit Chin Med. 2002 September; 22(3): 183. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12400421
•
Factors influencing the features of postherpetic neuralgia and outcome when treated with tricyclics. Author(s): Bowsher D. Source: European Journal of Pain (London, England). 2003; 7(1): 1-7. Erratum In: Eur J Pain. 2003; 7(2): 201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12527312
•
Famciclovir and postherpetic neuralgia. Author(s): Bassett KL, Green CJ, Wright JM. Source: Annals of Internal Medicine. 1999 November 2; 131(9): 712-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10577337
•
Familial trigeminal neuralgia and contralateral hemifacial spasm. Author(s): Duff JM, Spinner RJ, Lindor NM, Dodick DW, Atkinson JL. Source: Neurology. 1999 July 13; 53(1): 216-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10408564
•
Familial trigeminal neuralgia. Author(s): Gupta V, Singh AK, Kumar S, Sinha S. Source: Neurology India. 2002 March; 50(1): 87-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11960159
•
Familial trigeminal neuralgia. Case report and review of the literature. Author(s): Fleetwood IG, Innes AM, Hansen SR, Steinberg GK. Source: Journal of Neurosurgery. 2001 September; 95(3): 513-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11565877
•
Familial trigeminal neuralgia: case reports and review of the literature. Author(s): Smyth P, Greenough G, Stommel E. Source: Headache. 2003 September; 43(8): 910-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12940815
34
Neuralgia
•
Focal enhancement of cranial nerve V after radiosurgery with the Leksell gamma knife: experience in 15 patients with medically refractory trigeminal neuralgia. Author(s): Alberico RA, Fenstermaker RA, Lobel J. Source: Ajnr. American Journal of Neuroradiology. 2001 November-December; 22(10): 1944-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11733329
•
Follow-up of clinical efficacy of iontophoresis therapy for postherpetic neuralgia (PHN). Author(s): Ozawa A, Haruki Y, Iwashita K, Sasao Y, Miyahara M, Sugai J, Matsuyama T, Iizuka M, Kawakubo Y, Nakamori M, Ohkido M. Source: The Journal of Dermatology. 1999 January; 26(1): 1-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10063205
•
Foreword: The Fourth International Conference on Varicella, Herpes Zoster and PostHerpetic Neuralgia (PHN). Author(s): Perkin RT. Source: Journal of Medical Virology. 2003; 70 Suppl 1: S1-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12627477
•
Fosphenytoin: an intravenous option for the management of acute trigeminal neuralgia crisis. Author(s): Cheshire WP. Source: Journal of Pain and Symptom Management. 2001 June; 21(6): 506-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11397609
•
From neuralgia to peripheral neuropathic pain: evolution of a concept. Author(s): Quintner JL, Bove GM. Source: Regional Anesthesia and Pain Medicine. 2001 July-August; 26(4): 368-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11464359
•
From the dermatology clinic.postherpetic neuralgia, in which the source of radiculopathy is revealed by examination of the skin. Author(s): Fardon D. Source: The Spine Journal : Official Journal of the North American Spine Society. 2002 January-February; 2(1): 85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14598807
•
Frontal intraosseous cryptic hemangioma presenting with supraorbital neuralgia. Author(s): Sharma RR, Pawar SJ, Lad SD, Netalkar AS, Musa MM. Source: Clinical Neurology and Neurosurgery. 1999 September; 101(3): 215-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10536912
Studies
35
•
Gabapentin for postherpetic neuralgia. Author(s): Colman E, Stadel BV. Source: Jama : the Journal of the American Medical Association. 1999 July 14; 282(2): 134-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10411191
•
Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study. Author(s): Rice AS, Maton S; Postherpetic Neuralgia Study Group. Source: Pain. 2001 November; 94(2): 215-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11690735
•
Gabapentin therapy for genitofemoral and ilioinguinal neuralgia. Author(s): Benito-Leon J, Picardo A, Garrido A, Cuberes R. Source: Journal of Neurology. 2001 October; 248(10): 907-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11697532
•
Gabapentin treatment of glossopharyngeal neuralgia: a follow-up of four years of a single case. Author(s): Moretti R, Torre P, Antonello RM, Bava A, Cazzato G. Source: European Journal of Pain (London, England). 2002; 6(5): 403-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12160515
•
Gabapentin: in postherpetic neuralgia. Author(s): Curran MP, Wagstaff AJ. Source: Cns Drugs. 2003; 17(13): 975-82. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14533947
•
Gamma knife radiosurgery for idiopathic and secondary trigeminal neuralgia. Author(s): Chang JW, Chang JH, Park YG, Chung SS. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 147-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143233
•
Gamma knife radiosurgery for primary management for trigeminal neuralgia. Author(s): Brisman R. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 159-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143236
•
Gamma knife radiosurgery for recurrent trigeminal neuralgia. Author(s): Shetter AG, Rogers CL, Ponce F, Fiedler JA, Smith K, Speiser BL. Source: Journal of Neurosurgery. 2002 December; 97(5 Suppl): 536-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12507092
36
Neuralgia
•
Gamma knife radiosurgery for the treatment of trigeminal neuralgia. Author(s): Rosenberg M, Zerris V, Borden J. Source: J Mass Dent Soc. 2001 Fall; 50(3): 40-3, 49. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11695147
•
Gamma knife radiosurgery for treatment of trigeminal neuralgia in multiple sclerosis patients. Author(s): Huang E, Teh BS, Zeck O, Woo SY, Lu HH, Chiu JK, Butler EB, Gormley WB, Carpenter LS. Source: Stereotactic and Functional Neurosurgery. 2002; 79(1): 44-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12677104
•
Gamma knife radiosurgery for trigeminal neuralgia associated with multiple sclerosis. Author(s): Rogers CL, Shetter AG, Ponce FA, Fiedler JA, Smith KA, Speiser BL. Source: Journal of Neurosurgery. 2002 December; 97(5 Suppl): 529-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12507090
•
Gamma knife radiosurgery for trigeminal neuralgia: dose-volume histograms of the brainstem and trigeminal nerve. Author(s): Brisman R, Mooij R. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 155-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143235
•
Gamma knife radiosurgery for trigeminal neuralgia: experience at the Barrow Neurological Institute. Author(s): Han PP, Shetter AG, Smith KA, Fiedler JA, Rogers CL, Speiser B, Feiz-Erfan I. Source: Stereotactic and Functional Neurosurgery. 1999; 73(1-4): 131-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10853118
•
Gamma knife radiosurgery for trigeminal neuralgia: the dry-eye complication. Author(s): Matsuda S, Serizawa T, Sato M, Ono J. Source: Journal of Neurosurgery. 2002 December; 97(5 Suppl): 525-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12507089
•
Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of The Barrow Neurological Institute. Author(s): Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL. Source: International Journal of Radiation Oncology, Biology, Physics. 2000 July 1; 47(4): 1013-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10863073
Studies
37
•
Gamma knife radiosurgery using 90 Gy for trigeminal neuralgia. Author(s): Nicol B, Regine WF, Courtney C, Meigooni A, Sanders M, Young B. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 152-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143234
•
Gamma knife stereotactic radiosurgery for treatment of trigeminal neuralgia. Author(s): Nicholson M, O'Neil M. Source: Hawaii Dent J. 2003 November-December; 34(6): 14-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14964081
•
Gamma knife surgery for trigeminal neuralgia. Author(s): Kao MC. Source: Journal of Neurosurgery. 2002 January; 96(1): 160-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11794600
•
Gamma-knife radiosurgery for trigeminal neuralgia. Author(s): Kannan V, Deopujari CE, Misra BK, Shetty PG, Shroff MM, Pendse AM. Source: Australasian Radiology. 1999 August; 43(3): 339-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10901930
•
Geniculate neuralgia as a manifestation of neuroborreliosis. Author(s): Frese A, Luttmann RJ, Husstedt IW, Ringelstein EB, Evers S. Source: Headache. 2002 September; 42(8): 826-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390649
•
Geniculate neuralgia: long-term results of surgical treatment. Author(s): Pulec JL. Source: Ear, Nose, & Throat Journal. 2002 January; 81(1): 30-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11816385
•
Giant cell arteritis presenting as occipital neuralgia. Author(s): Gonzalez-Gay MA, Garcia-Porrua C, Branas F, Alba-Losada J. Source: Clin Exp Rheumatol. 2001 July-August; 19(4): 479. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11491514
•
Glossopharyngeal neuralgia and MS. Author(s): Minagar A, Sheremata WA. Source: Neurology. 2000 March 28; 54(6): 1368-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10746612
38
Neuralgia
•
Glossopharyngeal neuralgia associated with aberrant internal carotid artery in the oropharynx. Author(s): Iwasaki S, Fujishiro Y, Abbey K. Source: The Annals of Otology, Rhinology, and Laryngology. 2002 February; 111(2): 1935. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11860076
•
Glossopharyngeal neuralgia associated with cardiac syncope. Author(s): Elias J, Kuniyoshi R, Carloni WV, Borges MR, Peixoto CA, Pimentel D. Source: Arquivos Brasileiros De Cardiologia. 2002 May; 78(5): 510-9. English, Portuguese. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12045849
•
Glossopharyngeal neuralgia caused by adhesive arachnoid. Author(s): Fukuda H, Ishikawa M, Yamazoe N. Source: Acta Neurochirurgica. 2002 October; 144(10): 1057-8; Discussion 1058. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12382135
•
Glossopharyngeal neuralgia following foreign body impaction in the neck. Author(s): Webb CJ, Makura ZG, McCormick MS. Source: The Journal of Laryngology and Otology. 2000 January; 114(1): 70-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10789419
•
Glossopharyngeal neuralgia with cardiac syncope treated by glossopharyngeal rhizotomy and microvascular decompression. Author(s): Ozenci M, Karaoguz R, Conkbayir C, Altin T, Kanpolat Y. Source: Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 2003 April; 5(2): 149-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12633639
•
Gluteal neuralgia - unusual presentation in an adult with intrasacral meningocele: a case report and review of literature. Author(s): Mishra GP, Sharma RR, Lad SD, Pawar SJ, Mahapatra AK. Source: Neurology India. 2000 September; 48(3): 279-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11025636
•
Great auricular neuralgia: a case report. Author(s): Maimone-Baronello M, Piccoli F, La Bella V. Source: Headache. 2003 October; 43(9): 1005-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14511279
Studies
39
•
Hearing preservation in microvascular decompression for trigeminal neuralgia. Author(s): Rizvi SS, Goyal RN, Calder HB. Source: The Laryngoscope. 1999 April; 109(4): 591-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10201746
•
Herpes zoster and postherpetic neuralgia in the elderly. Author(s): Lee VK, Simpkins L. Source: Geriatric Nursing (New York, N.Y.). 2000 May-June; 21(3): 132-5; Quiz 136. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10864692
•
Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Author(s): Opstelten W, Mauritz JW, de Wit NJ, van Wijck AJ, Stalman WA, van Essen GA. Source: Family Practice. 2002 October; 19(5): 471-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12356697
•
Herpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in chloroform for anodyne. Author(s): Kochar DK, Agarwal RP, Joshi A, Kumawat BL. Source: J Assoc Physicians India. 1998 April; 46(4): 337-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11273312
•
Herpes zoster in the immunocompetent patient: management of post-herpetic neuralgia. Author(s): Johnson RW. Source: Herpes : the Journal of the Ihmf. 2003 August; 10(2): 38-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14577953
•
Herpes zoster infection and postherpetic neuralgia. Author(s): Tenser RB. Source: Curr Neurol Neurosci Rep. 2001 November; 1(6): 526-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11898565
•
Herpes zoster. Treating postherpetic neuralgia. Author(s): Baldwin PD. Source: Clinical Journal of Oncology Nursing. 2002 January-February; 6(1): 55-8, 61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11842491
40
Neuralgia
•
Herpes zoster--predicting and minimizing the impact of post-herpetic neuralgia. Author(s): Johnson R. Source: The Journal of Antimicrobial Chemotherapy. 2001 February; 47 Suppl T1: 1-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11160029
•
Herpetic neuralgia. Use of combination therapy for pain relief in acute and chronic herpes zoster. Author(s): Bajwa ZH, Ho CC. Source: Geriatrics. 2001 December; 56(12): 18-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11766559
•
Heterogenous patterns of sensory dysfunction in postherpetic neuralgia suggest multiple pathophysiologic mechanisms. Author(s): Pappagallo M, Oaklander AL, Quatrano-Piacentini AL, Clark MR, Raja SN. Source: Anesthesiology. 2000 March; 92(3): 691-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10719948
•
High-concentration tetracaine for the management of trigeminal neuralgia: quantitative assessment of sensory function after peripheral nerve block. Author(s): Radwan IA, Saito S, Goto F. Source: The Clinical Journal of Pain. 2001 December; 17(4): 323-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11783812
•
High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction. Author(s): Regis J. Source: Neurosurgery. 2002 June; 50(6): 1401-2; Author Reply 1402-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12051192
•
High-dose trigeminal neuralgia radiosurgery associated with increased risk of trigeminal nerve dysfunction. Author(s): Pollock BE, Phuong LK, Foote RL, Stafford SL, Gorman DA. Source: Neurosurgery. 2001 July; 49(1): 58-62; Discussion 62-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11440460
•
HLA-A33 and -B44 and susceptibility to postherpetic neuralgia (PHN). Author(s): Ozawa A, Sasao Y, Iwashita K, Miyahara M, Sugai J, Iizuka M, Kawakubo Y, Ohkido M, Naruse T, Anzai T, Takashige N, Ando A, Inoko H. Source: Tissue Antigens. 1999 March; 53(3): 263-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10203019
Studies
41
•
Home-based patient-controlled epidural analgesia with bupivacaine for patients with intractable herpetic neuralgia. Author(s): Tsai YC, Wang LK, Chen BS, Chen HP. Source: J Formos Med Assoc. 2000 August; 99(8): 659-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10969513
•
How accurate is magnetic resonance angiography in predicting neurovascular compression in patients with trigeminal neuralgia? A prospective, single-blinded comparative study. Author(s): Patel NK, Aquilina K, Clarke Y, Renowden SA, Coakham HB. Source: British Journal of Neurosurgery. 2003 February; 17(1): 60-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12779203
•
Idiopathic trigeminal neuralgia associated with a severe atypical facial pain exacerbated by hydrocephalus. Author(s): Iseki M, Mitsuhata H, Tanabe Y, Miyazaki T. Source: Anesthesiology. 1999 December; 91(6): 1968. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10598651
•
Ilioinguinal neuralgia complicating percutaneous renal biopsy. Author(s): Kanai H, Hirakawa M, Arimura Y, Taniguchi M, Tsuruya K, Masutani K, Ninomiya T, Sugawara K, Koga Y, Hirakata H. Source: Journal of Neurology. 2001 August; 248(8): 708-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11569903
•
Ilioinguinal neuralgia following anterior iliac crest bone harvesting. Author(s): Bents RT. Source: Orthopedics. 2002 December; 25(12): 1389-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12502203
•
Imaging the trigeminal nerve and pons before and after surgical intervention for trigeminal neuralgia. Author(s): Jawahar A, Kondziolka D, Kanal E, Bissonette DJ, Lunsford LD. Source: Neurosurgery. 2001 January; 48(1): 101-6; Discussion 106-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11152335
•
Integrative approach to the treatment of postherpetic neuralgia: a case series. Author(s): Hui F, Cheng A, Chiu M, Vayda E. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1999 December; 4(6): 429-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10608916
42
Neuralgia
•
Intrathecal methylprednisolone for intractable postherpetic neuralgia. Author(s): Kotani N, Kushikata T, Hashimoto H, Kimura F, Muraoka M, Yodono M, Asai M, Matsuki A. Source: The New England Journal of Medicine. 2000 November 23; 343(21): 1514-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11087880
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Srinivasan B. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1021; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280324
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Niebergall H, Priebe HJ. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280323
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Lewis G. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280322
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Zetlaoui PJ, Cosserat J. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1020-1; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280321
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Nelson DA, Landau WM. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1019; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280320
•
Intrathecal methylprednisolone for postherpetic neuralgia. Author(s): Lampe JB, Hindinger C, Reichmann H. Source: The New England Journal of Medicine. 2001 March 29; 344(13): 1019-20; Author Reply 1021-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11280319
Studies
43
•
Intrathecal steroid injection for postherpetic neuralgia: what are the risks? Author(s): Abram SE. Source: Regional Anesthesia and Pain Medicine. 1999 July-August; 24(4): 283-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10445765
•
Investigation and medical management of trigeminal neuralgia by consultant oral and maxillofacial surgeons in the British Isles. Author(s): Pemberton MN, Dewi PS, Hindle I, Thornhill MH. Source: The British Journal of Oral & Maxillofacial Surgery. 2001 April; 39(2): 114-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11286444
•
Iontophoretic vincristine in the treatment of postherpetic neuralgia: a double-blind, randomized, controlled trial. Author(s): Dowd NP, Day F, Timon D, Cunningham AJ, Brown L. Source: Journal of Pain and Symptom Management. 1999 March; 17(3): 175-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10098360
•
Lamotrigine in trigeminal neuralgia secondary to multiple sclerosis. Author(s): Leandri M, Lundardi G, Inglese M, Messmer-Uccelli M, Mancardi GL, Gottlieb A, Solaro C. Source: Journal of Neurology. 2000 July; 247(7): 556-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10993501
•
Lamotrigine monotherapy for control of neuralgia after nerve section. Author(s): Sandner-Kiesling A, Rumpold Seitlinger G, Dorn C, Koch H, Schwarz G. Source: Acta Anaesthesiologica Scandinavica. 2002 November; 46(10): 1261-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12421199
•
Laser-evoked potentials in post-herpetic neuralgia. Author(s): Truini A, Haanpaa M, Zucchi R, Galeotti F, Iannetti GD, Romaniello A, Cruccu G. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 April; 114(4): 702-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12686278
•
Late recurrence of glossopharyngeal neuralgia after IXth and partial Xth nerve rhizotomy: treatment by microvascular decompression. Author(s): Owler BK, Johnston I, Kennedy M. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 December; 69(6): 8345. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11185643
44
Neuralgia
•
Lateral femoral cutaneous neuralgia: an anatomical insight. Author(s): Dias Filho LC, Valenca MM, Guimaraes Filho FA, Medeiros RC, Silva RA, Morais MG, Valente FP, Franca SM. Source: Clinical Anatomy (New York, N.Y.). 2003 July; 16(4): 309-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12794914
•
Lidocaine and methylprednisolone in management of herpes zoster and post-herpetic neuralgia. Author(s): Gintautas J, Abraham Y, Doss NW, Ghobriel A, Kashem A, Fogler RJ. Source: Proc West Pharmacol Soc. 2002; 45: 73. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12434534
•
Life after shingles: the management of postherpetic neuralgia. Author(s): Williams H. Source: British Journal of Community Nursing. 2002 June; 7(6): 286-7, 290-1. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12066061
•
Linear accelerator radiosurgery using 90 gray for essential trigeminal neuralgia: results and dose volume histogram analysis. Author(s): Goss BW, Frighetto L, DeSalles AA, Smith Z, Solberg T, Selch M. Source: Neurosurgery. 2003 October; 53(4): 823-8; Discussion 828-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14519214
•
Linear pontine and trigeminal root lesions and trigeminal neuralgia. Author(s): Ferroli P, Farina L, Franzini A, Milanese C, Broggi G. Source: Archives of Neurology. 2001 August; 58(8): 1311-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11493180
•
Local immune responses and systemic cytokine responses in zoster: relationship to the development of postherpetic neuralgia. Author(s): Zak-Prelich M, McKenzie RC, Sysa-Jedrzejowska A, Norval M. Source: Clinical and Experimental Immunology. 2003 February; 131(2): 318-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12562395
•
Long-term cohort study comparing medical (oxcarbazepine) and surgical management of intractable trigeminal neuralgia. Author(s): Zakrzewska JM, Patsalos PN. Source: Pain. 2002 February; 95(3): 259-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11839425
Studies
45
•
Long-term outcome after gamma knife surgery for secondary trigeminal neuralgia. Author(s): Regis J, Metellus P, Dufour H, Roche PH, Muracciole X, Pellet W, Grisoli F, Peragut JC. Source: Journal of Neurosurgery. 2001 August; 95(2): 199-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11780888
•
Long-term outcome of percutaneous thermocoagulation for trigeminal neuralgia. Author(s): Yoon KB, Wiles JR, Miles JB, Nurmikko TJ. Source: Anaesthesia. 1999 August; 54(8): 803-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10460537
•
Long-term pain control in trigeminal neuralgia with local anesthetics using an indwelling catheter in the mandibular nerve. Author(s): Umino M, Kohase H, Ideguchi S, Sakurai N. Source: The Clinical Journal of Pain. 2002 May-June; 18(3): 196-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048422
•
Low-dose gabapentin combined with either lamotrigine or carbamazepine can be useful therapies for trigeminal neuralgia in multiple sclerosis. Author(s): Solaro C, Messmer Uccelli M, Uccelli A, Leandri M, Mancardi GL. Source: European Neurology. 2000; 44(1): 45-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10894995
•
Management of herpes zoster (shingles) and postherpetic neuralgia. Author(s): Stankus SJ, Dlugopolski M, Packer D. Source: American Family Physician. 2000 April 15; 61(8): 2437-44, 2447-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10794584
•
Mandibular neuralgia due to anatomical variations. Author(s): Krmpotic-Nemanic J, Vinter I, Hat J, Jalsovec D. Source: European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (Eufos) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 1999; 256(4): 205-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10337513
•
Measurement of pulse pressure profiles in patients with trigeminal neuralgia. Author(s): Turner CL, Mendoza N, Illingworth RD, Kirkpatrick PJ. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 April; 74(4): 533-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640085
46
Neuralgia
•
Mechanism of trigeminal neuralgia: an ultrastructural analysis of trigeminal root specimens obtained during microvascular decompression surgery. Author(s): Devor M, Govrin-Lippmann R, Rappaport ZH. Source: Journal of Neurosurgery. 2002 March; 96(3): 532-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11883839
•
Medically unexplained chronic orofacial pain. Temporomandibular pain and dysfunction syndrome, orofacial phantom pain, burning mouth syndrome, and trigeminal neuralgia. Author(s): Marbach JJ. Source: The Medical Clinics of North America. 1999 May; 83(3): 691-710, Vi-Vii. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10386121
•
Microscopic perineuritis. An unexpected finding of post-herpetic neuralgia in a temporal artery biopsy. Author(s): Hernandez-Rodriguez J, Cid MC, Grau JM. Source: Clin Exp Rheumatol. 2000 July-August; 18(4): 541-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10949744
•
Microsurgical posterior fossa exploration for trigeminal neuralgia: a study on 48 cases. Author(s): Delitala A, Brunori A, Chiappetta F. Source: Minimally Invasive Neurosurgery : Min. 2001 September; 44(3): 152-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11696884
•
Microvascular decompression as treatment of trigeminal neuralgia in the elderly patient. Author(s): Jodicke A, Winking M, Deinsberger W, Boker DK. Source: Minimally Invasive Neurosurgery : Min. 1999 June; 42(2): 92-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10422706
•
Microvascular decompression for treating glossopharyngeal neuralgia complicated by sick sinus syndrome. Author(s): Nishikawa Y, Suzuki M, Kuwata N, Ogawa A. Source: Acta Neurochirurgica. 2000; 142(3): 351-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10819268
•
Microvascular decompression for treatment of trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: three surgical approach variations: technical note. Author(s): Hitotsumatsu T, Matsushima T, Inoue T. Source: Neurosurgery. 2003 December; 53(6): 1436-41; Discussion 1442-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633313
Studies
47
•
Microvascular decompression for trigeminal neuralgia in Charcot-Marie-Tooth disease. Author(s): de Matas M, Francis P, Miles JB. Source: Journal of Neurosurgery. 2000 April; 92(4): 715-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10761666
•
Microvascular decompression for trigeminal neuralgia in patients over 65 years of age. Author(s): Berk C, Honey CR. Source: British Journal of Neurosurgery. 2001 February; 15(1): 76-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11303671
•
Microvascular decompression for trigeminal neuralgia in patients over 70 years of age. Author(s): Javadpour M, Eldridge PR, Varma TR, Miles JB, Nurmikko TJ. Source: Neurology. 2003 February 11; 60(3): 520. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12578946
•
Microvascular decompression for trigeminal neuralgia. Author(s): Allende R, Teja S, Alleyne CH Jr. Source: Neurology. 2001 September 25; 57(6): 1093. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11571340
•
Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis. Author(s): Broggi G, Ferroli P, Franzini A, Servello D, Dones I. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 January; 68(1): 59-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10601403
•
Microvascular decompression for trigeminal neuralgia: report of outcome in patients over 65 years of age. Author(s): Ogungbo BI, Kelly P, Kane PJ, Nath FP. Source: British Journal of Neurosurgery. 2000 February; 14(1): 23-7. Erratum In: Br J Neurosurg 2000 October; 14(5): 504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10884880
•
Microvascular decompression in the management of glossopharyngeal neuralgia: analysis of 217 cases. Author(s): Patel A, Kassam A, Horowitz M, Chang YF. Source: Neurosurgery. 2002 April; 50(4): 705-10; Discussion 710-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11904019
48
Neuralgia
•
Microvascular decompression in trigeminal neuralgia: a correlation of threedimensional time-of-flight magnetic resonance angiography and surgical findings. Author(s): Chang JW, Chang JH, Park YG, Chung SS. Source: Stereotactic and Functional Neurosurgery. 2000; 74(3-4): 167-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279357
•
Microvascular decompression of a developmental venous anomaly in the cerebellopontine angle causing trigeminal neuralgia. Author(s): Korinth MC, Moller-Hartmann W, Gilsbach JM. Source: British Journal of Neurosurgery. 2002 February; 16(1): 52-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11926466
•
Microvascular decompression surgery for trigeminal neuralgia. Author(s): Kondo A. Source: Stereotactic and Functional Neurosurgery. 2001; 77(1-4): 187-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12378075
•
Misoprostol in the treatment of trigeminal neuralgia associated with multiple sclerosis. Author(s): DMKG study group. Source: Journal of Neurology. 2003 May; 250(5): 542-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12736732
•
Multidisciplinary approach for the management of post-herpetic neuralgia in elderly patients. Author(s): Ackerman WE 3rd, Ahmad M. Source: J Ark Med Soc. 1999 May; 95(12): 528-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10341481
•
Nervus intermedius neuralgia: an uncommon pain syndrome with an uncommon etiology. Author(s): Yentur EA, Yegul I. Source: Journal of Pain and Symptom Management. 2000 June; 19(6): 407-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10991643
•
Neuroendoscopy in microvascular decompression for trigeminal neuralgia and hemifacial spasm: technical note. Author(s): Abdeen K, Kato Y, Kiya N, Yoshida K, Kanno T. Source: Neurological Research. 2000 July; 22(5): 522-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10935228
Studies
49
•
Neuronal hamartoma of the trigeminal sensory root associated with trigeminal neuralgia. Author(s): Patel N, Moss T, Coakham H. Source: Journal of Neurosurgery. 2000 September; 93(3): 514. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10969957
•
Neurovascular compression associated with trigeminal neuralgia and systemic arterial hypertension: surgical treatment. Author(s): Sendeski M, Aguiar PH, Zanetti MV, Teixeira MJ, Cescato VA. Source: Stereotactic and Functional Neurosurgery. 2002; 79(3-4): 284-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890987
•
Neurovascular decompression for trigeminal neuralgia in elderly patients. Author(s): Ryu H, Yamamoto S, Sugiyama K, Yokota N, Tanaka T. Source: Neurol Med Chir (Tokyo). 1999 March; 39(3): 226-9; Discussion 229-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10344111
•
No acute varicella-zoster virus replication in peripheral blood mononuclear cells during postherpetic neuralgia. Author(s): Schunemann S, Mainka C, Wolff MH. Source: Acta Virol. 1999 December; 43(6): 337-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10825921
•
Objective assessment of autonomic signs during triggered first division trigeminal neuralgia. Author(s): Pareja JA, Baron M, Gili P, Yanguela J, Caminero AB, Dobato JL, Barriga FJ, Vela L, Sanchez-del-Rio M. Source: Cephalalgia : an International Journal of Headache. 2002 May; 22(4): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12100085
•
Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia. Author(s): Zhang Z. Source: J Tradit Chin Med. 1997 December; 17(4): 272-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437209
•
Occipital (Arnold) neuralgia secondary to greater occipital nerve schwannoma. Author(s): Ballesteros-Del Rio B, Ares-Luque A, Tejada-Garcia J, Muela-Molinero A. Source: Headache. 2003 July-August; 43(7): 804-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890139
50
Neuralgia
•
Occipital neuralgia as isolated symptom of an upper cervical cavernous angioma. Author(s): Cerrato P, Bergui M, Imperiale D, Baima C, Grasso M, Giraudo M, Lentini A, Lopiano L, Bradac GB, Bergamasco B. Source: Journal of Neurology. 2002 October; 249(10): 1464-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532938
•
Occipital neuralgia secondary to hypermobile posterior arch of atlas. Case report. Author(s): Post AF, Narayan P, Haid RW Jr. Source: Journal of Neurosurgery. 2001 April; 94(2 Suppl): 276-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11302631
•
Occipital neuralgias: clinical recognition of a complicated headache. A case series and literature review. Author(s): Kuhn WF, Kuhn SC, Gilberstadt H. Source: J Orofac Pain. 1997 Spring; 11(2): 158-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10332322
•
On the natural history of trigeminal neuralgia. Author(s): Burchiel KJ, Slavin KV. Source: Neurosurgery. 2000 January; 46(1): 152-4; Discussion 154-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10626945
•
Operative findings in cases of trigeminal neuralgia without vascular compression: proposal of a different mechanism. Author(s): Ishikawa M, Nishi S, Aoki T, Takase T, Wada E, Ohwaki H, Katsuki T, Fukuda H. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2002 March; 9(2): 200-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11922717
•
Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebocontrolled trial. Author(s): Raja SN, Haythornthwaite JA, Pappagallo M, Clark MR, Travison TG, Sabeen S, Royall RM, Max MB. Source: Neurology. 2002 October 8; 59(7): 1015-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12370455
•
Opioids versus antidepressants in postherpetic neuralgia: a randomized, placebocontrolled trial. Author(s): Manfredi PL. Source: Neurology. 2003 March 25; 60(6): 1052-3; Author Reply 1052-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12654988
Studies
51
•
Oral brivudin in comparison with acyclovir for herpes zoster: a survey study on postherpetic neuralgia. Author(s): Wassilew SW, Wutzler P; Brivddin Herpes Zoster Study Group. Source: Antiviral Research. 2003 June; 59(1): 57-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12834861
•
Osteochondroma of the cervical spine causing occipital nerve neuralgia. Case report. Author(s): Baer-Henney S, Tatagiba M, Samii M. Source: Neurological Research. 2001 October; 23(7): 777-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11680521
•
Osteoid osteoma -- a rare cause of brachial neuralgia. Author(s): Muthukumar N. Source: Child's Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery. 2002 April; 18(3-4): 161-3. Epub 2001 December 06. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981626
•
Outcome after microvascular decompression for typical trigeminal neuralgia, hemifacial spasm, tinnitus, disabling positional vertigo, and glossopharyngeal neuralgia (honored guest lecture). Author(s): Jannetta PJ. Source: Clin Neurosurg. 1997; 44: 331-83. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10080016
•
Pain coping strategies play a role in the persistence of pain in post-herpetic neuralgia. Author(s): Haythornthwaite JA, Clark MR, Pappagallo M, Raja SN. Source: Pain. 2003 December; 106(3): 453-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14659529
•
Patient and family factsheet. Trigeminal neuralgia. Author(s): Kernich CA. Source: The Neurologist. 2003 January; 9(1): 57-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801433
•
Percutaneous stereotactic radiofrequency thermal rhizotomy for the treatment of trigeminal neuralgia. Author(s): Mathews ES, Scrivani SJ. Source: The Mount Sinai Journal of Medicine, New York. 2000 September; 67(4): 288-99. Erratum In: Mt Sinai J Med. 2003 January; 70(1): 2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11021779
52
Neuralgia
•
Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia--part I: pressure recordings. Author(s): Lee ST, Chen JF. Source: Surgical Neurology. 2003 January; 59(1): 63-6; Discussion 66-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12633968
•
Percutaneous trigeminal ganglion balloon compression for treatment of trigeminal neuralgia--part I: pressure recordings. Author(s): Wilkinson HA. Source: Surgical Neurology. 2003 November; 60(5): 470. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14572977
•
Percutaneous trigeminal ganglion compression for the treatment of trigeminal neuralgia: report of two cases. Author(s): Chen JF, Lee ST, Lui TN, Wu CT. Source: Chang Gung Med J. 2002 February; 25(2): 122-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11952272
•
Peripheral and gasserian ganglion-level procedures for the treatment of trigeminal neuralgia. Author(s): Peters G, Nurmikko TJ. Source: The Clinical Journal of Pain. 2002 January-February; 18(1): 28-34. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11803300
•
Pharmacotherapy of trigeminal neuralgia. Author(s): Sindrup SH, Jensen TS. Source: The Clinical Journal of Pain. 2002 January-February; 18(1): 22-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11803299
•
Postherpetic neuralgia after shingles: an under-recognized cause of chronic vulvar pain. Author(s): Oaklander AL, Rissmiller JG. Source: Obstetrics and Gynecology. 2002 April; 99(4): 625-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12039124
•
Postherpetic neuralgia. Author(s): Lancaster T, Wareham D, Yaphe J. Source: Clin Evid. 2002 June; (7): 738-46. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230700
Studies
53
•
Postherpetic neuralgia: a descriptive analysis of patients seen in pain clinics. Author(s): Lazaro C, Caseras X, Banos JE; Catalonian Group for the Study of Postherpetic Neuralgia. Source: Regional Anesthesia and Pain Medicine. 2003 July-August; 28(4): 315-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12945025
•
Postherpetic ophthalmic neuralgia. Author(s): Devulder JE. Source: Bull Soc Belge Ophtalmol. 2002; (285): 19-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12442339
•
Predictive model for pain recurrence after posterior fossa surgery for trigeminal neuralgia. Author(s): Theodosopoulos PV, Marco E, Applebury C, Lamborn KR, Wilson CB. Source: Archives of Neurology. 2002 August; 59(8): 1297-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12164727
•
Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression. Author(s): Tyler-Kabara EC, Kassam AB, Horowitz MH, Urgo L, Hadjipanayis C, Levy EI, Chang YF. Source: Journal of Neurosurgery. 2002 March; 96(3): 527-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11883838
•
Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of highresolution magnetic resonance imaging. Author(s): Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N. Source: Neurosurgery. 2002 October; 51(4): 956-61; Discussion 961-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12234403
•
Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of highresolution magnetic resonance imaging. Author(s): Jannetta PJ. Source: Neurosurgery. 2003 June; 52(6): 1511; Author Reply 1511. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12800844
•
Prevalence of postherpetic neuralgia after a first episode of herpes zoster: prospective study with long term follow up. Author(s): Helgason S, Petursson G, Gudmundsson S, Sigurdsson JA. Source: Bmj (Clinical Research Ed.). 2000 September 30; 321(7264): 794-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11009518
54
Neuralgia
•
Prevention of postherpetic neuralgia with varicella-zoster hyperimmune globulin. Author(s): Hugler P, Siebrecht P, Hoffmann K, Stucker M, Windeler J, Altmeyer P, Laubenthal H. Source: European Journal of Pain (London, England). 2002; 6(6): 435-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12413432
•
Prognostic factors of postherpetic neuralgia. Author(s): Herr H. Source: Journal of Korean Medical Science. 2002 October; 17(5): 655-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12378018
•
Prolonged cardiac arrest caused by glossopharyngeal neuralgia. Author(s): Takaya N, Sumiyoshi M, Nakata Y. Source: Heart (British Cardiac Society). 2003 April; 89(4): 381. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12639862
•
Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia. Author(s): Van Zundert J, Brabant S, Van de Kelft E, Vercruyssen A, Van Buyten JP. Source: Pain. 2003 August; 104(3): 449-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927617
•
Quality of reporting in evaluations of surgical treatment of trigeminal neuralgia: recommendations for future reports. Author(s): Zakrzewska JM, Lopez BC. Source: Neurosurgery. 2003 July; 53(1): 110-20; Discussion 120-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12823880
•
Radiation induced vascular injury after stereotactic radiosurgery for trigeminal neuralgia: case report. Author(s): Maher CO, Pollock BE. Source: Surgical Neurology. 2000 August; 54(2): 189-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11077103
•
Radiosurgery and trigeminal neuralgia. Author(s): Kanpolat Y, Savas A. Source: Journal of Neurosurgery. 2001 June; 94(6): 1018-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11409506
Studies
55
•
Radiosurgery for trigeminal neuralgia. Author(s): Kanpolat Y, Savas A. Source: Surgical Neurology. 2001 July; 56(1): 67-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11546584
•
Radiosurgery for trigeminal neuralgia. Author(s): Lunsford LD, Young RF. Source: Surgical Neurology. 2000 October; 54(4): 285-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11221773
•
Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes. Author(s): Petit JH, Herman JM, Nagda S, DiBiase SJ, Chin LS. Source: International Journal of Radiation Oncology, Biology, Physics. 2003 July 15; 56(4): 1147-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12829153
•
Rash severity in herpes zoster: correlates and relationship to postherpetic neuralgia. Author(s): Nagasako EM, Johnson RW, Griffin DR, Dworkin RH. Source: Journal of the American Academy of Dermatology. 2002 June; 46(6): 834-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12063479
•
Recurrent trigeminal neuralgia after microvascular decompression using an interposing technique. Teflon felt adhesion and the sling retraction technique. Author(s): Matsushima T, Yamaguchi T, Inoue TK, Matsukado K, Fukui M. Source: Acta Neurochirurgica. 2000; 142(5): 557-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10898363
•
Recurrent trigeminal neuralgia attributable to veins after microvascular decompression. Author(s): Lee SH, Levy EI, Scarrow AM, Kassam A, Jannetta PJ. Source: Neurosurgery. 2000 February; 46(2): 356-61; Discussion 361-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10690724
•
Reduction of postherpetic neuralgia in herpes zoster. Author(s): Vander Straten M, Carrasco D, Lee P, Tyring SK. Source: Journal of Cutaneous Medicine and Surgery. 2001 September-October; 5(5): 40916. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11907852
56
Neuralgia
•
Refractory occipital neuralgia: preoperative assessment with CT-guided nerve block prior to dorsal cervical rhizotomy. Author(s): Kapoor V, Rothfus WE, Grahovac SZ, Amin Kassam SZ, Horowitz MB. Source: Ajnr. American Journal of Neuroradiology. 2003 November-December; 24(10): 2105-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14625243
•
Relief of cluster headache and cranial neuralgias. Promising prophylactic and symptomatic treatments. Author(s): Dalessio DJ. Source: Postgraduate Medicine. 2001 January; 109(1): 69-72, 75-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11198259
•
Relief of post-herpetic neuralgia by surgical removal of painful skin. Author(s): Petersen KL, Rice FL, Suess F, Berro M, Rowbotham MC. Source: Pain. 2002 July; 98(1-2): 119-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12098623
•
Repeat radiosurgery for refractory trigeminal neuralgia. Author(s): Hasegawa T, Kondziolka D, Spiro R, Flickinger JC, Lunsford LD. Source: Neurosurgery. 2002 March; 50(3): 494-500; Discussion 500-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11841716
•
Repeated peripheral nerve blocks by the co-administration of ketamine, morphine, and bupivacaine attenuate trigeminal neuralgia. Author(s): Chang FL, Huang GS, Cherng CH, Ho ST, Wong CS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 February; 50(2): 201-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12560318
•
Repositioning of the vertebral artery with titanium bone fixation plate for trigeminal neuralgia. Author(s): Taki W, Matsushima S, Hori K, Mouri G, Ishida F. Source: Acta Neurochirurgica. 2003 January; 145(1): 55-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12545263
•
Results of repeated gamma knife radiosurgery for medically unresponsive trigeminal neuralgia. Author(s): Pollock BE, Foote RL, Stafford SL, Link MJ, Gorman DA, Schomberg PJ. Source: Journal of Neurosurgery. 2000 December; 93 Suppl 3: 162-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143237
Studies
57
•
Risk and prognostic factors of postherpetic neuralgia and focal sensory denervation: a prospective evaluation in acute herpes zoster ophthalmicus. Author(s): Zaal MJ, Volker-Dieben HJ, D'Amaro J. Source: The Clinical Journal of Pain. 2000 December; 16(4): 345-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11153792
•
Role of enhanced MRI in the follow-up of patients with medically refractory trigeminal neuralgia undergoing stereotactic radiosurgery using the gamma knife: initial experience. Author(s): Friedman DP, Morales RE, Goldman HW. Source: Journal of Computer Assisted Tomography. 2001 September-October; 25(5): 72732. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11584232
•
Role of microvascular decompression in trigeminal neuralgia and multiple sclerosis. Author(s): Broggi G, Ferroli P, Franzini A, Pluderi M, La Mantia L, Milanese C. Source: Lancet. 1999 November 27; 354(9193): 1878-9. Erratum In: Lancet 2000 April 29; 355(9214): 1560. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10584731
•
Role of microvascular decompression in trigeminal neuralgia. Author(s): Bonicalzi V, Canavero S. Source: Lancet. 2000 March 11; 355(9207): 928-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10752728
•
Sacral magnetic stimulation for pain relief from pudendal neuralgia and sciatica. Author(s): Sato T, Nagai H. Source: Diseases of the Colon and Rectum. 2002 February; 45(2): 280-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11852346
•
Saphenous neuralgia after arthroscopically assisted anterior cruciate ligament reconstruction with a semitendinosus and gracilis tendon graft. Author(s): Bertram C, Porsch M, Hackenbroch MH, Terhaag D. Source: Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2000 October; 16(7): 763-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11027764
•
Saphenous neuralgia after coronary artery bypass grafting. Author(s): Mountney J, Wilkinson GA. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 1999 October; 16(4): 440-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10571092
58
Neuralgia
•
Schwannoma of the suprascapular nerve presenting with atypical neuralgia: case report and review of the literature. Author(s): Sharma RR, Pawar SJ, Netalkar AS. Source: Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. 2001 January; 8(1): 60-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11148084
•
Serotonin mediated cluster headache, trigeminal neuralgia, glossopharyngeal neuralgia, and superior laryngeal neuralgia with SAD chronicity. Author(s): Weiss JL, Weiss KL, Benecke SM. Source: Child Psychiatry and Human Development. 2001 Fall; 32(1): 45-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11579658
•
Simultaneous display of MRA and MPR in detecting vascular compression for trigeminal neuralgia or hemifacial spasm: comparison with oblique sagittal views of MRI. Author(s): Arbab AS, Nishiyama Y, Aoki S, Yoshikawa T, Kumagai H, Araki T, Nagaseki Y, Nukui H. Source: European Radiology. 2000; 10(7): 1056-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11003397
•
Small-fiber dysfunction in trigeminal neuralgia: carbamazepine effect on laserevoked potentials. Author(s): Cruccu G, Leandri M, Iannetti GD, Mascia A, Romaniello A, Truini A, Galeotti F, Manfredi M. Source: Neurology. 2001 June 26; 56(12): 1722-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11425940
•
Spinal cord stimulation in postherpetic neuralgia and in acute herpes zoster pain. Author(s): Harke H, Gretenkort P, Ladleif HU, Koester P, Rahman S. Source: Anesthesia and Analgesia. 2002 March; 94(3): 694-700; Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11867400
•
Stereotactic radiosurgery for idiopathic trigeminal neuralgia. Author(s): Pollock BE, Phuong LK, Gorman DA, Foote RL, Stafford SL. Source: Journal of Neurosurgery. 2002 August; 97(2): 347-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12186463
•
Stereotactic radiosurgery for primary trigeminal neuralgia using the Leksell Gamma unit. Author(s): Zheng LG, Xu DS, Kang CS, Zhang ZY, Li YH, Zhang YP, Liu D, Jia Q. Source: Stereotactic and Functional Neurosurgery. 2001; 76(1): 29-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12007276
Studies
59
•
Stereotactic radiosurgery for the treatment of trigeminal neuralgia. Author(s): Kondziolka D, Lunsford LD, Flickinger JC. Source: The Clinical Journal of Pain. 2002 January-February; 18(1): 42-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11803302
•
SUNCT syndrome or trigeminal neuralgia with lacrimation and conjunctival injection? Author(s): Sesso RM. Source: Cephalalgia : an International Journal of Headache. 2001 March; 21(2): 151-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422099
•
SUNCT syndrome or trigeminal neuralgia with lacrimation. Author(s): Goadsby PJ, Matharu MS, Boes CJ. Source: Cephalalgia : an International Journal of Headache. 2001 March; 21(2): 82-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422087
•
Supraorbital neuralgia. Author(s): Solomon S, Goodrich JT. Source: Headache. 1999 October; 39(9): 680-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279967
•
Supraorbital neuralgia: a clinical study. Author(s): Caminero AB, Pareja JA. Source: Cephalalgia : an International Journal of Headache. 2001 April; 21(3): 216-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11442557
•
Surgical treatment of glossopharyngeal neuralgia as vascular compression syndrome via transcondylar fossa (supracondylar transjugular tubercle) approach. Author(s): Matsushima T, Goto Y, Natori Y, Matsukado K, Fukui M. Source: Acta Neurochirurgica. 2000; 142(12): 1359-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11214629
•
Surgical treatment of trigeminal neuralgia. Author(s): Brown C. Source: Aorn Journal. 2003 November; 78(5): 744-58; Quiz 759-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14621949
•
Surgical treatment of trigeminal neuralgia. Author(s): Hong-Sai L. Source: Journal of Oral Rehabilitation. 1999 July; 26(7): 613-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10445482
60
Neuralgia
•
Symptomatic trigeminal-autonomic cephalalgia evolving to trigeminal neuralgia: report of a case associated with dual pathology. Author(s): Kowacs PA, Piovesan EJ, Tatsui CE, Lange MC, Werneck LC, Vincent M. Source: Cephalalgia : an International Journal of Headache. 2001 November; 21(9): 91720. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903287
•
Systemic absorption of topical lidocaine in normal volunteers, patients with postherpetic neuralgia, and patients with acute herpes zoster. Author(s): Campbell BJ, Rowbotham M, Davies PS, Jacob P 3rd, Benowitz NL. Source: Journal of Pharmaceutical Sciences. 2002 May; 91(5): 1343-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11977110
•
Temporary relief of postherpetic neuralgia pain with topical geranium oil. Author(s): Greenway FL, Frome BM, Engels TM 3rd, McLellan A. Source: The American Journal of Medicine. 2003 November; 115(7): 586-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14599644
•
The gamma knife for relief of trigeminal neuralgia. Author(s): Smith RR, Lavassani A, Zachow S, Wahl D, Mandybur G, Patrick B. Source: J Miss State Med Assoc. 2002 July; 43(7): 205-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189910
•
The management of post-herpetic neuralgia. Author(s): Cunningham AL, Dworkin RH. Source: Bmj (Clinical Research Ed.). 2000 September 30; 321(7264): 778-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11009498
•
The use of gabapentin for the treatment of postherpetic neuralgia. Author(s): Singh D, Kennedy DH. Source: Clinical Therapeutics. 2003 March; 25(3): 852-89. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852705
•
Tooth exfoliation, osteonecrosis and neuralgia following herpes zoster of trigeminal nerve. Author(s): Volvoikar P, Patil S, Dinkar A. Source: Indian J Dent Res. 2002 January-March; 13(1): 11-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12420562
Studies
61
•
Tramadol in post-herpetic neuralgia: a randomized, double-blind, placebo-controlled trial. Author(s): Boureau F, Legallicier P, Kabir-Ahmadi M. Source: Pain. 2003 July; 104(1-2): 323-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12855342
•
Treatment of trigeminal neuralgia: letter to editor. Author(s): Ranganath HN. Source: Neurology India. 2002 June; 50(2): 231. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12134205
•
Treatment options for trigeminal neuralgia. Author(s): Merrison AF, Fuller G. Source: Bmj (Clinical Research Ed.). 2003 December 13; 327(7428): 1360-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14670852
•
Trigeminal neuralgia (Fothergill's disease) in the 17th and 18th centuries. Author(s): Pearce JM. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 December; 74(12): 1688. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14638891
•
Trigeminal neuralgia caused by lymphomatous compression at oval foramen. Author(s): Watanabe J, Mizunuma N, Aruga A, Oguchi M, Hatake K. Source: European Journal of Haematology. 2002 May; 68(5): 323. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12144542
•
Trigeminal neuralgia caused by microarteriovenous malformations of the trigeminal nerve root entry zone: symptomatic relief following complete excision of the lesion with nerve root preservation. Author(s): Edwards RJ, Clarke Y, Renowden SA, Coakham HB. Source: Journal of Neurosurgery. 2002 October; 97(4): 874-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405376
•
Trigeminal neuralgia caused by nasopharyngeal carcinoma with skull base invasion-a case report. Author(s): Wang CJ, Howng SL. Source: Kaohsiung J Med Sci. 2001 December; 17(12): 630-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12168498
62
Neuralgia
•
Trigeminal neuralgia in a patient with a dural arteriovenous fistula in Meckel's cave: case report. Author(s): Du R, Binder DK, Halbach V, Fischbein N, Barbaro NM. Source: Neurosurgery. 2003 July; 53(1): 216-21; Discussion 221. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12823893
•
Trigeminal neuralgia presenting as Chiari I malformation. Author(s): Chakraborty A, Bavetta S, Leach J, Kitchen N. Source: Minimally Invasive Neurosurgery : Min. 2003 February; 46(1): 47-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640584
•
Trigeminal neuralgia. Author(s): Miles J, Eldridge P. Source: British Journal of Neurosurgery. 1998 June; 12(3): 288-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11013699
•
Trigeminal neuralgia. Author(s): Zakrzewska JM. Source: Clin Evid. 2002 June; (7): 1221-31. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230739
•
Trigeminal neuralgia. An overview of diagnosis and treatment. Author(s): Rash EM. Source: Adv Nurse Pract. 2003 November; 11(11): 56, 59-60. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639883
•
Trigeminal neuralgia: current treatments and future developments. Author(s): Fisher A, Zakrzewska JM, Patsalos PN. Source: Expert Opinion on Emerging Drugs. 2003 May; 8(1): 123-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14610917
•
Trigeminal neuralgia: pathogenesis and treatment. Author(s): Adams CB. Source: British Journal of Neurosurgery. 1997 December; 11(6): 493-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11013619
•
Trochlear nerve palsy after repeated percutaneous balloon compression for recurrent trigeminal neuralgia: case report and pathogenic considerations. Author(s): Urculo E, Alfaro R, Arrazola M, Astudillo E, Rejas G. Source: Neurosurgery. 2004 February; 54(2): 505-8; Discussion 508-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14744298
Studies
63
•
Unusual causes of trigeminal neuralgia treated by gamma knife radiosurgery. Report of two cases. Author(s): Chang JW, Choi JY, Yoon Y, Park YG, Chung SS. Source: Journal of Neurosurgery. 2002 December; 97(5 Suppl): 533-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12507091
•
Use of computed tomography for mandibular nerve block in the treatment of trigeminal neuralgia. Author(s): Okuda Y, Takanishi T, Shinohara M, Nagao M, Kitajima T. Source: Regional Anesthesia and Pain Medicine. 2001 July-August; 26(4): 382. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11464362
•
Use of computed tomography for maxillary nerve block in the treatment of trigeminal neuralgia. Author(s): Okuda Y, Okuda K, Shinohara M, Kitajima T. Source: Regional Anesthesia and Pain Medicine. 2000 July-August; 25(4): 417-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10925941
•
Use of endoscopic transthoracic sympathicotomy in intractable postherpetic neuralgia of the chest. Author(s): Matsumoto I, Oda M, Shintani H. Source: Chest. 2002 August; 122(2): 715-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12171855
•
Use of gabapentin for postherpetic neuralgia: results of two randomized, placebocontrolled studies. Author(s): Stacey BR, Glanzman RL. Source: Clinical Therapeutics. 2003 October; 25(10): 2597-608. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14667960
•
Vagoglossopharyngeal neuralgia caused by a neuroma of vagal rootlets. Author(s): Ferroli P, Franzini A, Pluderi M, Broggi G. Source: Acta Neurochirurgica. 1999; 141(8): 897-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10536731
•
Varicella-zoster virus, shingles and postherpetic neuralgia. Author(s): Shuttleworth A. Source: Prof Nurse. 2003 December; 19(4): 195-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14692251
64
Neuralgia
•
Vascular compression in glossopharyngeal neuralgia: demonstration by highresolution MRI at 3 tesla. Author(s): Fischbach F, Lehmann TN, Ricke J, Bruhn H. Source: Neuroradiology. 2003 November; 45(11): 810-1. Epub 2003 August 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12942220
•
Vascular compression in trigeminal neuralgia shown by magnetic resonance imaging and magnetic resonance angiography image registration. Author(s): Bakshi R, Lerner A, Fritz JV, Sambuchi GD. Source: Archives of Neurology. 2001 August; 58(8): 1290-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11493171
•
Venous angioma adjacent to the root entry zone of the trigeminal nerve: implications for management of trigeminal neuralgia. Author(s): Peterson AM, Williams RL, Fukui MB, Meltzer CC. Source: Neuroradiology. 2002 April; 44(4): 342-6. Epub 2002 February 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11914813
•
What is Sluder's neuralgia? Author(s): Ahamed SH, Jones NS. Source: The Journal of Laryngology and Otology. 2003 June; 117(6): 437-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818050
•
What is the prognosis of postherpetic neuralgia? Author(s): Gazewood JD, Meadows S. Source: The Journal of Family Practice. 2003 June; 52(6): 496-7; Discussion 497. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12791234
65
CHAPTER 2. NUTRITION AND NEURALGIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and neuralgia.
Finding Nutrition Studies on Neuralgia The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “neuralgia” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
66
Neuralgia
The following information is typical of that found when using the “Full IBIDS Database” to search for “neuralgia” (or a synonym): •
37 cases of trigeminal neuralgia treated by acupuncture of point quanliao. Source: Cui, S G J-Tradit-Chin-Med. 1988 June; 8(2): 101-2 0254-6272
•
51 cases of occipital neuralgia treated with acupuncture. Author(s): 157th Hospital of PLA, Guangzhou. Source: Xie, Z J-Tradit-Chin-Med. 1992 September; 12(3): 180-1 0254-6272
•
Acupuncture treatment of 61 cases of supraorbital neuralgia. Source: Xia, S Z Wang, W M Chen, Z S Zheng, J Z J-Tradit-Chin-Med. 1987 June; 7(2): 116-8 0254-6272
•
Effect of Ganoderma lucidum on postherpetic neuralgia. Author(s): Tokyo Hijikata Clinic, Osaka, Japan. Source: Hijikata, Y Yamada, S Am-J-Chin-Med. 1998; 26(3-4): 375-81 0192-415X
•
Evaluation of acceleration plethysmograms in dermatology--efficacy of lipo PGE1 preparations against herpes zoster and neuralgia following herpes. Author(s): Department of Dermatology, Tokyo Medical College, Japan. Source: Okuda, T Oh i, T Koga, M J-Dermatol. 1997 December; 24(12): 751-7 0385-2407
•
Long-term epidural ketamine, morphine and bupivacaine attenuate reflex sympathetic dystrophy neuralgia. Author(s): Department of Anaesthesiology, Tri-Service General Hospital and National Defence Medical Centre, Taipei, Taiwan, ROC. Source: Lin, T C Wong, C S Chen, F C Lin, S Y Ho, S T Can-J-Anaesth. 1998 February; 45(2): 175-7 0832-610X
•
Massage and acupuncture in 58 cases of superior clunial neuralgia. Author(s): Affiliated Hospital of Changchun College of Traditional Chinese Medicine, Jilin Province. Source: Li, X Mu, D J-Tradit-Chin-Med. 1992 December; 12(4): 288-9 0254-6272
•
Medical treatment of common cervicobrachial neuralgia. Author(s): Service de Rhumatologie, Centre hospitalier Lyon Sud, Pierre-Benite, France. Source: Larbre, J P Fournier, S Perret, P Llorca, G J-Neuroradiol. 1992 September; 19(3): 191-6 0150-9861
•
Postherpetic neuralgia: current concepts and management. Author(s): Pain Relief Clinic, Whipps Cross Hospital, London. Source: Lee, J J Gauci, C A Br-J-Hosp-Med. 1994 December 14-1995 January 17; 52(11): 565-7, 570 0007-1064
•
Sluder's sphenopalatine ganglion neuralgia--treatment with 88% phenol. Author(s): Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA. Source: Puig, C M Driscoll, C L Kern, E B Am-J-Rhinol. 1998 Mar-April; 12(2): 113-8 1050-6586
•
The use of capsaicin in herpes zoster ophthalmicus neuralgia. Author(s): Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel. Source: Frucht Pery, J Feldman, S T Brown, S I Acta-Ophthalmol-Scand. 1997 June; 75(3): 311-3 1395-3907
Nutrition
67
•
Topical 0.025% capsaicin in chronic post-herpetic neuralgia: efficacy, predictors of response and long-term course. Author(s): Neurologische Klinik und Poliklinik, Technischen Universitat, Munchen, Federal Republic of Germany. Source: Peikert, A Hentrich, M Ochs, G J-Neurol. 1991 December; 238(8): 452-6 0340-5354
•
Treatment of chronic pain syndromes with transcutaneous iontophoresis of vinca alkaloids, with special regard to post-herpetic neuralgia. Author(s): Department of Clinical Neurology, Albert Szent-Gyorgyi Medical University, Szeged, Hungary. Source: Tajti, J Somogyi, I Szilard, J Acta-Med-Hung. 1989; 46(1): 3-12 0236-5286
•
Treatment of postherpetic neuralgia. Author(s): Department of Neurology, University of California, San Francisco 94143. Source: Rowbotham, M C Semin-Dermatol. 1992 September; 11(3): 218-25 0278-145X
•
Treatment of primary trigeminal neuralgia with acupuncture at the sphenopalatine ganglion. Author(s): Third Teaching Hospital, Beijing Medical University. Source: Guo, J Kang, X Zhang, S J-Tradit-Chin-Med. 1995 March; 15(1): 31-3 0254-6272
•
Treatment of trigeminal neuralgia with acupuncture at renying point--A report of 7 cases. Author(s): Shanxi Provincial People's Hospital, Taiyuan. Source: Lu, X Liu, H Shi, X J-Tradit-Chin-Med. 1997 June; 17(2): 122-3 0254-6272
•
Trigeminal neuralgia managed by a change in lifestyle. Author(s): St. Christopher Hospice, Sydenham, London, UK. Source: Davies, A N O'Donnell, V J-Palliat-Care. 1997 Summer; 13(2): 50-1 0825-8597
•
Twenty-three cases of postherpetic neuralgia treated by acupuncture. Author(s): Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. Source: Wu, J Guo, Z J-Tradit-Chin-Med. 2000 March; 20(1): 36-7 0254-6272
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
•
The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
68
Neuralgia
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMDHealth: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to neuralgia; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com
•
Food and Diet Diabetes Source: Healthnotes, Inc.; www.healthnotes.com Pain Source: Healthnotes, Inc.; www.healthnotes.com
69
CHAPTER 3. ALTERNATIVE MEDICINE AND NEURALGIA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to neuralgia. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to neuralgia and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “neuralgia” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to neuralgia: •
37 cases of trigeminal neuralgia treated by acupuncture of point quanliao. Author(s): Cui SG. Source: J Tradit Chin Med. 1988 June; 8(2): 101-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3412001
•
51 cases of occipital neuralgia treated with acupuncture. Author(s): Xie Z. Source: J Tradit Chin Med. 1992 September; 12(3): 180-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1453754
•
A novel treatment of postherpetic neuralgia using peppermint oil. Author(s): Davies SJ, Harding LM, Baranowski AP.
70
Neuralgia
Source: The Clinical Journal of Pain. 2002 May-June; 18(3): 200-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12048423 •
A rapid hypnotic technique in a case of atypical facial neuralgia. Author(s): Swerdlow B. Source: Headache. 1984 March; 24(2): 104-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6715156
•
Acupuncture analgesia for the treatment of trigeminal neuralgias: a series of forty-one cases. Author(s): Man PL. Source: Journal of the National Medical Association. 1975 March; 67(2): 115-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1133858
•
Acupuncture and postherpetic neuralgia. Author(s): Jolly C. Source: British Medical Journal. 1980 September 27; 281(6244): 871. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7427486
•
Acupuncture and postherpetic neuralgia. Author(s): Lewith GT, Field J. Source: British Medical Journal. 1980 August 30; 281(6240): 622. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7427403
•
Acupuncture treatment of 61 cases of supraorbital neuralgia. Author(s): Xia SZ, Wang WM, Chen ZS, Zheng JZ. Source: J Tradit Chin Med. 1987 June; 7(2): 116-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3448389
•
Acupuncture vs carbamazepine in trigeminal neuralgia. Author(s): Salim M. Source: J Pak Med Assoc. 1993 January; 43(1): 13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8474213
•
Comment on the article by Paul R. Layman, E. Argyras, and C.J. Glynn entitled 'Iontophoresis of vincristine versus saline in post-herpetic neuralgia. A controlled trial.' Pain, 25 (1986) 165-170. Author(s): Gangarosa LP Sr. Source: Pain. 1988 November; 35(2): 230-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3070456
Alternative Medicine 71
•
Concerning the management of pain associated with herpes zoster and of postherpetic neuralgia. Author(s): King RB. Source: Pain. 1988 April; 33(1): 73-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3380554
•
Consumer views on management of trigeminal neuralgia. Author(s): Zakrzewska JM. Source: Headache. 2001 April; 41(4): 369-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11318883
•
Current concepts concerning the etiology and treatment of trigeminal neuralgia. Author(s): Rosenkopf KL. Source: Cranio. 1989 October; 7(4): 312-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2701091
•
Effect of Ganoderma lucidum on postherpetic neuralgia. Author(s): Hijikata Y, Yamada S. Source: The American Journal of Chinese Medicine. 1998; 26(3-4): 375-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9862025
•
Electrical stimulation of the trigeminal tract in chronic, intractable facial neuralgia. Author(s): Holsheimer J. Source: Archives of Physiology and Biochemistry. 2001 October; 109(4): 304-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11935364
•
Epidural electrical stimulation of the motor cortex in patients with facial neuralgia. Author(s): Rainov NG, Fels C, Heidecke V, Burkert W. Source: Clinical Neurology and Neurosurgery. 1997 August; 99(3): 205-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9350402
•
Evaluation of patients with atypical trigeminal neuralgia for permanent electrode implant by test stimulation of the ganglion gasseri. Author(s): Waidhauser E, Steude U. Source: Stereotactic and Functional Neurosurgery. 1994; 62(1-4): 304-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7631087
•
Experience in acupuncture treatment of occipital neuralgia. Author(s): Wang H, Chen H, Jiang H. Source: J Tradit Chin Med. 2002 September; 22(3): 183. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12400421
72
Neuralgia
•
Facial neuralgia cured by acupuncture a century and a half ago. Author(s): Ring ME. Source: Bull Hist Dent. 1995 March; 43(1): 28. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8696151
•
Hypnosis in the management of postherpetic neuralgia: three case studies. Author(s): Dane JR, Rowlingson JC. Source: Am J Clin Hypn. 1988 October; 31(2): 107-13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3228059
•
Integrative approach to the treatment of postherpetic neuralgia: a case series. Author(s): Hui F, Cheng A, Chiu M, Vayda E. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1999 December; 4(6): 429-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10608916
•
Iontophoresis of vincristine versus saline in post-herpetic neuralgia. A controlled trial. Author(s): Layman PR, Argyras E, Glynn CJ. Source: Pain. 1986 May; 25(2): 165-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3523393
•
Iontophoretic vincristine in the treatment of postherpetic neuralgia: a double-blind, randomized, controlled trial. Author(s): Dowd NP, Day F, Timon D, Cunningham AJ, Brown L. Source: Journal of Pain and Symptom Management. 1999 March; 17(3): 175-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10098360
•
Life after shingles: the management of postherpetic neuralgia. Author(s): Williams H. Source: British Journal of Community Nursing. 2002 June; 7(6): 286-7, 290-1. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12066061
•
Local anaesthetic block therapy of posttraumatic neuralgia of the infraorbital nerve. Author(s): de Vries N, Smelt WL. Source: Rhinology. 1990 June; 28(2): 103-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2385776
•
Management of herpes zoster (shingles) and postherpetic neuralgia. Author(s): Johnson RW, Whitton TL.
Alternative Medicine 73
Source: Expert Opinion on Pharmacotherapy. 2004 March; 5(3): 551-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15013924 •
Management of postherpetic neuralgia. Author(s): Lefkowitz M, Marini RA. Source: Ann Acad Med Singapore. 1994 November; 23(6 Suppl): 139-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7710224
•
Management of post-herpetic neuralgia. Author(s): Parris WC. Source: J Tenn Med Assoc. 1984 October; 77(10): 575-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6389985
•
Manipulative treatment of 12 cases of cervical spondylosis with trigeminal neuralgia. Author(s): Liu SJ, Shen ZX, Cao GL. Source: J Tradit Chin Med. 1982 June; 2(2): 115-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6765698
•
Massage and acupuncture in 58 cases of superior clunial neuralgia. Author(s): Li X, Mu D. Source: J Tradit Chin Med. 1992 December; 12(4): 288-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1291823
•
Neurophysiological explorations in cervicobrachial neuralgia. Author(s): Vial C, Bady B. Source: Journal of Neuroradiology. Journal De Neuroradiologie. 1992 September; 19(3): 154-9. Review. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1432113
•
Observation on the effect of acupuncture treatment in 300 cases of primary trigeminal neuralgia. Author(s): Xu BR, Ge SH. Source: J Tradit Chin Med. 1981 September; 1(1): 51-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6926691
•
Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia. Author(s): Zhang Z. Source: J Tradit Chin Med. 1997 December; 17(4): 272-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437209
74
Neuralgia
•
Palliative dental therapy of postsurgical side effects in trigeminal neuralgia: a case report. Author(s): Shapira EZ. Source: Cranio. 1990 October; 8(4): 359-62. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1711419
•
Percutaneous retrogasserian glycerol rhizolysis for treatment of trigeminal neuralgia. Technique and results in 191 patients. Author(s): Cappabianca P, Spaziante R, Graziussi G, Taglialatela G, Peca C, De Divitiis E. Source: Journal of Neurosurgical Sciences. 1995 March; 39(1): 37-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8568554
•
Plasma opioid levels in post-traumatic chronic headache and trigeminal neuralgia: maintained response to acupuncture. Author(s): Nappi G, Facchinetti F, Bono G, Micieli G, Parrini D, Martignoni E, Petraglia F, Genazzani AR. Source: Headache. 1982 November; 22(6): 276-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6293998
•
Postherpetic neuralgia. A review. Author(s): Watson PN, Evans RJ. Source: Archives of Neurology. 1986 August; 43(8): 836-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2873807
•
Post-herpetic neuralgia: 208 cases. Author(s): Watson CP, Evans RJ, Watt VR, Birkett N. Source: Pain. 1988 December; 35(3): 289-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2852344
•
Postherpetic neuralgia: clinical experience with a conservative treatment. Author(s): Niv D, Ben-Ari S, Rappaport A, Goldofski S, Chayen M, Geller E. Source: The Clinical Journal of Pain. 1989 December; 5(4): 295-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2562461
•
Post-herpetic neuralgia: possible mechanisms for pain relief with manual therapy. Author(s): Rabey MI. Source: Manual Therapy. 2003 August; 8(3): 180-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12909440
•
Postherpetic ophthalmic neuralgia. Author(s): Devulder JE.
Alternative Medicine 75
Source: Bull Soc Belge Ophtalmol. 2002; (285): 19-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12442339 •
Practical application of meridian acupuncture treatment for trigeminal neuralgia. Author(s): Beppu S, Sato Y, Amemiya Y, Tode I. Source: Anesth Pain Control Dent. 1992 Spring; 1(2): 103-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1392684
•
Results of treatment of trigeminal neuralgia by microvascular decompression of the Vth nerve at its root entry zone. Author(s): Romansky K, Stoianchev N, Dinev E, Iliev I. Source: Archives of Physiology and Biochemistry. 1998 December; 106(5): 392-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10441061
•
Retrogasserian glycerol rhizotomy and its selectivity in the treatment of trigeminal neuralgia. Author(s): Bergenheim AT, Hariz MI, Laitinen LV. Source: Acta Neurochir Suppl (Wien). 1993; 58: 174-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8109286
•
Sacral magnetic stimulation for pain relief from pudendal neuralgia and sciatica. Author(s): Sato T, Nagai H. Source: Diseases of the Colon and Rectum. 2002 February; 45(2): 280-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11852346
•
Selectivity of retrogasserian glycerol rhizotomy in the treatment of trigeminal neuralgia. Author(s): Bergenheim AT, Hariz MI, Laitinen LV. Source: Stereotactic and Functional Neurosurgery. 1991; 56(3): 159-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1796220
•
Temporary relief of postherpetic neuralgia pain with topical geranium oil. Author(s): Greenway FL, Frome BM, Engels TM 3rd, McLellan A. Source: The American Journal of Medicine. 2003 November; 115(7): 586-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14599644
•
The osteopathic management of trigeminal neuralgia. Author(s): Lay EM. Source: J Am Osteopath Assoc. 1975 January; 74(5): 373-89. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1037702
76
Neuralgia
•
Therapeutic effects of the point-injection therapy on primary trigeminal neuralgia--an observation of 103 cases. Author(s): Lin M. Source: J Tradit Chin Med. 2003 September; 23(3): 195-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14535184
•
Traumatic neuralgias. Author(s): Conway SR, Warfield CA. Source: Hosp Pract (Off Ed). 1986 July 15; 21(7): 44A, 44F-44G. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3088012
•
Treatment of chronic pain syndromes with transcutaneous iontophoresis of vinca alkaloids, with special regard to post-herpetic neuralgia. Author(s): Tajti J, Somogyi I, Szilard J. Source: Acta Med Hung. 1989; 46(1): 3-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2549500
•
Treatment of herpes zoster and postherpetic neuralgia. Author(s): Carmichael JK. Source: American Family Physician. 1991 July; 44(1): 203-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1676237
•
Treatment of post herpetic neuralgia in the elderly. Author(s): Robertson DR, George CF. Source: British Medical Bulletin. 1990 January; 46(1): 113-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2405937
•
Treatment of postherpetic neuralgia. Author(s): Menke JJ, Heins JR. Source: Journal of the American Pharmaceutical Association (Washington,D.C. : 1996). 1999 March-April; 39(2): 217-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10079653
•
Treatment of postherpetic neuralgia. Author(s): Rowbotham MC. Source: Semin Dermatol. 1992 September; 11(3): 218-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1390037
•
Treatment of primary trigeminal neuralgia with acupuncture at the sphenopalatine ganglion. Author(s): Guo J, Kang X, Zhang S.
Alternative Medicine 77
Source: J Tradit Chin Med. 1995 March; 15(1): 31-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7783458 •
Treatment of primary trigeminal neuralgia with acupuncture in 1500 cases. Author(s): Ge S, Xu B, Zhang Y. Source: J Tradit Chin Med. 1991 March; 11(1): 3-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1861508
•
Treatment of trigeminal neuralgia with acupuncture at renying point--A report of 7 cases. Author(s): Lu X, Liu H, Shi X. Source: J Tradit Chin Med. 1997 June; 17(2): 122-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10437181
•
Treatments for postherpetic neuralgia--a systematic review of randomized controlled trials. Author(s): Volmink J, Lancaster T, Gray S, Silagy C. Source: Family Practice. 1996 February; 13(1): 84-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8671108
•
Trigeminal neuralgia triggered by auditory stimuli in multiple sclerosis. Author(s): Hartmann M, Rottach KG, Wohlgemuth WA, Pfadenhauer K. Source: Archives of Neurology. 1999 June; 56(6): 731-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10369314
•
Trigeminal neuralgia: a personal review and nursing implications. Author(s): McConaghy DJ. Source: The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses. 1994 April; 26(2): 85-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8077780
•
Trigeminal neuralgia: are all of the treatment options being considered? Author(s): Campbell JK. Source: Headache. 1997 January; 37(1): H3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9091464
•
Trigeminal neuralgia: management of two cases with hypnotherapy. Author(s): Gurian B. Source: Anesthesia Progress. 1985 September-October; 32(5): 206-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3866504
78
Neuralgia
•
Trigeminal neuralgia: sudden and long-term remission with transcutaneous electrical nerve stimulation. Author(s): Thorsen SW, Lumsden SG. Source: Journal of Manipulative and Physiological Therapeutics. 1997 July-August; 20(6): 415-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9272474
•
Trigeminal neuralgia: treatment failure with auriculotherapy: two case reports. Author(s): Lapeer GL. Source: Cranio. 1990 January; 8(1): 55-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2098189
•
Trigeminal neuralgia--an update. Author(s): Turp JC, Gobetti JP. Source: Compend Contin Educ Dent. 2000 April; 21(4): 279-82, 284, 287-8 Passim; Quiz 292. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11199681
•
Twenty-three cases of postherpetic neuralgia treated by acupuncture. Author(s): Wu J, Guo Z. Source: J Tradit Chin Med. 2000 March; 20(1): 36-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10921168
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMDHealth: http://my.webmd.com/drugs_and_herbs
Alternative Medicine 79
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to neuralgia; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Low Back Pain Source: Integrative Medicine Communications; www.drkoop.com Nerve Pain Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Shingles and Postherpetic Neuralgia Source: Healthnotes, Inc.; http://www.healthnotes.com/ Wounds Source: Integrative Medicine Communications; www.drkoop.com
•
Chinese Medicine Sanqi Shangyao Pian Alternative names: anqi Shangyao Tablets; Sanqi Shangyao Pian (San Qi Shang Yao Pi An) Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China
•
Herbs and Supplements Adenosine Monophosphate Source: Healthnotes, Inc.; www.healthnotes.com Adenosine Monophosphate (amp) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10106,00.html Baclofen Source: Healthnotes, Inc.; www.healthnotes.com Cayenne Alternative names: Capsicum annuum, Capsicum frutescens Source: Healthnotes, Inc.; www.healthnotes.com
80
Neuralgia
Cayenne Source: Prima Communications, Inc.www.personalhealthzone.com Cayenne Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,765,00.html Corydalis Alternative names: Corydalis turtschaninovii, Corydalis yanhusuo Source: Healthnotes, Inc.; www.healthnotes.com Hops Alternative names: Humulus lupulus Source: Healthnotes, Inc.; www.healthnotes.com Hops Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Jamaica Dogwood Alternative names: Piscidia erythrina, Piscidia piscipula Source: Integrative Medicine Communications; www.drkoop.com Jamaican Dogwood Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lemon Balm Alternative names: Melissa officinalis Source: Healthnotes, Inc.; www.healthnotes.com Licorice Alternative names: Glycyrrhiza glabra, Glycyrrhiza uralensis Source: Healthnotes, Inc.; www.healthnotes.com Passiflora Incarnata Source: Integrative Medicine Communications; www.drkoop.com Passionflower Alternative names: Passiflora incarnata Source: Integrative Medicine Communications; www.drkoop.com Piscidia Erythrina Source: Integrative Medicine Communications; www.drkoop.com Piscidia Piscipula Source: Integrative Medicine Communications; www.drkoop.com Rosemary Alternative names: Rosmarinus officinalis Source: Integrative Medicine Communications; www.drkoop.com
Alternative Medicine 81
Rosemary Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Rosmarinus Officinalis Source: Integrative Medicine Communications; www.drkoop.com St. John's Wort Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Wild Yam Alternative names: Dioscorea villosa Source: Healthnotes, Inc.; www.healthnotes.com Wild Yam Source: Prima Communications, Inc.www.personalhealthzone.com Wild Yam Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Wood Betony Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
83
CHAPTER 4. CLINICAL TRIALS AND NEURALGIA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning neuralgia.
Recent Trials on Neuralgia The following is a list of recent trials dedicated to neuralgia.8 Further information on a trial is available at the Web site indicated. •
Controlled Study of NGX-4010 for the Treatment of Postherpetic Neuralgia Condition(s): Herpes Zoster; Neuralgia; Pain; Peripheral Nervous System Diseases Study Status: This study is currently recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of the study is to assess the efficacy, safety and tolerability of NGX 4010 applied for 60 minutes for the treatment of PHN. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00068081
•
Randomized Study of L-Baclofen in Patients with Refractory Trigeminal Neuralgia Condition(s): Trigeminal Neuralgia Study Status: This study is currently recruiting patients. Sponsor(s): FDA Office of Orphan Products Development; University of Pittsburgh Purpose - Excerpt: Objectives: I. Evaluate the efficacy of L-baclofen in patients with refractory trigeminal neuralgia. II. Evaluate the safety and tolerance of L-baclofen in these patients.
8
These are listed at www.ClinicalTrials.gov.
84
Neuralgia
Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004431 •
NGX-4010 for the Treatment of Postherpetic Neuralgia Condition(s): Herpes Zoster; Neuralgia; Pain; Peripheral Nervous System Diseases; Shingles Study Status: This study is no longer recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of the study is determine if an investigational drug, NGX-4010 (high-concentration capsaicin dermal patches) is effective in treating pain associated with post-herpetic neuralgia (PHN). Phase(s): Phase II; Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00061776
•
Pilot Study of High-Dose Capsaicin Patches to Treat Postherpetic Neuralgia Pain Condition(s): Neuralgia; Pain; Peripheral Nervous System Diseases; Herpes Zoster Study Status: This study is no longer recruiting patients. Sponsor(s): NeurogesX Purpose - Excerpt: The purpose of this study is to gain initial information on the tolerability of high-dose capsaicin patches in patients with Painful Postherpetic Neuralgia. The study will also collect preliminary information on safety and efficacy. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034710
•
Shingles Prevention Study Condition(s): Herpes Zoster; Postherpetic neuralgia Study Status: This study is no longer recruiting patients. Sponsor(s): Department of Veterans Affairs; Department of Veterans Affairs Cooperative Studies Program; SmithKline Beecham; Merck; National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: The incidence and severity of HZ (or shingles), as well as the frequency and severity of its complications, increases markedly with increasing age. More than half of all cases occur in persons over the age of 60. Even without complications, HZ can interfere with an elderly patient's ability to perform essential activities of daily living, resulting in a loss of independence that is emotionally devastating and frequently irreversible. The most common complication of HZ in elderly persons is postherpetic neuralgia (PHN), which frequently results in disordered sleep, chronic fatigue, anxiety and severe depression. Antiviral therapy has a modest
Clinical Trials 85
impact on the acute phase of HZ. However, it does not appear to prevent the development of PHN. This study is a 5.5 year randomized, double-blind, placebocontrolled, efficacy trial to determine whether vaccination with live-attenuated Oka/Merck varicella-zoster decreases the incidence and/or severity of herpes zoster (HZ) and its complications in adults 60 years of age and older. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00007501 •
Dextromethorphan Versus Placebo for Neuropathic Pain Condition(s): Diabetic Neuropathies; Herpes Zoster; Neuralgia Study Status: This study is completed. Sponsor(s): National Institute of Dental and Craniofacial Research (NIDCR) Purpose - Excerpt: In our current clinical trial, we are comparing the effects of two NMDA receptor antagonists to placebo in patients with painful distal symmetrical diabetic neuropathy or post-herpetic neuralgia. The treatments in this three-period crossover study are dextromethorphan, up to 920 mg/day (about 8 times the antitussive dose), memantine, 30-50 mg/day, and placebo. Memantine is an NMDA antagonist used in Europe to treat Parkinson's disease and Alzheimer's disease. The underlying hypothesis, based on studies of painful neuropathies in animal models, is that neuropathic pain is caused largely by sensitization of central nervous system neurons caused by excitatory amino acid neurotransmitters, acting largely through NMDA receptors. A previous small trial of dextromethorphan suggested efficacy in diabetic neuropathy pain. The study requires one visit to the NIH outpatient Pain Research Clinic, and consists of three 9-week treatment periods. Patients who respond to one of the medications will be invited to participate in further controlled studies of the medication followed by up to several years of open-label treatment under continued observation. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001344
•
Phase III Randomized Controlled Study of Morphine and Nortriptyline in the Management of Postherpetic Neuralgia Condition(s): Pain; Herpes Zoster Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); National Institute of Neurological Disorders and Stroke (NINDS); Johns Hopkins University Purpose - Excerpt: Objectives: I. Determine whether opioid (morphine) treatment results in better management of pain than treatment with tricyclic antidepressant (nortriptyline). II. Assess the effects the two treatments have on affective and cognitive functions. III. Determine whether the presence of psychiatric comorbidity, particularly depression, can predict the outcome of the two treatments.
86
Neuralgia
Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004390 •
Studies of Dextromethorphan and Topiramate to Treat Oral and Facial Pain Condition(s): Facial Neuralgia; Pain; Trigeminal Neuralgia Study Status: This study is completed. Sponsor(s): National Institute of Dental and Craniofacial Research (NIDCR) Purpose - Excerpt: This study will evaluate the safety and effectiveness of two drugsdextromethorphan and topiramate-in treating orofacial (mouth and face) pain. Dextromethorphan, a commonly used cough suppressant, and topiramate, an antiseizure medicine, block certain receptors on brain and spinal nerve cells that may cause the cells to produce electrical discharges and pain. Patients 18 years of age and older with oral and facial pain with trigeminal nerve damage and who have had pain daily for at least 3 months may be eligible for this study. Candidates will be screened with a medical history, physical examination, blood tests and psychiatric evaluation. These results will serve as baseline values for participants. Those enrolled in the study will take either dextromethorphan or topiramate in a 2-part study as follows: Dextromethorphan In Part 1, patients will take dextromethorphan and lorazepam (a commonly used anti-anxiety drug) separately in two 6-week periods. (Lorazepam is used in this study as an "active placebo" for comparison with dextromethorphan. An active placebo is a drug that does not work for the problem being studied but whose side effects are like those of the test drug.) They will take dextromethorphan for 4 weeks to determine the maximum tolerated dose (the highest dose that does not cause troubling side effects) and will stay on that dose for the remaining 2 weeks. Then they will repeat this process with lorazepam. Patients who respond to either drug may continue with Part 2 of the study, which compares these two drugs four more times to confirm the response seen in Part 1. In Part 2, the maximum tolerated dose will be determined in a 2-week period and that dose will be continued for another 2 weeks. This procedure will be repeated eight times. Throughout the study, patients will keep a daily pain diary. They will be contacted by telephone 2 to 3 times a week during dose escalation to check for side effects. At the end of each of the two 6-week periods in Part 1 and at the end of each 4-week period in Part 2 of the study, patients will have a 1-hour clinic visit. Participants who live more than a few hours' drive from NIH will have a full telephone follow-up evaluation instead of the clinic visits. Topiramate Patients who receive topiramate will follow a plan similar to that described above for dextromethorphan, with the following exceptions. They will take topiramate and an inactive placebo (a look-alike pill that has no active ingredients) in two separate 12-week periods. Patients' maximum tolerated dose will be determined in the first 8 weeks and they will stay on that dose for the remaining 4 weeks of each period. Patients who respond to the medication in Part 1 may continue with Part 2 to confirm the response. Part 2 consists of six 6-week periods. The first 4 weeks of each will be used to determine the maximum tolerated dose and the patient will remain on that dose for the next 2 weeks. Patients will keep a daily pain diary and will be contacted by phone 2 to 3 times a week while doses are being increased. Patients who complete Part 2 of the topiramate study may participate in another phase of the study that will last for 2 years. Those who continue for this phase will take topiramate for the 2-year period. They will be followed regularly by a study nurse and will come to NIH every 6 months for a follow-up visit.
Clinical Trials 87
Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001725
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “neuralgia” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
•
For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
•
For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
•
For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
•
For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
•
For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
•
For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
•
For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
•
For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
•
For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
•
For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
88
Neuralgia
•
For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
•
For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
•
For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
•
For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
89
CHAPTER 5. PATENTS ON NEURALGIA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “neuralgia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on neuralgia, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Neuralgia By performing a patent search focusing on neuralgia, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We
9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
90
Neuralgia
will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on neuralgia: •
All-in-one girdling belt for lumbar and coxa support Inventor(s): Nagaoka; Nobuo (107-11 Hirata-cho, Hikone City, Shiga, JP) Assignee(s): None Reported Patent Number: 5,782,781 Date filed: April 25, 1996 Abstract: The object of the invention is to provide an elastic girdling belt which serves to secure and maintain in a normal condition the connective structure of the coxae and lumbar vertebrae which support the pelvis in the human body, thus correcting the figure and not only serving to cure daily life affecting diseases caused by abnormalities in those regions such as lumbago, neuralgia, or internal organ disorders, but also producing significant effects in the prevention of these diseases. The girdling belt, while easy to handle, also produces noticeable effects in shaping the body and raising the hips, and at the same time allowing the greatest to the subtlest range of motion required for daily life without producing tight, uncomfortable feeling. Excerpt(s): The present invention details an all-in-one girdling belt which supports the lumbar vertebrae and the coxae (this device hereinafter shall be referred to as the Belt). The Belt is designed to secure and stabilize the connective structure of the coxae and lumbar vertebrae in a natural configuration in order to lend support to the pelvis. The employment of the Belt facilitates in correcting structural ailments in the pelvic region and also serves to shape the body, especially in achieving significant results by producing shapely hips. In the past, various products including corsets and belts have been utilized to correct or prevent abnormal curvatures or distortions in the lumbar vertebrae. These abnormalities can lead to sundry diseases such as lumbago, neuralgia, or disorders of internal organs. Some of the products produced consist of soft material, others hard; some are wide, others narrow. Each product has its own merits and demerits: a wide belt, designed primarily to immobilize the lumbar vertebrae, limits movement like a clamp; and a narrow belt, because it often slips up and down, does not provide sufficient steadiness. No corsets or belts have ever been developed for specialized use on the coxae, except for a method developed and used in Japan that consists of taking rubber tubes from bicycle tires and wrapping them tightly around the coxae. This method is effective for alleviating pains during stretching and bending exercises; however, the rubber tubes prove impractical for daily use because they are insecurely fixed and hamper freedom of walking. Web site: http://www.delphion.com/details?pn=US05782781__
•
Anticonvulsant derivatives useful in treating neuropathic pain Inventor(s): Shank; Richard P. (Blue Bell, PA), Wild; Kenneth (Pipersville, PA) Assignee(s): Ortho-mcneil Pharmaceutical, Inc. (raritan, Nj) Patent Number: 5,935,933 Date filed: May 5, 1998 Abstract: Anticonvulsant derivatives useful in treating neuropathic pain including but not limited to neuralgia are disclosed.
Patents 91
Excerpt(s): Compounds of Formula I were initially found to possess anticonvulsant activity in the traditional maximal electroshock seizure (MES) test in mice (SHANK, R. P., GARDOCKI, J. F., VAUGHT, J. L., DAVIS, C. B., SCHUPSKY, J. J., RAFFA, R. B., DODGSON, S. J., NORTEY, S. O., and MARYANOFF, B. E., Epilepsia 35 450-460, 1994). Subsequent studies revealed that Compounds of Formula I were also highly effective in the MES test in rats. More recently topiramate was found to effectively block seizures in several rodent models of epilepsy (J. NAKAMURA, S. TAMURA, T. KANDA, A. ISHII, K. ISHIHARA, T. SERIKAWA, J. YAMADA, and M. SASA, Eur. J. Pharmacol. 254 83-89, 1994), and in an animal model of kindled epilepsy (A. WAUQUIER and S. ZHOU, Epilepsy Res. 24 73-77, 1996). Recent preclinical studies on topiramate have revealed previously unrecognized pharmacological properties which suggest that topiramate is effective in treating some other disorders. One of these is neuropathic pain. R.sub.6 and R.sub.7 are the same or different and are hydrogen, lower alkyl or are alkyl and are joined to form a cyclopentyl or cyclohexyl ring. Web site: http://www.delphion.com/details?pn=US05935933__ •
Method for alleviating varicella related post-herpetic neuralgia Inventor(s): Calandra; Gary B. (Blue Bell, PA), Levin; Myron J. (Denver, CO), Provost; Philip J. (Lansdale, PA), White; C. Jo (Gwynedd, PA) Assignee(s): Merck & Co., Inc. (rahway, Nj), University of Colorado (boulder, Co) Patent Number: 5,997,880 Date filed: March 18, 1994 Abstract: Herpes Zoster, or varicella related post herpetic neuralgia is alleviated by immunizing people at risk of developing herpes zoster with varicella zoster virus (VZV) antigen. Excerpt(s): Post-herpetic neuralgia is the predominant morbidity associated with development of herpes-zoster, also known as shingles. The neuralgia typically lasts for from one to six months and is often excruciatingly painful. Evidence has accrued in recent years which shows that herpes-zoster is caused by reactivation of latent varicella virus [Straus et al., Ann. Int. Med. (1988); 108, 221-237; Hyman et al., Lancet (1983) 2, 814-816; Gilden et al., Nature (1983) 306, 478-80; Croen et al., Proc. Natl. Acad. Sci. USA (1988); 85, 9773-9777; Mahalingham et al., New Eng. J. Med. (1990) 323, 627-631]. The initial varicella infection may have occurred as a result of infantile chickenpox or as a result of immunization with a live-attenuated varicella zoster virus vaccine to prevent chickenpox. In either case, the virus appears to remain in the infected individual's system long after chickenpox or vaccination. The locus of VZV latency appears to be neural cells within dorsal root ganglia. Years after VZV has become latent, the virus reactivates by an as yet poorly understood mechanism. Nonetheless, the reactivation of VZV and its subsequent replication gives rise to herpes zoster. It is in the course of and subsequent to this reactivation of VZV that severe post-herpetic neuralgia develops. Web site: http://www.delphion.com/details?pn=US05997880__
92
•
Neuralgia
Method for treating nerve injury pain associated with shingles Inventor(s): Hind; Harry (Los Altos, CA) Assignee(s): Hind Health Care, Inc. (los Altos, Ca) Patent Number: 5,709,869 Date filed: December 23, 1996 Abstract: Methods and compositions are offered for reducing nerve injury pain associated with shingles (herpes-zoster and post-herpetic neuralgia), where intradermal delivery of lidocaine is maintained for a predetermined period of time. The lidocaine appears to specifically affect the damaged nerve fibers, while leaving the undamaged and normal nerve fibers with retention of response to other stimuli. Lidocaine formulations are provided which allow for the necessary dosage of the lidocaine in the dermis during the period of treatment. The formulation may be covered with an occlusive or non-occlusive dressing, which protects the lidocaine formulation from mechanical removal and enhances the transport of the lidocaine into the dermis. Long term relief is realized after maintenance of the administration of lidocaine has been terminated. Excerpt(s): The field of this invention is extended pain relief methods and compositions. The mechanism of pain generation in post-herpetic neuralgia is unknown. Post-herpetic neuralgia (PHN) begins with a cutaneous rash and the chronic state is notable for skin scarring and painfully sensitive skin (allodynia). Although the initial outbreak may be widespread, occasionally appearing to cover more than the area of skin innervated by a single dorsal root ganglion, most PHN patients are able to localize a limited area of skin as the source of their pain. PHN patients nearly always have a sensory deficit in the region obtained. The majority of work carried out on topical agents for analgesia in recent years has been in patients with PHN. Other conditions, particularly diabetic neuropathy, have been treated in clinical trials and clinical practice with topical agents, primarily capsaicin. Topical therapies represent a very attractive alternative to oral medications for conditions like PHN. The primarily elderly patients with PHN frequently cannot be treated with tricyclic antidepressants because of pre-existing cognitive impairment, cardiac disease, or systemic illness. Diabetic autonomic disfunction may significantly enhance orthostatic hypotension from tricyclic antidepressants. Side effects like constipation, dry mouth and sedation may prove so bothersome that compliance becomes a major problem in therapy. Anticonvulsants are of uncertain efficacy in PHN, though carbamazepine and antiarrhythmics like mexiletine are effective for diabetic neuropathy. Non-narcotic analgesics are rarely effective and benzodiazepines have been proven ineffective. Opioids may be effective, but have not been adequately evaluated as long term treatment for PHN or diabetic neuropathy. Web site: http://www.delphion.com/details?pn=US05709869__
•
Pain reliever and method of use Inventor(s): Holt; Stephen D. (Little Rock, AR), Laughlin; Timothy R. (Little Rock, AR) Assignee(s): Medical Merchandising, Inc. (little Rock, Ar) Patent Number: 5,856,361 Date filed: June 6, 1997
Patents 93
Abstract: A composition containing capsaicin together with another ingredient to neutralize the discomfort resulting from the application of capsaicin to the skin can be used to treat many types of discomforts, including musculo-skeletal pain, neuralgia and neurpathies, without the discomfort normally associated with the topical application of capsaicin. Excerpt(s): In one aspect, this invention relates to a composition of matter useful for treating bodily pains and discomforts. In another aspect, this invention relates to a method for treating bodily pains and discomforts. In yet another aspect, this invention relates to formulating a pain and discomfort reliever. Arthritis is medically termed as an inflammation of a joint or joints and is one of a number of diseases and disorders of the skeleton and body system. Arthritis arises from many causes, some well-defined, some still unknown, and it is treated in many different ways. There are two common types, the first of which is inflammatory, of which rheumatoid arthritis is the most commonly acknowledged and a non-inflammatory, second type, most commonly represented by degenerative joint disease, or "wear and tear" arthritis. Inflammatory arthritis is a disease not of the joints alone but of the whole bodily system, in particular, the connective tissues of the body. It is an autoimmune disease, where the body's immune system attacks its own host (i.e. itself) and produces inflammation. Degenerative joint disease is a chronic joint disease, often occurring in more elderly people. In both cases many manifestations are similar. The joints, whether singly or in multiples, are affected. The joints may become swollen, warm, deformed, gnarled, and in many instances present grotesque deformities. In many cases it also affects the adjacent muscles and tendons, as well as other connective tissues of the body. The primary disease produces symptomatic swelling, pain and stiffness. Various new and old drugs have been developed for the treatment of arthritis, anywhere from non-steroidal anti-inflammatory drugs to cortisone. Many of these systemic drugs have dangerous side effects. Their dosage must be carefully prescribed and administered under controlled conditions and circumstances to avoid unpleasant and dangerous side effects. Web site: http://www.delphion.com/details?pn=US05856361__ •
Peripheral nerve stimulation method Inventor(s): Weiner; Richard L. (5950 Lindenshire La., #408, Dallas, TX 75230) Assignee(s): None Reported Patent Number: 6,505,075 Date filed: May 22, 2000 Abstract: A method for treating pain by subcutaneous electrical stimulation of a peripheral nerve is disclosed. A lead is placed subcutaneously over a peripheral nerve that is causing pain. The peripheral nerve is electrically stimulated to cause paresthesia. The method encompasses subcutaneous placement of an electrical lead near any peripheral nerve causing pain and subsequent electrical stimulation of the nerve to cause paresthesia. In particular, a method for treating intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques is disclosed. Excerpt(s): This invention relates to a method for subcutaneously electrically stimulating peripheral nerves and in a particular embodiment relates to a method for subcutaneously electrically stimulating one or more occipital peripheral nerve to treat occipital neuralgia. Peripheral nerves are nerves in the body other than the nerves of the brain or spinal cord. Peripheral nerve injury may result in the development of chronic
94
Neuralgia
intractable pain. Some patients prove unresponsive to conservative pain management techniques. Peripheral Nerve Stimulation (PNS) has developed as a successful therapy for pain management when the pain is known to result from a specific nerve. PNS is based in part on the Melzack-Wall gate control theory of pain. Sweet and Wespic first used electrical stimulation of peripheral nerves in the 1960s to mask the sensation of pain with a tingling sensation (paresthesia) caused by the electrical stimulation. Subsequent refinements in the technology, surgical technique and patient selection have led to improved long term results. The surgical procedure is relatively simple. Web site: http://www.delphion.com/details?pn=US06505075__ •
Piperidine and morphonline derivatives and their use as therapeutic agents Inventor(s): Baker; Raymond (Uley, GB), Elliott; Jason Matthew (Knockholt, GB), Stevenson; Graeme Irvine (Saffron Walden, GB), Swain; Christopher John (Duxford, GB) Assignee(s): Merck Sharp & Dohme Ltd. (hoddesdon, Gb3) Patent Number: 5,830,892 Date filed: December 18, 1997 Abstract: The present invention provides compounds of formula (I), wherein R.sup.1 is a 5- or 6-membered aromatic heterocyclic group containing 1, 2, 3 or 4 heteroatoms selected from nitrogen, oxygen and sulphur, which group is optionally substituted; R.sup.2 is hydrogen, halogen, C.sub.1-6 alkyl, C.sub.1-6 alkoxy, CF.sub.3, OCF.sub.3, NO.sub.2, CN, SR.sup.a, SOR.sup.a, SO.sub.2 R.sup.a, CO.sub.2 R.sup.a, CONR.sup.a R.sup.b, C.sub.2-6 alkenyl, C.sub.2-6 alkynyl or C.sub.1-4 alkyl substitued by C.sub.1-4 alkoxy, where R.sup.a and R.sup.a R.sup.b each independently represent hydrogen or C.sub.1-4 alkyl; R.sup.3 is hydrogen, halogen, C.sub.1-6 alkyl, C.sub.1-6 -alkoxy substituted by C.sub.1-4 alkoxy or CF.sub.3; R.sup.4, R.sup.5, R.sup.6, R.sup.9a, R.sup.9b, A, X and Y are as defined in the specification; and m is zero or , and pharmaceutically acceptable salts and prodrugs thereof. The compounds are of particular use in the treatment or prevention of pain, inflammation, migraine, emesis and pos therpetic neuralgia. Excerpt(s): This application is a 371 of PCT/GB96/01478 filed on Jun. 20, 1996. This invention relates to a class of aromatic compounds which are useful as tachykinin antagonists. More particularly, the compounds of the invention contain an aminesubstituted azo-heterocyclic moiety. The tachykinins are a group of naturally occurring peptides found widely distributed throughout mammalian tissues, both within the central nervous system and in peripheral nervous and circulatory systems. Web site: http://www.delphion.com/details?pn=US05830892__
•
Portable therapeutic device Inventor(s): An; Byung-Yul (106-105, Karam Apt., 735, Ilwon-Dong, Kangnam-ku Seoul, KR) Assignee(s): None Reported Patent Number: 6,461,377 Date filed: August 4, 2000
Patents 95
Abstract: A portable therapeutic device radiates far infrared rays from Macbanseok received therein and applies electric stimulation to the body by means of an electric needle, in addition to generating magnetic vibration through rotation of two permanent magnets having magnetic polarities different from each other. The portable therapeutic device smoothes blood circulation by means of the magnetic vibration, and may relieve neuralgia and arthritis by applying the electric stimulation to a pain area of the human body. Also, the portable therapeutic device can easily be worn on a desired area of the human body by using a band. Excerpt(s): This invention relates to a portable therapeutic device, and more particularly, to a portable therapeutic device which radiates far infrared rays from Macbanseok received therein and applies electric stimulation to the body by means of an electric needle, in addition to generating a magnetic vibration through rotation of two permanent magnets having magnetic polarities different from each other, in order to eliminate cholesterol in blood and smooth the blood circulation. For several decades interest in the application of non-traditional treatment techniques for the relief of body pain and other organic irregularities has increased. An important area of these nontraditional techniques is called Diathetic Medicine, which is related to the constitutional tendency of the human body to suffer from certain diseases. Magnets, Macbanseok, and an electric stimulating devices are used in the non-traditional techniques. Web site: http://www.delphion.com/details?pn=US06461377__ •
Spiro-azacyclic derivatives, their preparation and their use as tachykinin antagonists Inventor(s): Haworth; Karen Elizabeth (Sawbridgeworth, GB), Seward; Eileen Mary (Bishops Stortford, GB), Swain; Christopher John (Duxford, GB) Assignee(s): Merck Sharp & Dohme Ltd. (hoddesdon, Gb) Patent Number: 6,046,195 Date filed: March 23, 1999 Abstract: The present invention relates to certain spiro-azacyclic derivatives which are tachykinin antagonists and are useful, for example, in the treatment or prevention of pain, inflammation, migraine, emesis and postherpetic neuralgia. Excerpt(s): This invention relates to a class of azacyclic compounds which are useful as tachykinin antagonists. More particularly, the compounds of the invention are spirosubstituted azacyclic derivatives. International (PCT) patent specification no. WO 94/20500 (published Sep. 15th, 1994) discloses spiroazacyclic derivatives as substance P antagonists. In particular, WO 94/20500 relates to spirocyclic piperidine derivatives containing a 1,8-diazaspiro[5.5]undecane core. We have now found a further class of non-peptides which are potent antagonists of tachykinins, especially of substance P. Web site: http://www.delphion.com/details?pn=US06046195__
•
Substituted morpholine derivative and its use as a therapeutic agent Inventor(s): Owen; Simon Neil (London, GB), Swain; Christopher John (Duxford, GB), Williams; Brian John (Dunmow, GB) Assignee(s): Merck Sharp & Dohme Ltd. (hoddesdon, Gb) Patent Number: 5,985,874 Date filed: May 7, 1999
96
Neuralgia
Abstract: The present invention relates to the compound of formula (I) or a pharmaceutically acceptable salt thereof.The compounds are of particular use in the treatment or prevention of pain or inflammation, migraine, emesis, postherpetic neuralgia, depression or anxiety. Excerpt(s): This invention relates to a novel compound which is useful as a tachykinin antagonist. More particularly, the invention relates to a novel morpholine derivative and to pharmaceutically acceptable salts thereof, to processes for its preparation, pharmaceutical compositions containing it, and to its use in medicine. Preferred classes of compounds of this formula include inter alia compounds in which the group Y is a CH.sub.2 OH group. We have now found that the novel compound of the present invention is a potent antagonist of tachykinins, especially of substance P. Web site: http://www.delphion.com/details?pn=US05985874__ •
Use of L-acetylcarnitine, L-isovalerylcarnitine, L-propionylcarnitine for increasing the levels of IGF-1 Inventor(s): De Simone; Claudio (Ardea RM, IT) Assignee(s): Mendes S.r.l. (roma, It), Sigma-tau Industrie Farmaceutiche Riunite S.p.a. (roma, It) Patent Number: 6,037,373 Date filed: January 4, 1999 Abstract: A method is provided for increasing the levels of IGF-1 for the therapeutic treatment or prophylaxis of cytological disorders or diseases related to IGF-1 selected from the group consisting of neuropathies of the optic nerve and of the olfactory nerve, neuralgia of the trigeminal nerve, Bell's paralysis, amyotrophic lateral sclerosis, osteoporosis, arthropathy, arthritis, cervical spondylosis and hernia of the intervertebral discs, clinical syndromes of reduced height, cachexia and acute or chronic hepatic necrosis, Turner's syndrome, sarcopoenia, growth hormone insensitivity syndromes, obesity, asthenia, myasthenia and heart asthenia, immunodeficiencies and reperfusion injuries, and for the cicatrization of wounds, the healing of ulcers, the treatment of burns, tissue regeneration, cutaneous, intestinal and hepatic tissue regeneration and the formation of dentine, that includes administering, to a patient in need thereof, at least one selected from the group consisting of L-acetylcarnitine, L-isovalerylcarnitine, and Lpropionylcarnitine or pharmacologically acceptable salts thereof. Excerpt(s): This is a 371 of PCT/IT97/00113 filed May 15, 1997. The present invention relates to a novel therapeutic use of L-acetylcarnitine, L-isovalerylcarnitine, Lpropionylcarnitine or pharmacologically acceptable salts thereof for increasing the levels of IGF-1 (insulin-like growth factor 1) for the therapeutic treatment or prophylaxis of cytological disorders or diseases related to IGF-1. More particularly, the present invention relates to the use of L-acetylcarnitine, L-isovalerylcarnitine, Lpropionylcarnitine or pharmacologically acceptable salts thereof for the therapeutic treatment or prophylaxis of individuals in whom IGF-1 contributes towards the pathogenesis of a particular disease or provokes cytological disorders. Like other growth factors, IGF-1 promotes cell growth and differentiation. The administration of IGF-1 obtained as a protein purified by molecular biology methods has made it possible to confirm the effects observed in vitro with cells, on animal models and in man. Essentially, the action of IGF- 1 is similar to that of insulin, that is to say an increase in the uptake of glucose, a reduction in ketones and fatty acids in the serum and an
Patents 97
increase in protein synthesis. In accordance with these and other metabolic effects, clinical studies have been undertaken in order to evaluate the efficacy of IGF-1 in a range of diseases. IGF- 1 has been administered to patients with type-II diabetes, to cachectic patients, to patients with ischemic damage at the neuronal, myocardial or renal level, and has been proposed for repairing and regenerating tissues (W.L. Lowe, Insulinlike growth factors, Scientific American Science and Medicine p. 62, March 1996). Web site: http://www.delphion.com/details?pn=US06037373__
Patent Applications on Neuralgia As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to neuralgia: •
3-alkyl-3-phenyl-piperidines Inventor(s): Chen, Michael Huai Gu; (Ann Arbor, MI), Chung, Fu-Zon; (Ann Arbor, MI), Lee, Helen Tsenwhei; (Ann Arbor, MI) Correspondence: Warner-lambert Company; 2800 Plymouth Road; Ann Arbor; MI; 48105; US Patent Application Number: 20010037023 Date filed: June 4, 2001 Abstract: The small nonpeptides of the instant invention are tachykinin antagonists. The compounds are highly selective and functional NK.sub.3 antagonists expected to be useful in the treatment of pain, depression, anxiety, panic, schizophrenia, neuralgia, addiction disorders, inflammatory diseases, gastrointestinal disorders, vascular disorders, and neuropathological disorders. Excerpt(s): Over the last decade, major advances have been made in the understanding of the biology of the mammalian tachykinin neuropeptides. It is now well established that substance-P (1), neurokinin A (NKA) (2), and neurokinin B (NKB) (3), all of which share a common C-terminal sequence Phe-X-Gly-Leu-Met-NH.sub.2. (Nakanishi S., Physiol. Rev., 1987;67:117), are widely distributed throughout the periphery and central nervous system (CNS) where they appear to interact with at least three receptor types referred to as NK.sub.1, NK.sub.2, and NK.sub.3, (Guard S., et al., Neurosci. Int., 1991;18:149). Substance-P displays highest affinity for NK.sub.1 receptors, whereas NKA and NKB bind preferentially to NK.sub.2 and NK.sub.3 receptors, respectively. Recently, all three receptors have been cloned and sequenced and shown to be members of the G-protein-linked "super family" of receptors (Nakanishi S., Annu. Rev. Neurosci., 1991;14:123). A wealth of evidence supports the involvement of tachykinin neuropeptides in a variety of biological activities including pain transmission, vasodilation, smooth muscle contraction, bronchoconstriction, activation of the immune system (inflammatory pain), and neurogenic inflammation (Pernow B., Pharmacol. Rev., 1983;35:85). However, to date, a detailed understanding of the physiological roles of tachykinin neuropeptides has been severely hampered by a lack of selective, high affinity, metabolically stable tachykinin receptor antagonists that possess both good
10
This has been a common practice outside the United States prior to December 2000.
98
Neuralgia
bioavailability and CNS penetration. Although several tachykinin receptor antagonists have been described (Tomczuk B. E., et al., Current Opinions in Therapeutic Patents, 1991;1:197), most have been developed through the modification and/or deletion of one or more of the amino acids that comprise the endogenous mammalian tachykinins such that the resulting molecules are still peptides that possess poor pharmacokinetic properties and limited in vivo activities. However, since 1991, a number of high-affinity nonpeptide antagonists have been reported. Snider R. M., et al., (Science, 1991;251:435), and Garret C., et al., (Proc. Natl. Acad. Sci., 1991;88:10208), described CP-96,345 and RP 67580, respectively, as antagonists at the NK.sub.1 receptor, while Advenier C., et al., (Brit. J. Pharmacol., 1992;105:78), presented data on SR 48968 showing its high affinity and selectivity for NK.sub.2 receptors. More recently Macleod, et al., (J. Med. Chem., 1993;36:2044) have published on a novel series of tryptophan derivatives as NK.sub.1 receptor antagonists. It is of interest that most of the nonpeptide tachykinin receptor antagonists described to date arose, either directly or indirectly, out of the screening of large compound collections using a robust radioligand binding assay as the primary screen. Recently, FK 888, a "dipeptide" with high affinity for the NK.sub.1 receptor was described (Fujii J., et al., Neuropeptide, 1992;22:24). Only one NK.sub.3 receptor selective ligand, SR 142801, has been published on to date (Edmonds-Alt, et al., Life Sciences, 1995;56:27). International Publication Numbers WO 93/01169, WO 93/01165, and WO 93/001160 cover certain nonpeptide tachykinin receptor antagonists. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Azaindole derivatives and their use as therapeutic agents Inventor(s): Dinnell, Kevin; (Much Hadham, GB), Elliott, Jason Matthew; (Felsted, GB), Hollingworth, Gregory John; (Brentwood, GB), Shaw, Duncan Edward; (Bishops Stortford, GB) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20020022624 Date filed: July 11, 2001 Abstract: The present invention relates to compounds of the formula (I): 1wherein:Het represents a heterocyclic residue selected from: 2where the dotted line in (b) represents an optional double bond;A completes a fused pyridine ring; andB completes a fused benzene or pyridine ring.The compounds are of particular use in the treatment or prevention of depression, anxiety, pain, inflammation, migaine, emesis or postherpetic neuralgia. Excerpt(s): This invention relates to indole and azaindole derivatives and their use as tachykinin antagonists, and in particular as neurokinin-1 receptor antagonists. We have now found a class of indole and azaindole derivatives which are potent receptor antagonists of tachykinins, especially of the neurokinin-1 (substance P) receptor. or a pharmaceutically acceptable salt thereof. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 99
•
Bisarylamines as potassium channel openers Inventor(s): Andrew McNaughton-Smith, Grant; (Morrisville, NC), Salvatore Amato, George; (Cary, NC) Correspondence: Townsend And Townsend And Crew, Llp; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20020193597 Date filed: March 11, 2002 Abstract: Compounds, compositions and methods are provided which are useful in the treatment of diseases through the modulation of potassium ion flux through voltagedependent potassium channels. More particularly, the invention provides bisarylamines, compositions and methods that are useful in the treatment of central or peripheral nervous system disorders (e.g., migraine, ataxia, Parkinson's disease, bipolar disorders, trigeminal neuralgia, spasticity, mood disorders, brain tumors, psychotic disorders, myokymia, seizures, epilepsy, hearing and vision loss, Alzheimer's disease, age-related memory loss, learning deficiencies, anxiety and motor neuron diseases) and as neuroprotective agents (e.g., to prevent stroke and the like) by opening potassium channels associated with the onset or recurrence of the indicated conditions. Excerpt(s): The present application claims priority to U.S. Provisional Patent Application Serial No. 60/277,329, filed on Mar. 19, 2001, the disclosure of which is incorporated herein by reference in its entirety for all purposes. This invention relates to the use of certain bisarylamines as potassium channel openers and to the treatment of diseases modulated by potassium channel opening. Additionally, this invention relates to novel compounds that are useful as potassium channel openers. Ion channels are cellular proteins that regulate the flow of ions, including calcium, potassium, sodium and chloride, into and out of cells. These channels are present in all human cells and affect such processes as nerve transmission, muscle contraction and cellular secretion. Among the ion channels, potassium channels are the most ubiquitous and diverse, being found in a variety of animal cells such as nervous, muscular, glandular, immune, reproductive, and epithelial tissue. These channels allow the flow of potassium in and/or out of the cell under certain conditions. For example, the outward flow of potassium ions upon opening of these channels makes the interior of the cell more negative, counteracting depolarizing voltages applied to the cell. These channels are regulated, e.g., by calcium sensitivity, voltage-gating, second messengers, extracellular ligands, and ATPsensitivity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Crude drug patch Inventor(s): Kim, Ki Hong; (Gangwon-do, KR) Correspondence: Jacobson Holman Pllc; 400 Seventh Street N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20020197303 Date filed: May 22, 2002 Abstract: The present invention relates to a crude drug patch, and in particular to a crude drug patch which is fabricated using a gardenia having a certain function such as an antimicrobial function, a suppression and fever removing function. A homeostasis
100 Neuralgia
function, etc., a raw rehmannia glutinose is capable of softening a coagulated blood, mitigating a blood stasis, and curing a wound. In addition, it is possible to mitigate a pain by sticking on a diseased part such as a labor pain/anti-inflammation, sprain, bruise, muscle pain, joint pain, lumbago, shoulder pain, neuralgia, rheumatic pain, etc. based on a combined prescription of a fermented soybean paste (toenjang), wheat flour and green tea at a certain ratio. Even when a crude drug patch according to the present invention is stuck on a skin using a natural material as an effective component, there is not any side effect. Excerpt(s): The present invention relates to a crude drug patch, and in particular to a crude drug patch which is fabricated using a gardenia having a certain function such as an antimicrobial function, a suppression and fever removing function, a homeostasis function, etc., a raw rehmannia glutinose capable of softening a coagulated blood, mitigating a blood stasis, and curing a wound. In addition, it is possible to mitigate a pain by sticking a crude drug patch on a diseased part such as a labor pain/inflammation, sprain, bruise, muscle pain, joint pain, lumbago, shoulder pain, neuralgia, rheumatic pain, etc. based on a combined prescription of a fermented soybean paste (toenjang), wheat flour and green tea at a certain ratio. Even when a crude drug patch according to the present invention is stuck on a skin using a natural material as an effective component, there is no any side effect. In the conventional art, in order to medically treat a labor pain/anti-inflammation, sprain, bruise, muscle pain, joint pain, lumbago, shoulder pain, neuralgia, rheumatic pain, etc., an anodyne or a patch which is an internal medicine is generally used. However, since the above internal medicine is an oral inoculation type medicine, a gastroenteric disorder may occur. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Cytokine antagonists for neurological and neuropsychiatric disorders Inventor(s): Tobinick, Edward Lewis; (Los Angeles, CA) Correspondence: Ezra Sutton, ESQ.; Ezra Sutton, P.A.; Plaza 9; 900 Route 9; Woodbridge; NJ; 07095; US Patent Application Number: 20030049256 Date filed: October 9, 2002 Abstract: Methods for treating neurological or neuropsychiatric diseases or disorders in humans by administering to the human a therapeutically effective dose of specific biologics are presented. The biologics of consideration include antagonists of tumor necrosis factor or of interleukin-1. The administration of these biologics is performed by specific methods, most, but not all of which fall into the category of anatomically localized administration designed for perispinal use. Anatomically localized administration involving perispinal use includes, but is not limited to the subcutaneous, intramuscular, interspinous, epidural, peridural, parenteral or intrathecal routes. Additonally, intranasal administration is discussed as a method to provide therapeutic benefit.The clinical conditions of consideration include, but are not limited to the following: diseases of the brain, including neurodegenerative diseases such as Alzheimer's Disease and Parkinson's Disease; migraine headache; spinal radiculopathy associated with intervertebral disc herniation, post-herpetic neuralgia, reflex sympathethic dystrophy, neuropathic pain, vertebral disc disease, low back pain, amyotrophic lateral sclerosis, chronic fatigue syndrome; and neuropsychiatric diseases, including bipolar affective disorder, anorexia nervosa, nicotine withdrawal, narcotic addiction, alcohol withdrawl, postpartum depression, and schizoaffective illness.
Patents 101
Excerpt(s): This is a continuation-in-part of application Ser. No. 10/236,097, filed on Sep. 6, 2002, which is a continuation-in-part of application Ser. No. 09/841,844, filed on Apr. 25, 2001, which is a continuation-in-part of application Ser. No. 09/826,976, filed on Apr. 5, 2001, now U.S. Pat. No. 6,419,944, which is a continuation-in-part of application Ser. No. 09/563,651, filed on May 2, 2000, which is a continuation-in-part of application Ser. No. 09/476,643, filed on Dec. 31, 1999, now U.S. Pat. No. 6,177,077, which is a continuation-in-part of application Ser. No. 09/275,070, filed on Mar. 23, 1999, now U.S. Pat. No. 6,015,557, which is a continuation-in-part of application Ser. No. 09/256,388, filed on Feb. 24, 1999, now abandoned. The present invention relates to novel methods of use of specific cytokine antagonists for the treatment of neuropsychiatric and neurological disorders in humans. More particularly, these cytokine antagonists are used in a new treatment of neuropsychiatric and neurologic diseases and disorders, including, but not limited to affective disorders, including unipolar and bipolar affective disorders; schizoaffective illness, schizophrenia, autism, depression, anorexia nervosa, obsessive-compulsive disorders, narcotic addiction, and smoking cessation/nicotine withdrawal; diseases and disorders of the brain; neurodegenerative disorders, including but not limited to Parkinson's Disease and Alzheimer's Disease; spinal cord injury, amyotrophic lateral sclerosis; headache syndromes, including, but not limited to migraine headaches and cluster headaches; neurologic disorders associated with neuropathic pain, including, but not limited to lumbar and cervical radiculopathy, low back pain, vertebral disc disease, fibromyalgia, post-herpetic neuralgia, and reflex sympathetic dystrophy; and chronic fatigue syndrome; utilizing specific anatomic methods of administration of these specific biologics. The delivery of these cytokine antagonists is performed by specific methods, most of which fall into the categories of perispinal administration or intranasal administration. Perispinal administration involves an anatomically localized injection performed so as to deliver the therapeutic molecule directly into the vicinity of the spine. Perispinal administration includes, but is not limited to the subcutaneous, intramuscular, interspinous, epidural, peridural, parenteral, or intrathecal routes, and may be perilesional or alternatively, particularly when treating diseases of the brain, remote from the ultimate site of pathology. Intranasal administration includes the delivery of these particular cytokine antagonists by instillation into the nasal passages, either by nasal spray or nasal inhaler. The cytokine antagonists of consideration are those designed to block the action of, inhibit, or antagonize the biologic effects of tumor necrosis factoralpha (TNF) or interleukin-1 (IL-1). These antagonists may take the form of a fusion protein (such as etanercept); a monoclonal antibody (such as infliximab); a binding protein (such as onercept; Serono); an antibody fragment (such as CDP 870, Pharmacia); or other types of molecules which are potent, selective, and specific inhibitors of the action of these proinflammatory cytokines and are capable of being used by parenteral injection. Localized administration for the treatment of localized clinical disorders has many clinical advantages over the use of conventional systemic treatment. Locally administered medication after delivery diffuses through local capillary, venous, arterial, and lymphatic action to reach the anatomic site of pathology, or, alternatively, to reach the cerebrospinal fluid (CSF). In addition local administration of a biologic in the vicinity of the spine (perispinal administration) has the key advantage of improved delivery of the agent to the central nervous system (CNS). Local intranasal administration of a biologic is another method to improve delivery of the biologic to the CNS, and is discussed here as a method to treat neuropsychiatric disorders, including disorders of mood (depression, bipolar disorder) utilizing TNF antagonists or IL-1 antagonists. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
102 Neuralgia
•
Heterocyclic carboxamide derivatives as inhibitors of nitric oxide production Inventor(s): Ohkawa, Takehiko; (Ibaraki, JP), Ohne, Kazuhiko; (Ibaraki, JP), Oku, Teruo; (Tokyo, JP), Setoi, Hiroyuki; (Ibaraki, JP), Shima, Ichiro; (Ibaraki, JP), Yoshihara, Kousei; (Ibaraki, JP), Zenko, Tatsuya; (Tokyo, JP) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20020132809 Date filed: February 25, 2002 Abstract: 1wherein each symbol is as defined in the specification, and pharmaceutically acceptable salts thereof. The compound (I) of the present invention and pharmaceutically acceptable salts thereof possess a strong inhibitory activity on the production of nitric oxide (NO), and are useful for prevention and/or treatment of NOmediated diseases such as adult respiratory distress syndrome, cardiovascular ischemia, myocarditis, heart failure, synovitis, shock, diabetes, diabetic nephropathy, diabetic retinopathy, diabetic neuropathy, glomerulonephritis, peptic ulcer, inflammatory bowel disease, cerebral infarction, cerebral ischemia, cerebral hemorrhage, migraine, rheumatoid arthritis, gout, neuritis, postherpetic neuralgia, osteoarthritis, osteoporosis, systemic lupus erythematosus, rejection by organ transplantation, asthma, metastasis, Alzheimer's disease, arthritis, CNS disorders, dermatitis, hepatitis, liver cirrhosis, multiple sclerosis, pancreatitis, atherosclerosis, and the like in human being and animals. Excerpt(s): This invention relates to new amide compounds and pharmaceutically acceptable salts thereof which are useful as medicament. Some peptide compounds have been known as described in, for example, EP 0 394 989 A2. This invention relates to new amide compounds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Human vanilloid receptor-like proteins Inventor(s): Shinjo, Katsuhiro; (Chita-gun, JP), Yabuuchi, Hikaru; (Yokohama, JP) Correspondence: Gregg C. Benson; Pfizer INC.; Patent Department, MS 4159; Eastern Point Road; Groton; CT; 06340; US Patent Application Number: 20030017527 Date filed: May 30, 2001 Abstract: This invention relates to human vanilloid receptor-like protein 2 (VRL-2) polypeptides, polynucleotides encoding such polypeptides, polynucleotide probes or primers, expression vectors and host cells comprising such DNA molecules. This invention further relates to a process for producing the polypeptides; an antibody immunospecific for the polypeptide; a diagnostic kit for diagnosing the VRL-2 receptor related disease; a method for screening to identify modulators which modulate the polypeptides; modulators identified by the screening method; a pharmaceutical composition for treatment of conditions associated with biological function of the polypeptides; and a non-human transgenic animal model for vanilloid receptor-like gene. The polypeptides and the DNA molecules of the present invention can be used to identify agonists, antagonists or the like. These agonists and antagonists are useful for treatment of diseases such as pain, nociceptive pain, chronic pain, neuropathic pain,
Patents 103
postoperative pain, cancer pain, rheumatoid arthritic pain, osteoarthritis, diabetic neuropathies, neuralgia, neuropathies, algesia, nerve injury, muscle-skeletal pain, low back pain, neurodegeneration, stroke, inflammatory disorders, athma, allergy, urogenital disorders, incontinence, hypertension, hypotension, perivasular disease and the like. Excerpt(s): The analgesic properties of capsaicin and capsaicinoides are known for their uses in the treatment of a variety of disorders such as pain, chronic pain, neuropathic pain, postoperative pain, rheumatoid arthritic pain, neuralgia, neuropathies, algesia, nerve injury, ischaemia, neurodegeneration stroke incontinence and inflammatory disorders (e.g., Campbell et al. "Clinical Applications of Capsaicin and Its Analogues" in Capsaicin in the Study of Pain, Academic Press pgs. 255-272 (1993)). Capsaicin receptors are believed to be members of the ion channel family of polypeptides. These receptors are believed to be associated with the mechanism of action of capsaicin (a vanilloid compound). Capsaicin elicits a senstation of burning pain by selectively activating sensory neurons that convey information about noxious stimuli to the central nervous system (e.g, Caterina, M. J. eta al., "The Capsaicin Receptor: A Heat Activated Ion Channel In the Pain Pathway", Nature 389, 816-824 (1997) and Caterina, M. J. et al., "A Capsaicin-Receptor Homologue with A High Threshold For Noxious Heat", Nature 398, 436-441 (1999)). The channels are permeable to cations and exhibit a notable preferance for divalent cations, particularly calcium ions. The level of calcium ion permeability exceeds that observed for most non-selective cation channels and is similar to values observed for NMDA-type glutamate receptors and alpha-7 nicotinic acetylcholine receptors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Iminopyrimidine NMDA NR2B receptor antagonists Inventor(s): Claremon, David A.; (Maple Glen, PA), Liverton, Nigel J.; (Harleysville, PA), McCauley, John A.; (Maple Glen, PA), Theberge, Cory R.; (Dover, NH) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20020013329 Date filed: June 25, 2001 Abstract: Compounds described by the chemical structural formula 1or a pharmaceutically acceptable salt thereof, are useful in the treatment of pain, migraine, depression, anxiety, schizophrenia, Parkinson's disease, stroke, and in the treatment of neuropathies including postherpetic neuralgia, central pain from spinal cord injury, and phantom limb pain. Excerpt(s): This invention relates to novel iminopyrimidine compounds. In particular, this invention relates to novel iminopyrimidine compounds effective as NMDA NR2B antagonists. Ions play a key role in processes related to chronic pain and pain-associated neurotoxicity--primarily by acting through N-methyl-D-aspartate ("NMDA") receptors. Thus, inhibition of such action--by employing ion channel antagonists, particularly NMDA antagonists--can be beneficial in the treatment and control of pain. Known NMDA antagonists include ketamine, dextromophan, and 3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid ("CPP"). Although these compounds have been reported (J. D. Kristensen, et al., Pain, 51:249-253 (1992); K. Eide, et al., Pain, 61:221-228 (1995); D. J. Knox, et al., Anaesth. Intensive Care 23:620-622 (1995); and M. B. Max, et al., Clin. Neuropharmacol. 18:360-368 (1995)) to produce symptomatic relief in a number of
104 Neuralgia
neuropathies including postherpetic neuralgia, central pain from spinal cord injury, and phantom limb pain, widespread use of these compounds is precluded by their undesirable side effects. Such side effects at analgesic doses include psychotomimetic effects such as dizziness, headache, hallucinations, dysphoria, and disturbances of cognitive and motor function. Additionally, more severe hallucinations, sedation, and ataxia are produced at doses only marginally higher than analgesic doses. Thus, it would be desirable to provide novel NMDA antagonists that are absent of undesirable side effects or that produce fewer and/or milder side effects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Neuralgia pain treatment by peripheral administration of a neurotoxin Inventor(s): Aoki, Kei Roger; (Coto de Caza, CA), Cui, Minglei; (Irvine, CA), Jenkins, Stephen W.; (Mission Viejo, CA) Correspondence: Stephen Donovan; Allergan, INC.; 2525 Dupont Drive; Irvine; CA; 92612; US Patent Application Number: 20040028706 Date filed: July 29, 2003 Abstract: Methods for treating a non-spasm caused pain by peripheral administration to a patient of a therapeutically effective amount of a neurotoxin, such as a botulinum toxin. Excerpt(s): The present invention relates to methods for treating pain. In particular, the present invention relates to methods for treating pain by peripheral administration of a neurotoxin. Many, if not most ailments of the body cause pain. Generally pain is experienced when the free nerve endings which constitute the pain receptors in the skin as well as in certain internal tissues are subjected to mechanical, thermal, chemical or other noxious stimuli. The pain receptors can transmit signals along afferent neurons into the central nervous system and thence to the brain. The causes of pain can include inflammation, injury, disease, muscle spasm and the onset of a neuropathic event or syndrome. Ineffectively treated pain can be devastating to the person experiencing it by limiting function, reducing mobility, complicating sleep, and dramatically interfering with the quality of life. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Novel genes relating to pain and use of the genes for pharmaceuticals Inventor(s): Hayashizaki, Yoshihide; (Ibaraki, JP), Hirokawa, Hiroe; (Kanagawa, JP), Kamiya, Mamoru; (Tokyo, JP), Nakao, Kaoru; (Kanagawa, JP), Suzuki, Tomohiko; (Kanagawa, JP), Tanaka, Toshiaki; (Kanagawa, JP) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20040019006 Date filed: May 9, 2003 Abstract: An object of the present invention is to find novel genes that relate to, but are not limited to, pain, such as neuropathic pain, shingles pain, and post-herpetic neuralgia, and are induced upon pain, and provide a reagent, method and
Patents 105
pharmaceutical for diagnosing and assessing pain, or preventing and treating pain.The present invention provides polynucleotides having nucleotide sequences composing novel genes, polypeptides encoded by the polynucleotides, and partial peptides thereof, recombinant vectors containing the polynucleotides, transformants having the recombinant vectors, antibodies against the polypeptides or partial peptides thereof, and the like, which are utilizable in biology, medicine, veterinary medicine, and the like. Further, the present invention provides a method for producing the polypeptides, compounds whose target molecules are the polynucleotides or the polypeptides, and pharmaceuticals containing the polypeptides or the partial peptides thereof, compounds whose target molecules are the polynucleotides or the polypeptides, or antibodies against the polypeptides. They are used particularly to diagnose and assess pain, or prevent and treat pain. Further, the present invention provides a method for identifying compounds and the like using these polynucleotides, polypeptides, or the partial peptides thereof, or salts thereof as a target molecule to prevent and treat pain, a method for using the identified compound to prevent and treat pain, a method for diagnostic monitoring a patient to be subjected to clinical evaluation for pain treatment, a method for monitoring the clinical efficiency of the compound, and a method for identifying a patient having diathesis of pain. Excerpt(s): This application claims the benefit under 35 U.S.C.sctn.119(e) of U.S. provisional patent application Serial No. 60/378,955, filed on May 10, 2002, which is incorporated herein, by reference, in its entirety. The present invention relates to a method and a composition for treating and diagnosing pain, which relates to, but not limited to, neuropathic pain, shingles pain, post-herpetic neuralgia, and the like. More specifically, the present invention relates to novel genes which is identified as being expressed in a pain state differentially from the normal state, or gene products thereof and the like. Further, the present invention relates to a use of the identified novel gene or the gene products thereof for diagnosis and evaluation, and to a use for prophylactic and therapeutic applications or a use as a target for therapeutic intervention. More particularly, the present invention relates to a method for identifying a compound for preventing, treating and diagnosing pain, and a compound found by the identification method, a diagnostic method of monitoring patients to be clinically evaluated upon pain treatment, a method for monitoring the clinical efficiency of a compound, and a method for identifying a patient with diathesis of pain. The nervous system that transmits pain is a system for knowing the state of the outside or the inside of the body, and it plays an important role as a defense system of the living body. Pain due to exogenous stimulation is useful to protect the body from risk, and pain due to organic disease of the body is an alarm signal to indicate that an abnormality is occurring in the body. However, pain is an unpleasant feeling, and is not beneficial for the person who feels the pain. When the pain lingers, it can be complicated with other functional disorders, and can even cause adverse effects on the treatment. Pathophysiological pain, such as cancer pain and post-herpetic neuralgia, can be itself a serious invasion for the living body. Thus, surgical and medical measures are now actively taken to remove pain unnecessary for the living body. Known measures to prevent and treat pain include nerve block therapy, electric stimulation therapy, surgical therapy, physical therapy, and drug therapy using analgesic agents such as long-known opioids and nonsteroidal anti-inflammatory drugs. However, nerve block therapy and surgical therapy are themselves associated with invasion, and in frequent cases, sufficient analgesic effects cannot be obtained by administration of the analgesic agents. Thus, further improvement of methods for removing pain and research and development of new analgesic agents are still underway. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
106 Neuralgia
•
Peripheral nerve stimulation apparatus Inventor(s): Weiner, Richard L.; (Dallas, TX) Correspondence: Banner & Witcoff, LTD.; Ten South Wacker Drive; Suite 3000; Chicago; IL; 60606; US Patent Application Number: 20020198572 Date filed: July 30, 2002 Abstract: A method for treating pain by subcutaneous electrical stimulation of a peripheral nerve is disclosed. A lead is placed subcutaneously over a peripheral nerve that is causing pain. The peripheral nerve is electrically stimulated to cause paresthesia. The method encompasses subcutaneous placement of an electrical lead near any peripheral nerve causing pain and subsequent electrical stimulation of the nerve to cause paresthesia. In particular, a method for treating intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques is disclosed. Excerpt(s): This patent application is a continuation of U.S. patent application Ser. No. 09/577,258, filed May 22, 2000, for which priority is claimed. This parent application is incorporated herein by reference in its entirety. This invention relates to a method for subcutaneously electrically stimulating peripheral nerves and in a particular embodiment relates to a method for subcutaneously electrically stimulating one or more occipital peripheral nerve to treat occipital neuralgia. Peripheral nerves are nerves in the body other than the nerves of the brain or spinal cord. Peripheral nerve injury may result in the development of chronic intractable pain. Some patients prove unresponsive to conservative pain management techniques. Peripheral Nerve Stimulation (PNS) has developed as a successful therapy for pain management when the pain is known to result from a specific nerve. PNS is based in part on the Melzack-Wall gate control theory of pain. Sweet and Wespic first used electrical stimulation of peripheral nerves in the 1960s to mask the sensation of pain with a tingling sensation (paresthesia) caused by the electrical stimulation. Subsequent refinements in the technology, surgical technique and patient selection have led to improved long term results. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
PIPERIDINE DERIVATIVES AND THEIR USE AS TACHYKININ ANTAGONISTS Inventor(s): ELLIOTT, MATTHEW JASON; (FELSTED, GB) Correspondence: Merck & CO Inc; 126 East Lincoln Avenue; Rahway; NJ; 07065; US Patent Application Number: 20020052504 Date filed: May 8, 2000 Abstract: Substituted piperidine derivatives of structural formula (I) wherein R1 represents a hydrogen atom or a methyl or trifluoromethyl group; R2 represents a hydrogen or halogen atom, and R3 represents a hydrogen or halogen atom, and pharmaceutically acceptable salts thereof are tachykinin receptor antagonists of use, for example, in the treatment or prevention of pain, inflammation, migraine, emesis, postherpetic neuralgia, depression and anxiety. Excerpt(s): This invention relates to piperidine derivatives and their use as tachykinin antagonists, and in particular as neurokinin-1 receptor antagonists. We have now found
Patents 107
a class of piperidine derivatives which are potent receptor antagonists of tachykinins, especially of the neurokinin-1 (substance P) receptor. In addition, the compounds of the present invention exhibit a high level of hepatic stability as measured by, for example, conventional liver microsome analysis. m is zero or 1. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Regulation of human substance p-like g protein-coupled receptor Inventor(s): Ramakrishnan, Shyam; (Brighton, MA) Correspondence: Banner & Witcoff; 1001 G Street N W; Suite 1100; Washington; DC; 20001; US Patent Application Number: 20030104435 Date filed: September 11, 2002 Abstract: Reagents which regulate human substance P G protein-coupled receptor (SPGPCR) protein and reagents which bind to human SP-GPCR gene products can play a role in preventing, ameliorating, or correcting dysfunctions or diseases including, but not limited to, urinary incontinence, inflammatory diseases (e.g., arthritis, psoriasis, asthma and inflammatory bowel disease), anxiety, depression or dysthymic disorders, cluster headache, colitis, psychosis, pain, allergies such as eczema and rhinitis, chronic obstructive airways disease, hypersensitivity disorders such as poison ivy, vasospastic diseases such as angina, migraine and Reynaud's disease, fibrosing and collagen diseases such as scleroderma and eosinophilic fascioliasis, reflex sympathetic dystrophy such as shoulder/hand syndrome, addiction disorders such as alcoholism, stress related somatic disorders, peripheral neuropathy, neuralgia, neuropathological disorders such as Alzheimer's disease, AIDS related dementia, diabetic neuropathy and multiple sclerosis, disorders related to immune enhancement or suppression such as systemic lupus erythematosus, and rheumatic diseases such as fibrositis. Excerpt(s): The invention relates to the area of G-protein coupled receptors. More particularly, it relates to the area of human substance P-like G protein-coupled receptor and its regulation. Many medically significant biological processes are mediated by signal transduction pathways that involve G-proteins (Lefkowitz, Nature 351, 353-354, 1991). The family of G-protein coupled receptors (GPCR) includes receptors for hormones, neurotransmitters, growth factors, and viruses. Specific examples of GPCRs include receptors for such diverse agents as dopamine, calcitonin, adrenergic hormones, endothelin, cAMP, adenosine, acetylcholine, serotonin, histamine, thrombin, kinin, follicle stimulating hormone, opsins, endothelial differentiation gene-1, rhodopsins, odorants, cytomegalovirus, G-proteins themselves, effector proteins such as phospholipase C, adenyl cyclase, and phosphodiesterase, and actuator proteins such as protein kinase A and protein kinase C. GPCRs possess seven conserved membranespanning domains connecting at least eight divergent hydrophilic loops. GPCRs (also known as 7TM receptors) have been characterized as including these seven conserved hydrophobic stretches of about 20 to 30 amino acids, connecting at least eight divergent hydrophilic loops. Most GPCRs have single conserved cysteine residues in each of the first two extracellular loops, which form disulfide bonds that are believed to stabilize functional protein structure. The seven transmembrane regions are designated as TM1, TM2, TM3, TM4, TM5, TM6, and TM7. TM3 has been implicated in signal transduction. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
108 Neuralgia
•
Topical and oral administration of a composition containing Pelargonium Graveolens for diagnosis and treatment of various neuralgias and other conditions Inventor(s): Frome, Bruce Marshall; (Beverly Hills, CA) Correspondence: Bruce M. Frome; PO Box 15157; Beverly Hills; CA; 90209; US Patent Application Number: 20030224072 Date filed: May 28, 2003 Abstract: This present invention describes a method of diagnosing and treating neuropathic pain, Bell's palsy, viral sore throat, pain due to burns, including sunburn, and pain and itching due to insect bites with compositions of essential aromatic oils, all of which contain Pelargonium graveolens (also called geranium oil bourbon or GOB). This invention discloses compositions of one or more of five other essential aromatic oils, particularly lavender, bergamot, blue chamomile, eucalyptus and tea tree, which when added to GOB acts synergistically with the GOB. These compositions can be used alone or in a composition with a pharmaceutically acceptable carrier in topical or oral dosage form. The present invention is an improvement in the methods and expansion of uses as stated in the previous United States Patent issued in 1993 entitled "Diagnosis and Treatment of Various Neuralgias" (Frome)--U.S. Pat. No. 5,260,313. Excerpt(s): This non-provisional utility application claims the benefits of the earlier provisional application No. 60/385,081 filed on Jun. 3, 2002. The present invention is a) an improvement in the methods as stated in the previous United States Patent issued in 1993 entitled "Diagnosis and Treatment of Various Neuralgias" (Frome)--U.S. Pat. No. 5,260,313 and b) by improving the method as stated in U.S. Pat. No. 5,260,313, the present invention expands the uses of the invention as stated in U.S. Pat. No. 5,260,313. The method of the present invention differs from the method of the invention described in U.S. Pat. No. 5,260,313 in that this invention is a composition of two or more aromatic essential oils as the active therapeutic or diagnostic agent while the invention detailed in U.S. Pat. No. 5,260,313 utilizes a single aromatic essential oil, specifically Pelargonium Graveolens, as the active therapeutic or diagnostic agent. This invention relates to the topical and oral administration of various compositions of essential aromatic oils, all of which contain Pelargonium Graveolens, also called geranium oil bourbon and hereinafter sometimes referred to as GOB. This invention is used for diagnosis and treatment of pain that is neuropathic (nerve tissue injury) in origin and treatment of other miscellaneous conditions such as burns, viral sore throat, insect bites and Bell's palsy. Neuropathic pain encompasses various pain syndromes associated with disorders due to injuries of the peripheral, sympathetic and central nervous system. Not only are curative measures for these neural abnormalities generally unavailable but symptomatic treatments are often ineffective causing an enormous problem for clinicians in treatment and management of neuropathic pain. Distinguishing neuropathic pain from somatic or visceral pain is often difficult. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 109
•
Use of benzopyranols to treat neurological disorders Inventor(s): Evans, John Morris; (Roydon, GB), Parsons, Andrew; (Arlesey, GB), Thompson, Mervyn; (Harlow, GB), Upton, Neil; (Harlow, GB) Correspondence: Glaxosmithkline; Corporate Intellectual Property - Uw2220; P.O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20020010209 Date filed: July 19, 2001 Abstract: Benzopyran derivatives and analogs are disclosed as useful for the treatment and/or prophylaxis of degenerative diseases such as Huntingdon's chorea, schizophrenia, neurological deficits associated with AIDS, sleep disorders (including circadian rhythm disorders, insomnia and narcolepsy), tics (e.g. Giles de la Tourette's syndrome), traumatic brain injury, tinnitus, neuralgia, especially trigeminal neuralgia, neuropathic pain, dental pain, cancer pain, inappropriate neuronal activity resulting in neurodysthesias in diseases such as diabetes, MS and motor neurone disease, ataxias, muscular rigidity (spasticity), temporomandibular joint dysfunction. Excerpt(s): This invention relates to a novel method of treatment. EP-A-0 126 311 discloses substituted benzopyran compounds having blood pressure lowering activity, including 6-acetyl-trans-4-(4-fluoroben- zoylamino)-3,4-dihydro-2,2-dimethyl-2H-1benzopyran-3-ol. Also EP-A-0 376 524, EP-A-0 205 292, EP-A-0 250 077, EP-A-0 093 535, EP-A-0 150 202, EP-A-0 076 075 and WO/89/05808 (Beecham Group plc) describe certain benzopyran derivatives which possess anti-hypertensive activity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
•
Use of botulinum toxin for the treatment of chronic facial pain Inventor(s): Acquadro, Martin A.; (Wellesly, MA), Borodic, Gary E.; (Canton, MA) Correspondence: Milbank, Tweed, Hadley & Mccloy Llp; 1 Chase Manhattan Plaza; New York; NY; 10005-1413; US Patent Application Number: 20020192239 Date filed: January 8, 2002 Abstract: The present invention includes a method of treating pain caused by neuralgia comprising administering botulinum toxin to an afflicted area of a patient. The pain may be caused by trigeminal neuralgia or be associated with dental extraction or reconstruction, and may be facial pain. The neuralgia may be associated with compressive forces on a sensory nerve, intrinsic nerve damage, demyelinating disease, a genetic disorder, a metabolic disorder, central neurologic vascular disease, or trauma. The present invention also includes a method of treating post-operative incisional wound pain comprising administering botulinum toxin to an afflicted area of a patient. The post-operative incisional wound pain may be associated with medical treatments selected from the group consisting of sinus surgery, removal of an eye, temporal mandibular joint surgery, parotid gland extraction and resection, craniotomy for removal of an intracranial tumor, intra-ocular surgery, acoustic neuroma surgery, reconstructive procedures after tumor resection, radiation therapy for the treatment of cancer, skull base surgery, orbitectomy, facial bone removal, muscle removal, skin removal, and construction of myocutaneous flaps.
110 Neuralgia
Excerpt(s): This application claims the benefit of U.S. Provisional Application Ser. No. 60/260,515, filed Jan. 9, 2001. Chronic facial pain caused by neuralgia often presents difficult management problems requiring interdisciplinary consultations and multiple attempts at different therapy modalities. In a recent study, a series of chronic facial pain patients deemed to be ineffectively controlled with conventional medical and surgical procedures were treated with transcutaneous injection of botulinum type A toxin. The cases were classified into the following categories: 1. idiopathic trigeminal neuralgia; 2. post surgical chronic pain syndromes. The trigeminal neuralgia patients included who failed medical therapy and did not go on to have a surgical procedure, and those who failed medical therapy but later had temporary relief for a variable duration following a surgical procedure, only to have their pain return. Botulinum toxin has been used extensively to treat regional dystonias which are often associated with pain or some form of sensory disturbance. Botulinum toxin injections for the treatment of spasmodic torticollis repeatedly demonstrated efficacy mitigating pain at rates substantially greater than other components of this syndrome (see references 1-3). Such observations led to the study of non-dystonic pain syndromes, such as myofascial pain and tension headache, which initially produced beneficial results (reference 4) and is currently being studied in larger controlled trials. Furthermore, trial injections after skull base surgery further indicated potential efficacy in a small series of patients. Recently, botulinum toxin is being investigated for the treatment of migraine headache (reference 5) and initial blinded controlled studies have produced some evidence of efficacy. The mechanisms involved in migraine headache have been reviewed (see references 20, 21), and have been noted to be vascular in origin. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with neuralgia, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “neuralgia” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on neuralgia. You can also use this procedure to view pending patent applications concerning neuralgia. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
111
CHAPTER 6. BOOKS ON NEURALGIA Overview This chapter provides bibliographic book references relating to neuralgia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on neuralgia include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “neuralgia” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on neuralgia: •
Striking Back!: The Trigeminal Neuralgia Handbook Source: Barnegat Light, NJ: Trigeminal Neuralgia Association. 2000. 256 p. Contact: Available from Trigeminal Neuralgia Association. P.O. Box 340, Barnegat Light, NJ 08006. (609) 361-6250. Fax (609) 361-0982. E-mail:
[email protected]. Website: www.tna-support.org. PRICE: $16.95 plus shipping and handling. ISBN: 0967239303. Summary: This book offers a detailed explanation of trigeminal neuralgia (tic douloureux), a neurological disorder characterized by sharp, stabbing pain in the face and teeth. The book includes 14 chapters, covering a description of trigeminal neuralgia (TN), diagnosis and misdiagnosis, classic TN symptoms, typical versus atypical TN, the causes of the condition, drug therapy (medications), treatment options featuring injections or balloon compression, radiosurgery (the no-incision surgery), the microvascular decompression procedure (MVD), the use of alternatives to manage TN (including capsaicin creams, acupuncture, chiropractic, nutrition, herbal therapy,
112 Neuralgia
transcutaneous electrical nerve stimulation), strategies for coping, the psychological effects of living with TN and chronic pain, the Trigeminal Neuralgia Association (TNA), and future hopes for treatments and better understanding of the condition. Throughout the book, the authors include quotations and case reports from patients with TN. The book also includes a list of resources, a glossary of terms, a reference list, and a subject index. 115 references.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “neuralgia” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “neuralgia” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “neuralgia” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Engorro y neuralgia de Toledo by Mariano Calvo; ISBN: 848599650X; http://www.amazon.com/exec/obidos/ASIN/848599650X/icongroupinterna
•
Herpes Zoster and Postherpetic Neuralgia, 2nd Revised and Enlarged Edition by C. Peter N. Watson (Editor), Anne A. Gershon (Editor); ISBN: 0444506799; http://www.amazon.com/exec/obidos/ASIN/0444506799/icongroupinterna
•
Medical and Surgical Management of Trigeminal Neuralgia by Gerhard H. Fromm (Editor); ISBN: 0879933038; http://www.amazon.com/exec/obidos/ASIN/0879933038/icongroupinterna
•
Neurosurgical and Medical Management of Pain: Trigeminal Neuralgia, Chronic Pain, and Cancer Pain by Ronald Brisman (Editor); ISBN: 0898384052; http://www.amazon.com/exec/obidos/ASIN/0898384052/icongroupinterna
•
On Neuralgia: Its Causes and Cure by J. Compton Burnett; ISBN: 8170211492; http://www.amazon.com/exec/obidos/ASIN/8170211492/icongroupinterna
•
Striking Back: The Trigeminal Neuralgia Handbook by George Weigel, Kenneth L. Casey; ISBN: 0967239303; http://www.amazon.com/exec/obidos/ASIN/0967239303/icongroupinterna
•
The Official Patient's Sourcebook on Occipital Neuralgia: A Revised and Updated Directory for the Internet Age by Icon Health Publications; ISBN: 0597835292; http://www.amazon.com/exec/obidos/ASIN/0597835292/icongroupinterna
•
Trigeminal Neuralgia by Richard L. Rovit; ISBN: 0683073931; http://www.amazon.com/exec/obidos/ASIN/0683073931/icongroupinterna
•
Trigeminal Neuralgia by Joanna Zakrzewska; ISBN: 0702016969; http://www.amazon.com/exec/obidos/ASIN/0702016969/icongroupinterna
•
Trigeminal Neuralgia: Current Concepts Regarding Pathogenesis and Treatment by Gerhard H. Fromm, Barry J. Sessle (Editor); ISBN: 0409901261; http://www.amazon.com/exec/obidos/ASIN/0409901261/icongroupinterna
Books
113
Chapters on Neuralgia In order to find chapters that specifically relate to neuralgia, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and neuralgia using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “neuralgia” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on neuralgia: •
Pain and Neurological Disorders Source: in Scully, C., et al. Color Atlas of Orofacial Health and Disease in Children and Adolescents. London, England: Martin Dunitz Ltd. 2002. p.193-199. Contact: Available from Martin Dunitz Ltd, The Livery House. 7-9 Pratt Street, London, England NW1 0AE. 4404074822202. Website: www.dunitz.co.uk. Email:
[email protected]. PRICE: $125.00 plus shipping and handling. ISBN: 1841841021. Summary: Most orofacial pain is of odontogenic origin, that is, arising from the teeth or the tissues that support the teeth and from which the teeth develop. This chapter on pain and neurological disorders is from a full-color atlas that covers the presentation of the common orofacial disorders and a wide range of less common and some rare disorders. The chapter begins with a discussion of the causes of orofacial pain, including local causes and referred pain. The authors then discuss neurological disorders (for example, trigeminal neuralgia), vascular disorders (such as migraine), migrainous neuralgia (cluster headache), and psychogenic orofacial pain. Two sections on facial palsy and sensory loss include full-color photographs. Each entry describes the condition and notes diagnostic and management considerations. 3 figures. 2 tables.
•
Extraoral Sources of Facial Pain Source: in Montgomery, M.T.; Redding, S.W., eds. Oral-Facial Emergencies: Diagnosis and Management. Portland, OR: JBK Publishing, Inc. 1994. p. 335-366. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Fax (312) 440-2824. PRICE: $27.00 (member) or $30.00 (nonmember), plus shipping and handling; institutional prices and bulk orders available. ISBN: 0945892055. Summary: This chapter on extraoral sources of facial pain is from an emergency room handbook that addresses a variety of orofacial injuries that are likely to be encountered in an acute care setting. The numerous organs that lie within the face and skull, their rich innervation, and the variety of ailments to which they are susceptible account for the extensive and complicated array of pains found in the craniofacial region. Pain may arise from intraoral sources such as the teeth, periodontium and jaws and from extraoral sources including ligaments and muscles of the head, neck and face; the nasal cavity and paranasal sinuses; the temporomandibular joints; eyes and ears; blood vessels of the scalp and face; dural and intracerebral arteries; and the cranial and cervical nerves. The author notes that the pathophysiology responsible for most facial pain is ill-defined, requiring that most treatment be palliative rather than disease specific. The author focuses on assisting primary care providers in developing a differential diagnosis, the
114 Neuralgia
delivery of any needed emergency treatment, and the appropriate referral of patients who present with craniofacial pain from nonodontogenic sources (i.e., neuralgias, headaches, sinusitis). The authors present a diagnostic workup format appropriate for the emergency setting along with descriptions and treatment (both emergency and definitive) for some of the more common craniofacial pain entities. One chart summarizes the extraoral sources of facial pain. 3 figures. 5 tables. 28 references. (AAM). •
Orofacial Pain Source: in Lamey, P.J.; Lewis, M.A.O. Clinical Guide to Oral Medicine. 2nd ed. Hampshire, United Kingdom: British Dental Journal (BDJ), Stockton Press. 1997. p. 2734. Contact: Available from British Dental Journal (BDJ) Books, BDA Shop, British Dental Association (BDA). 64 Wimpole Street, London W1G 8YS, United Kingdom. Telephone +44 (0) 20 7563 4555. Fax +44 (0) 20 7563 4556. E-mail:
[email protected]. Website: www.bdashop.com. PRICE: Contact publisher for current pricing. ISBN: 0904588505. Summary: This chapter on orofacial pain is from a clinical guide to oral medicine. The authors note that the diagnosis of orofacial pain, particularly of non-dental origin, may present the clinician with a considerable diagnostic problem. However, detailed assessment of the history and nature of the pain, combined with a thorough clinical examination, will achieve a correct diagnosis relatively easily. The authors discuss orofacial pain in two categories, by origin: dental or non-dental, focusing on the nondental conditions. Topics include pain of salivary gland origin; pain of vascular origin, including giant cell arteritis, periodic migrainous neuralgia, and paroxysmal facial hemicrania; pain of bony origin, including bone tumors, trauma, and Paget's disease; pain from the maxillary sinus; pain from the temporomandibular joint; pain of central nervous system origin, including trigeminal neuralgia, and glossopharyngeal neuralgia; pain of infective origin, such as post-herpetic neuralgia and Ramsay Hunt syndrome; pain of psychogenic origin, including atypical facial pain; and miscellaneous conditions. One table summarizes the characteristic timing and nature of the more common causes of orofacial pain. 13 figures. 1 table.
•
Management of Neuropathic Pain Source: in Lund, J.P., et al., eds. Orofacial Pain: From Basic Science to Clinical Management. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 259-269. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail:
[email protected]. Website: www.quintpub.com. PRICE: $38.00 plus shipping and handling. ISBN: 0867153814. Summary: This chapter on the management of neuropathic pain is from a textbook on orofacial pain that focuses on the topics that would be found in an undergraduate curriculum for dentistry, emphasizing acute pain and chronic pain states other than temporomandibular disorders (TMD). Most of the chapters in the book were first presented as papers at a symposium for teachers of orofacial pain held in Vancouver, Canada, in March 1999 in conjunction with the American and Canadian Associations of Dental Schools and the International Association for Dental Research. In this chapter, the author considers lesions of peripheral nerves and excludes the uncommon pain syndromes caused by lesions of the central nervous system (e.g., pain in stroke or
Books
115
multiple sclerosis). Neurogenic pain at the orofacial level can result from nerve trauma associated with pressure, deafferentation, or amputation; infection; or metabolic disturbance (e.g., diabetes). The cause may be unknown or iatrogenic (due to medical treatment). The author focuses on the management of neuropathic pain and neuralgia, the two main types of neurogenic orofacial pain. The former includes neuritis, nerve damage, neuroma, and metabolic nerve disturbances such as diabetic neuropathy. Neuralgias include trigeminal neuralgia, glossopharyngeal neuralgia, and post herpetic neuralgia. The author discusses drug therapy and outlines the use of drugs commonly used to treat neuropathic pain and trigeminal neuralgia. Dentists are advised to prescribe these drugs with the collaboration of a family physician, neurologist, or oral medicine specialist. 3 figures. 1 table. 21 references. •
Chapter 56: Foot Problems Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 9 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who experience common foot injuries and conditions with information on their symptoms, diagnosis, and treatment. An ankle sprain is an injury to the ligaments in the ankle. Sprains are graded from mild to severe, and their severity depends on the degree of stretching or tearing of the ligaments. Diagnosis is based on a physical examination and x rays to rule out a fracture. Treatment depends on severity. Mild sprains are treated with conservative measures, whereas surgery may be needed to treat severe sprains. Complications include chronic inflammation, neuralgia, reflex sympathetic dystrophy, and sinus tarsi syndrome. Orthotics may help prevent future sprains. Fractures can occur in almost any bone in the foot. All ankle fractures should be placed in a cast, and surgery may be needed for severe ankle fractures. Fractures of the metatarsal bones are common. These bones will usually heal with immobilization in a stiff soled shoe rather than a cast. The sesamoid bones and the bones of the toes may also be fractured. Using orthoses or splints may help relieve pain. Heel spurs are growths of extra bone at the heel and are usually painful. Diagnosis is based on a physical examination. X rays may confirm the diagnosis. Treatment options include corticosteroid or anesthetic injections and orthotics. In children, Sever's disease is heel pain caused by cartilage damage. Diagnosis is based on the medical history and a physical examination. Healing occurs over a period of several months. Posterior Achilles tendon bursitis is an inflammation of the bursa located between the skin of the heel and the Achilles tendon. The inflamed bursa appears as a red lump under the skin of the heel and causes pain at and above it. Treatment is aimed at reducing inflammation and adjusting the position of the foot in the shoe. Anterior Achilles tendon bursitis is an inflammation of the bursa in front of the attachment of the Achilles tendon to the heel bone. Symptoms include swelling and warmth at the back of the heel. Conservative measures may help reduce pain and inflammation. Posterior tibial neuralgia is pain in the ankle, foot, and toes caused by nerve compression or damage. Pain that has a burning or tingling quality is the most common symptom. Diagnosis is based on a physical examination and diagnostic tests. Injections of corticosteroids or analgesics may relieve pain, and orthotics may be useful. Other foot problems include pain in the ball of the foot caused by nerve damage and toe joint pain caused by misalignment. Orthotics and corticosteroid or analgesic injections
116 Neuralgia
are commonly used to treat these problems. Conditions affecting the toenails include ingrown toenail, onychomycosis (fungal infection), and nail discoloration. 4 figures. •
Neuropathic Pain Source: in Okeson, J.P. Bell's Orofacial Pains. 5th ed. Carol Stream, IL: Quintessence Publishing Company, Inc. 1995. p. 403-455. Contact: Available from Quintessence Publishing Company, Inc. 551 North Kimberly Drive, Carol Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223; Fax (630) 682-3288; E-mail:
[email protected]; http://www.quintpub.com. PRICE: $68.00 plus shipping and handling. ISBN: 0867152931. Summary: This chapter, from a text on orofacial pains, discusses neuropathic pains. The author discusses the behavior of neuropathic pains; paroxysmal neuralgia; the pathophysiologic features of neuralgic pain; the management of paroxysmal neuralgias; continuous neuropathic pains; peripheral neuritis; herpes zoster; postherapeutic neuralgia; traumatic neuralgia; atypical odontalgia; and the clinical characteristics, pathophysiologic features, precipitating factors, diagnostic considerations, and management of sympathetically maintained pains. The author presents 11 detailed case studies. 9 figures. 95 references.
•
Neurological Disorders Source: in Scully, C. and Cawson, R.A. Oral Disease: Colour Guide. 2nd ed. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 147-148. Contact: Available from W.B. Saunders Company, A Harcourt Health Sciences Company. Book Order Fulfillment Department, 11830 Westline Industrial Drive, St Louis, MO 63146-9988. (800) 545-2522. Fax (800) 568-5136. E-mail:
[email protected]. Website: www.wbsaunders.com. PRICE: $19.95 plus shipping and handling. ISBN: 044306170X. Summary: This one page chapter on neurological disorders is from a book that is intended as an aid to oral medicine and the diagnosis and treatment of oral disease. The chapter includes 2 full color photographs of a patient with Bell's palsy. The text describes facial palsy (usually due to stroke or Bell's palsy), trigeminal neuralgia, and sensory loss in the trigeminal region. The text covers incidence and etiology, clinical features, diagnosis and diagnostic tests, and treatment options.
117
CHAPTER 7. PERIODICALS AND NEWS ON NEURALGIA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover neuralgia.
News Services and Press Releases One of the simplest ways of tracking press releases on neuralgia is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “neuralgia” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to neuralgia. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “neuralgia” (or synonyms). The following was recently listed in this archive for neuralgia: •
IL-8 level indicates postherpetic neuralgia duration Source: Reuters Medical News Date: March 18, 2004
•
Radiosurgery shows promise as primary treatment for trigeminal neuralgia Source: Reuters Industry Breifing Date: March 02, 2004
118 Neuralgia
•
Postherpetic neuralgia rapidly responds to treatment with pregabalin Source: Reuters Industry Breifing Date: May 05, 2003
•
Opioids can relieve postherpetic neuralgia without undue side effects Source: Reuters Industry Breifing Date: October 07, 2002
•
Fosphenytoin relieves trigeminal neuralgia crisis Source: Reuters Industry Breifing Date: June 22, 2001
•
Thermal therapy effective for trigeminal neuralgia Source: Reuters Medical News Date: March 15, 2001
•
Intrathecal methylprednisolone effective for postherpetic neuralgia Source: Reuters Industry Breifing Date: November 22, 2000
•
Baseline herpes zoster pain predicts extent of postherpetic neuralgia in AIDS patients Source: Reuters Medical News Date: June 30, 1999
•
Gabapentin treats nerve pain Source: Reuters Health eLine Date: December 01, 1998
•
Oral Acyclovir Reduces Postherpetic Neuralgia In Herpes Zoster Patients Source: Reuters Medical News Date: May 07, 1997
•
Gamma Knife Radiosurgery Effective For Trigeminal Neuralgia Source: Reuters Medical News Date: March 17, 1997
•
Microvascular Decompression Effective For Intractable Trigeminal Neuralgia Source: Reuters Medical News Date: April 25, 1996
•
Misoprostol Relieves MS-Associated Trigeminal Neuralgia In Some Patients Source: Reuters Medical News Date: June 26, 1995
•
Topical Lidocaine Effective Treatment For Postherpetic Neuralgia Source: Reuters Medical News Date: February 28, 1995 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine.
Periodicals and News
119
Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “neuralgia” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “neuralgia” (or synonyms). If you know the name of a company that is relevant to neuralgia, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “neuralgia” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “neuralgia” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on neuralgia: •
Trigeminal Neuralgia: Which Surgical Procedure Is Best for You? Source: Lifeline: The Newsletter of the National Chronic Pain Outreach Association, Inc. p. 5. Summer 1999.
120 Neuralgia
Contact: Available from National Chronic Pain Outreach Association, Inc. P.O. Box 274, Millboro, VA. (540) 862-9437. Fax (540) 862-9485. E-mail:
[email protected]. Summary: This commentary is printed as an accompaniment to a newsletter article that reviews the management and treatment of trigeminal neuralgia, a painful condition caused by a disturbance in the normal function of the trigeminal nerve, which carries sensation from the face to the brain. The newsletter article outlines the various treatment options available, focusing on surgical techniques. This commentary helps readers determine which surgical treatment might be most appropriate in each individual situation. The commentary offers nine suggestions for readers to consider: make sure all nonsurgical options have been exhausted; make sure of the diagnosis; determine how much time can be spent recovering from surgery; how to decide if a major operation can be tolerated at a particular time in the patient's life; the level of tolerance for facial numbness; consider the impact of surgery on the sensation in the cornea of the eye; ability to tolerate recurrence of the pain; learn about the risks of each procedure and determine what level of risk one is comfortable with; and consider the distinction between an established procedure with a track record and something that is promising but new. The author encourages readers to educate themselves and work closely with their physicians to make the best decision about which procedure will be most appropriate. •
Management and Treatment of Trigeminal Neuralgia Source: Lifeline: The Newsletter of the National Chronic Pain Outreach Association, Inc. p. 1, 3-4. Summer 1999. Contact: Available from National Chronic Pain Outreach Association, Inc. P.O. Box 274, Millboro, VA. (540) 862-9437. Fax (540) 862-9485. E-mail:
[email protected]. Summary: This newsletter article reviews the management and treatment of trigeminal neuralgia, a painful condition caused by a disturbance in the normal function of the trigeminal nerve, which carries sensation from the face to the brain. The author cautions that the treatment for trigeminal neuralgia is complex and should be tailored to each specific patient. The treatment plan includes medical management, and if that fails, a variety of surgical options. The factors taken into account are the age of the patient, severity of the condition, underlying medical conditions, and the willingness of the patient to undergo certain procedures. The author reviews the options for treating the disease with medications, then describes each of the surgical options that may be used, including glycerol rhizotomy, microvascular decompression, the use of a gamma knife, and the Linac (high energy X ray). The author concludes with brief discussions of insurance considerations and the history of trigeminal neuralgia. 2 references.
Academic Periodicals covering Neuralgia Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to neuralgia. In addition to these sources, you can search for articles covering neuralgia that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.”
Periodicals and News
121
If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
123
CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for neuralgia. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with neuralgia. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
124 Neuralgia
following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to neuralgia: Anticonvulsants, Hydantoin •
Systemic - U.S. Brands: Cerebyx; Dilantin; Dilantin Infatabs; Dilantin Kapseals; Dilantin-125; Mesantoin; Peganone; Phenytex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202052.html
Baclofen •
Systemic - U.S. Brands: Lioresal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202080.html
Capsaicin •
Topical - U.S. Brands: Zostrix; Zostrix-HP http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202626.html
Carbamazepine •
Systemic - U.S. Brands: Atretol; Carbatrol; Epitol; Tegretol; Tegretol-XR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202111.html
Phenothiazines •
Systemic - U.S. Brands: Chlorpromazine Hydrochloride Intensol; Compazine; Compazine Spansule; Mellaril; Mellaril Concentrate; Mellaril-S; Permitil; Permitil Concentrate; Prolixin; Prolixin Concentrate; Prolixin Decanoate; Prolixin Enanthate; Serentil; Serentil Concentrate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202457.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html.
Researching Medications
125
Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to neuralgia by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “neuralgia” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for neuralgia: •
L-baclofen http://www.rarediseases.org/nord/search/nodd_full?code=177
•
Lidocaine patch 5% (trade name: Lidoderm Patch) http://www.rarediseases.org/nord/search/nodd_full?code=249
•
L-baclofen http://www.rarediseases.org/nord/search/nodd_full?code=869
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
127
APPENDICES
129
APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
11
These publications are typically written by one or more of the various NIH Institutes.
130 Neuralgia
•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
Physician Resources 131
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
132 Neuralgia
•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “neuralgia” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 12243 221 52 13 40 12569
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “neuralgia” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
14
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
15
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
Physician Resources 133
Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
The Genome Project and Neuralgia In the following section, we will discuss databases and references which relate to the Genome Project and neuralgia. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
134 Neuralgia
To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “neuralgia” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for neuralgia: •
Trigeminal Neuralgia Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=190400 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
•
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
•
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
•
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
•
Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
Physician Resources 135
•
Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
•
Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •
3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
•
Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
•
Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
•
NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
•
Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
•
OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
•
PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
•
ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
•
Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
•
PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
•
Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
•
Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then
136 Neuralgia
select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “neuralgia” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “neuralgia” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
23
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
137
APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on neuralgia can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to neuralgia. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to neuralgia. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “neuralgia”:
138 Neuralgia
•
Other guides Diabetic Nerve Problems http://www.nlm.nih.gov/medlineplus/diabeticnerveproblems.html Neck Disorders and Injuries http://www.nlm.nih.gov/medlineplus/neckdisordersandinjuries.html Peripheral Nerve Disorders http://www.nlm.nih.gov/medlineplus/peripheralnervedisorders.html Shingles http://www.nlm.nih.gov/medlineplus/shingles.html Throat Disorders http://www.nlm.nih.gov/medlineplus/throatdisorders.html Trigeminal Neuralgia http://www.nlm.nih.gov/medlineplus/trigeminalneuralgia.html Trigeminal Neuralgia http://www.nlm.nih.gov/medlineplus/tutorials/trigeminalneuralgialoader.html
Within the health topic page dedicated to neuralgia, the following was listed: •
General/Overviews Trigeminal Neuralgia (Tic Douloureux) Source: Harvard Medical School, InteliHealth http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10901.html
•
Diagnosis/Symptoms MR Imaging (MRI)-Head Source: American College of Radiology, Radiological Society of North America http://www.radiologyinfo.org/content/mr_of_the_head.htm
•
Treatment Gamma-Knife Radiosurgery: Neurosurgery without a Scalpel Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00736
•
Latest News Radiosurgery Helps with Painful Nerve Condition Source: 03/02/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16364 .html
•
Organizations National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
Patient Resources 139
Trigeminal Neuralgia Association http://www.tna-support.org/ •
Research Neurosurgeons Use Gamma Knife Radiosurgery for Treatment of Trigeminal Neuralgia Source: American Association of Neurological Surgeons http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZRI2VBUOC& sub_cat=2
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on neuralgia. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Trigeminal Neuralgia Association: A Nonprofit Voluntary Organization Source: Barnegat Light, NJ: Trigeminal Neuralgia Association. 199x. 2 p. Contact: Available from Trigeminal Neuralgia Association. P.O. Box 340, Barnegat Light, NJ 08006. (609) 361-1014; Fax (609) 361-0982. PRICE: Single copy free. Summary: This brochure describes the Trigeminal Neuralgia Association (TNA), a nonprofit organization established to provide the opportunity for TN patients to share experiences, to receive support, and to obtain current information on the treatment of this disorder. The Association has an Educational Outreach Program directed to medical and dental practitioners, TN patients, and the general public; the program is intended to increase public and professional awareness of the disorder and the modes of treatment available. The brochure lists the goals of the TNA and includes a form with which readers can join or contribute to the organization. The back panel of the brochure lists the Board of Directors and Medical Advisory Board of the TNA.
•
Trigeminal Neuralgia Source: Bethesda, MD: National Institute of Neurological Disorders and Stroke. 1997. [1 p.]. Contact: Available from National Institute of Neurological Disorders and Stroke. Office of Scientific and Health Reports, P.O. Box 5801, Bethesda, MD 20824. (800) 352-9424 or (301) 496-5751. PRICE: Single copy free.
140 Neuralgia
Summary: This fact sheet from the National Institute of Neurological Disorders and Stroke describes trigeminal neuralgia (tic douloureux), a condition that affects the trigeminal nerve (the 5th cranial nerve), one of the largest nerves in the head. Trigeminal neuralgia is characterized by a sudden, severe, electric shock like or stabbing pain typically felt on one side of the jaw or cheek. The disorder is more common in women than in men and rarely affects anyone younger than 50. The fact sheet describes the syndrome, treatment options, prognosis, and present research efforts on the disorder. The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing, or swallowing. The disorder is characterized by recurrences and remissions, and successive recurrences may incapacitate the patient. Due to the intensity of the pain, even the fear of an impending attack may prevent activity. The fact sheet concludes with the telephone numbers and addresses for three organizations through which readers can obtain more information. 4 references. •
Trigeminal Neuralgia (Tic Douloureux) Source: in Griffith, H.W. Instruction for Patients. 5th ed. Orlando, FL: W.B. Saunders Company. 1994. p. 478. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $52.00 (English); $49.95 (Spanish); plus shipping and handling. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This fact sheet on trigeminal neuralgia (tic douloureux) is from a compilation of instructions for patients, published in book format. Trigeminal neuralgia is a nerve condition that causes episodes of severe facial pain. The fact sheet provides information in three sections: basic information, including a description of the condition, frequent signs and symptoms, causes, risk factors, preventive measures, expected outcome, and possible complications; treatment, including general measures, medication, activity guidelines, and diet; and when to contact one's health care provider. The fact sheet is designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool.
•
Trigeminal Neuralgia: A Primer for Physicians and Patients Source: Barnegat Light, NJ: Trigeminal Neuralgia Association. 200x. 9 p. Contact: Available from Trigeminal Neuralgia Association. P.O. Box 340, Barnegat Light, NJ 08006. (609) 361-6250. Fax (609) 361-0982. E-mail:
[email protected]. Website: www.tna-support.org. PRICE: Single copy free. Summary: Trigeminal neuralgia (TN) is a chronic disorder that usually affects people in middle or late life and is characterized by excruciating pain around the eyes, nose, lips, jaw, forehead, or scalp. This brochure provides an overview of the causes, diagnosis, medical treatments, and surgical options for trigeminal neuralgia. TN is believed to be caused when a blood vessel presses on the trigeminal nerve (vascular compression) and causes the covering (myelin sheath) to deteriorate. This deterioration causes the nerve to send abnormal signals to the brain which can cause a soft touch or simple facial movement to feel painful. TN can be easily diagnosed by a dentist or physician familiar with its pain and symptoms. There is no specific test to confirm TN. Many patients find that TN can be effectively managed with medication, usually on an ongoing basis (at least four to six weeks on medications, then a gradual tapering off if the pain stays in
Patient Resources 141
remission). The most commonly prescribed medications for TN are anticonvulsants, which work by suppressing the abnormal signaling activity of the trigeminal nerve. Surgical options can include radiofrequency rhizotomy (or electrocoagulation), glycerol rhizotomy, balloon compression, microvascular decompression, and stereotactic (or gamma knife or LINAC) radiosurgery. The brochure concludes with information about the non profit Trigeminal Neuralgia Association (TNA), a group that sponsors support groups, a national patient network, and educational outreach (www.tna-support.org). 1 figure. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “neuralgia” (or synonyms). The following was recently posted: •
2002 national guidelines on the management of early syphilis Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3036&nbr=2262&a mp;string=nerve+AND+pain
•
AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1997 (updated 2001 May-Jun); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2848&nbr=2074&a mp;string=nerve+AND+pain
•
AAOS clinical guideline on shoulder pain Source: American Academy of Orthopaedic Surgeons - Medical Specialty Society; 2001; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2998&nbr=2224&a mp;string=nerve+AND+pain
•
ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guide Source: American College of Cardiology Foundation - Medical Specialty Society; 2001 October; 70 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2968&nbr=2194&a mp;string=nerve+AND+pain
142 Neuralgia
•
ACR Appropriateness Criteria™ for acute trauma to the knee Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2001); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3261&nbr=2487&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteria™ for imaging recommendations for patients with dysphagia Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2001); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3259&nbr=2485&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for acute low back pain--radiculopathy Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2441&nbr=1667&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for chronic elbow pain Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2001); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3260&nbr=2486&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for chronic foot pain Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2002); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3555&nbr=2781&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for multiple sclerosis -- when and how to image Source: American College of Radiology - Medical Specialty Society; 1999; 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2447&nbr=1673&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for myelopathy Source: American College of Radiology - Medical Specialty Society; 1996 (revised 1999); 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2443&nbr=1669&a mp;string=nerve+AND+pain
Patient Resources 143
•
ACR Appropriateness Criteriatm for orbits, vision and visual loss Source: American College of Radiology - Medical Specialty Society; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2450&nbr=1676&a mp;string=nerve+AND+pain
•
ACR Appropriateness Criteriatm for suspected cervical spine trauma Source: American College of Radiology - Medical Specialty Society; 1995 (revised 2002); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3564&nbr=2790&a mp;string=nerve+AND+pain
•
Acute low back pain Source: University of Michigan Health System - Academic Institution; 1997 (revised 2003 Apr); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4112&nbr=3157&a mp;string=nerve+AND+pain
•
Acute pain management Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1997 (revised 1999 April 6); 38 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1888&nbr=1114&a mp;string=nerve+AND+pain
•
Acute sinusitis in adults Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 July (revised 2002 Dec); 30 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3673&nbr=2899&a mp;string=nerve+AND+pain
•
Adult low back pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 June (revised 2002 Sep); 61 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3498&nbr=2724&a mp;string=neuralgia
144 Neuralgia
•
American Gastroenterological Association medical position statement on anorectal testing techniques Source: American Gastroenterological Association - Medical Specialty Society; 1998 July 24 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3066&nbr=2292&a mp;string=nerve+AND+pain
•
American Gastroenterological Association medical position statement: celiac sprue Source: American Gastroenterological Association - Medical Specialty Society; 2000 November 12 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3058&nbr=2284&a mp;string=nerve+AND+pain
•
American Gastroenterological Association medical position statement: epidemiology, diagnosis, and treatment of pancreatic ductal adenocarcinoma Source: American Gastroenterological Association - Medical Specialty Society; 1999 May (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3063&nbr=2289&a mp;string=nerve+AND+pain
•
American Gastroenterological Association medical position statement: treatment of pain in chronic pancreatitis Source: American Gastroenterological Association - Medical Specialty Society; 1998 April 9 (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3068&nbr=2294&a mp;string=nerve+AND+pain
•
Ankle sprain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1997 August (revised 2002 Mar); 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3356&nbr=2582&a mp;string=nerve+AND+pain
•
Assessment and management of acute pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 2000 October (revised 2002 Oct); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3500&nbr=2726&a mp;string=neuralgia
Patient Resources 145
•
Cancer pain Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 March; 88 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3748&nbr=2974&a mp;string=nerve+AND+pain
•
Carpal tunnel syndrome Source: Work Loss Data Institute - Public For Profit Organization; 2003; 99 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3799&nbr=3025&a mp;string=nerve+AND+pain
•
Chronic pain management in the long-term care setting Source: American Medical Directors Association - Professional Association; 1999; 34 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2158&nbr=1384&a mp;string=nerve+AND+pain
•
Clinical practice guideline (second edition) for the diagnosis, treatment, and management of reflex sympathetic dystrophy/complex regional pain syndrome (RSD/CRPS) Source: Reflex Sympathetic Dystrophy Syndrome Association - Private Nonprofit Organization; 2002 February; 46 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3204&nbr=2430&a mp;string=neuralgia
•
Clinical practice guideline for the management of postoperative pain Source: Department of Defense - Federal Government Agency [U.S.]; 2001 July (revised 2002 May); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3284&nbr=2510&a mp;string=nerve+AND+pain
•
Clinical practice guidelines for chronic non-malignant pain syndrome patients II: An evidence-based approach Source: Siskin Hospital for Physical Rehabilitation Hospital/Medical Center; 1995 (updated 1999); 12 pages
(Chattanooga,
TN)
http://www.guideline.gov/summary/summary.aspx?doc_id=2812&nbr=2038&a mp;string=nerve+AND+pain
-
146 Neuralgia
•
Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient Source: American College of Critical Care Medicine - Professional Association; 1995 (revised 2002); 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3170&nbr=2396&a mp;string=nerve+AND+pain
•
Clinical utility of surface EMG: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 July; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2828&nbr=2054&a mp;string=nerve+AND+pain
•
Complex regional pain syndrome (CRPS) Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1905&nbr=1131&a mp;string=nerve+AND+pain
•
Control of pain in patients with cancer. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 June; 61 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2910&nbr=2136&a mp;string=nerve+AND+pain
•
Criteria for cervical surgery related to entrapment of a single cervical nerve root Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 1 page http://www.guideline.gov/summary/summary.aspx?doc_id=1894&nbr=1120&a mp;string=nerve+AND+pain
•
Criteria for entrapment of a single lumbar nerve root Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 1 page http://www.guideline.gov/summary/summary.aspx?doc_id=1895&nbr=1121&a mp;string=nerve+AND+pain
Patient Resources 147
•
Criteria for MRI of the lumbar spine Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 1 page http://www.guideline.gov/summary/summary.aspx?doc_id=1897&nbr=1123&a mp;string=nerve+AND+pain
•
Diabetic foot disorders: a clinical practice guideline. Source: American College of Foot and Ankle Orthopedics and Medicine - Professional Association; 2000 September; 60 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2892&nbr=2118&a mp;string=nerve+AND+pain
•
Diagnosis and management of asthma Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 August (revised 2003 May); 49 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3874&nbr=3083&a mp;string=nerve+AND+pain
•
Diagnosis and treatment of adult degenerative joint disease (DJD) of the knee Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 June (revised 2002 May); 42 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3355&nbr=2581&a mp;string=nerve+AND+pain
•
Diagnosis and treatment of first metatarsophalangeal joint disorders Source: American College of Foot and Ankle Surgeons - Medical Specialty Society; 2003 May-June; 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3849&nbr=3064&a mp;string=nerve+AND+pain
•
Diagnosis and treatment of otitis media in children Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 May (revised 2002 Dec); 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3667&nbr=2893&a mp;string=nerve+AND+pain
•
Diagnosis of chest pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 July (revised 2002 Oct); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3674&nbr=2900&a mp;string=nerve+AND+pain
148 Neuralgia
•
Disorders of the ankle and foot Source: Work Loss Data Institute - Public For Profit Organization; 2003; 76 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3798&nbr=3024&a mp;string=nerve+AND+pain
•
Disorders of the elbow Source: Work Loss Data Institute - Public For Profit Organization; 2003; 78 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3800&nbr=3026&a mp;string=nerve+AND+pain
•
Disorders of the neck and upper back Source: Work Loss Data Institute - Public For Profit Organization; 2003; 109 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3803&nbr=3030&a mp;string=nerve+AND+pain
•
Evidence based clinical practice guideline for children with acute bacterial sinusitis in children 1 to 18 years of age Source: Cincinnati Children's Hospital Medical Center - Hospital/Medical Center; 2001; 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3118&nbr=2344&a mp;string=nerve+AND+pain
•
Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain Source: American Society of Interventional Pain Physicians - Medical Specialty Society; 2003; 79 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3598&nbr=2824&a mp;string=neuralgia
•
General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) Source: American Academy of Family Physicians - Medical Specialty Society; 2002 February 8; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3180&nbr=2406&a mp;string=nerve+AND+pain
Patient Resources 149
•
Guideline for hospitalization for low back pain Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1891&nbr=1117&a mp;string=nerve+AND+pain
•
Guideline for the management of acute and chronic pain in sickle cell disease Source: American Pain Society - Professional Association; 1999 August; 96 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2621&nbr=1847&a mp;string=nerve+AND+pain
•
Guideline for the use of Neurontin® in the management of neuropathic pain Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 2002; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3550&nbr=2776&a mp;string=neuralgia
•
Guidelines for detection of thyroid dysfunction Source: American Thyroid Association - Professional Association; 2000 June 12; 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2361&nbr=1587&a mp;string=nerve+AND+pain
•
Guidelines for lumbar fusion (arthrodesis) Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999 (revised 2001); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3423&nbr=2649&a mp;string=nerve+AND+pain
•
Guidelines for outpatient prescription of oral opioids for injured workers with chronic, noncancer pain Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 2000 May 1; 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2609&nbr=1835&a mp;string=neuralgia
•
Guidelines for the management of uterine fibroids Source: New Zealand Guidelines Group - Private Nonprofit Organization; 1999 August; 120 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2279&nbr=1505&a mp;string=nerve+AND+pain
150 Neuralgia
•
Hallux abductovalgus Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4240&nbr=3240&a mp;string=nerve+AND+pain
•
Hallux limitus and hallux rigidus Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4244&nbr=3244&a mp;string=nerve+AND+pain
•
Hammer toe syndrome Source: American College of Foot and Ankle Surgeons - Medical Specialty Society; 1992 (revised 1999); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2891&nbr=2117&a mp;string=nerve+AND+pain
•
Hammertoe syndrome Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4242&nbr=3242&a mp;string=nerve+AND+pain
•
Heart failure - systolic dysfunction Source: University of Michigan Health System - Academic Institution; 1999 August; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2282&nbr=1508&a mp;string=nerve+AND+pain
•
Heel spur syndrome Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4245&nbr=3245&a mp;string=nerve+AND+pain
•
Herniated disc. In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 104 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2803&nbr=2029&a mp;string=nerve+AND+pain
Patient Resources 151
•
Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3639&nbr=2865&a mp;string=nerve+AND+pain
•
Intermetatarsal neuroma Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4243&nbr=3243&a mp;string=nerve+AND+pain
•
Intermittent positive pressure breathing: 2003 revision and update Source: American Association for Respiratory Care - Professional Association; 1993 December (revised 2003); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3753&nbr=2979&a mp;string=nerve+AND+pain
•
K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification Source: National Kidney Foundation - Disease Specific Society; 2002 February; 246 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3192&nbr=2418&a mp;string=nerve+AND+pain
•
Literature review: nervepace digital electroneurometer in the diagnosis of carpal tunnel syndrome Source: American Association of Electrodiagnostic Medicine - Medical Specialty Society; 2003 March; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3729&nbr=2955&a mp;string=nerve+AND+pain
•
Low back Source: Work Loss Data Institute - Public For Profit Organization; 2003; 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3802&nbr=3029&a mp;string=nerve+AND+pain
152 Neuralgia
•
Low back pain or sciatica in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 May; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2578&nbr=1804&a mp;string=neuralgia
•
Lung cancer. Palliative care Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3653&nbr=2879&a mp;string=nerve+AND+pain
•
Management of chronic kidney disease and pre-ESRD in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 2000 November; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3099&nbr=2325&a mp;string=nerve+AND+pain
•
Management of unerupted and impacted third molar teeth. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 March; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2305&nbr=1531&a mp;string=nerve+AND+pain
•
Mealtime difficulties for older persons: assessment and management Source: The John A. Hartford Foundation Institute for Geriatric Nursing - Academic Institution; 2003; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3506&nbr=2732&a mp;string=nerve+AND+pain
•
Metatarsalgia/intractable plantar keratosis/Tailor's bunion Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4246&nbr=3246&a mp;string=nerve+AND+pain
Patient Resources 153
•
Migraine headache Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 November (revised 2002 Jul); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3441&nbr=2667&a mp;string=nerve+AND+pain
•
North American Spine Society Phase III: clinical guidelines for multidisciplinary spine care specialists. Spinal stenosis version 1.0. Source: North American Spine Society - Medical Specialty Society; 2002; 91 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3609&nbr=2835&a mp;string=nerve+AND+pain
•
Oral hygiene care for functionally dependent and cognitively impaired older adults Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2002 November; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3611&nbr=2837&a mp;string=nerve+AND+pain
•
Overview of implementation of outcome assessment case management in the clinical practice Source: Washington State Chiropractic Association - Professional Association; 2001; 54 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2786&nbr=2012&a mp;string=nerve+AND+pain
•
Pain Source: Work Loss Data Institute - Public For Profit Organization; 2003; 65 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3804&nbr=3031&a mp;string=nerve+AND+pain
•
Pain in osteoarthritis, rheumatoid arthritis, and juvenile chronic arthritis Source: American Pain Society - Professional Association; 2002; 179 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3691&nbr=2917&a mp;string=nerve+AND+pain
•
Palliative treatment of cancer Source: Finnish Medical Society Duodecim - Professional Association; 2001 December 27 (revised 2003 May 30); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=4374&nbr=3296&a mp;string=nerve+AND+pain
154 Neuralgia
•
Practice parameter: electrodiagnostic studies in carpal tunnel syndrome Source: American Academy of Neurology - Medical Specialty Society; 1993 October (revised 2002); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3289&nbr=2515&a mp;string=nerve+AND+pain
•
Practice parameter: evidence-based guidelines for migraine headache (an evidencebased review). Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 September; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2820&nbr=2046&a mp;string=nerve+AND+pain
•
Prevention and management of hip fracture in older people. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2002 January; 40 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3184&nbr=2410&a mp;string=nerve+AND+pain
•
Prevention, diagnosis and treatment of failure to progress in obstetrical labor Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 September (revised 2002 Oct); 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3497&nbr=2723&a mp;string=nerve+AND+pain
•
Primary angle closure Source: American Academy of Ophthalmology - Medical Specialty Society; 2000 September; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2548&nbr=1774&a mp;string=nerve+AND+pain
•
Procedure guideline for bone scintigraphy Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1333&nbr=601&am p;string=nerve+AND+pain
Patient Resources 155
•
Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update Source: American College of Rheumatology - Medical Specialty Society; 2000 September; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2935&nbr=2161&a mp;string=nerve+AND+pain
•
Recommendations for the treatment of dysmenorrhea Source: University of Texas at Austin School of Nursing, Family Nurse Practitioner Program - Academic Institution; 2001 February; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2737&nbr=1963&a mp;string=nerve+AND+pain
•
Reflex sympathetic dystrophy/complex regional pain syndrome clinical practice guidelines - third edition Source: International Research Foundation for RSD/CRPS - Private Nonprofit Research Organization; 2003 January 1; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4117&nbr=3162&a mp;string=neuralgia
•
Shoulder Source: Work Loss Data Institute - Public For Profit Organization; 2003; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3805&nbr=3032&a mp;string=nerve+AND+pain
•
Specialty referral guidelines for cardiovascular evaluation and management Source: American Healthways, Inc - Public For Profit Organization; 2002; 26 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3168&nbr=2394&a mp;string=nerve+AND+pain
•
Spondylolysis, lytic spondylolisthesis and degenerative spondylolisthesis (SLD). In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 106 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2804&nbr=2030&a mp;string=nerve+AND+pain
156 Neuralgia
•
Surgery for thoracic outlet syndrome (TOS) Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1900&nbr=1126&a mp;string=nerve+AND+pain
•
Systemic lupus erythematosus (SLE) Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3390&nbr=2616&a mp;string=nerve+AND+pain
•
The diagnosis and treatment of heel pain Source: American College of Foot and Ankle Surgeons - Medical Specialty Society; 2001 Sep-October; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3173&nbr=2399&a mp;string=nerve+AND+pain
•
The management of persistent pain in older persons Source: American Geriatrics Society - Medical Specialty Society; 1998 October (revised 2002 Jun); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3365&nbr=2591&a mp;string=neuralgia
•
Treatment of acute myocardial infarction Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 May (revised 2002 Nov); 68 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3659&nbr=2885&a mp;string=nerve+AND+pain
•
Unremitting low back pain. In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 96 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2805&nbr=2031&a mp;string=nerve+AND+pain
•
Upper extremity musculoskeletal disorders Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2003; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3694&nbr=2920&a mp;string=nerve+AND+pain
Patient Resources 157
•
VHA/DoD clinical practice guideline for the management of substance use disorders Source: Department of Defense - Federal Government Agency [U.S.]; 2001 September; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3169&nbr=2395&a mp;string=nerve+AND+pain Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
TN-Alert Articles and Archives Summary: This page provides access to several articles published in the newsletter of the Trigeminal Neuralgia Association (TNA), TN Alert. Source: Trigeminal Neuralgia Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7688
•
Trigeminal Neuralgia Summary: A general overview of trigeminal neuralgia that includes a description of the disorder, treatment, prognosis and research information. Source: National Institute of Neurological Disorders and Stroke, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2057 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to neuralgia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
158 Neuralgia
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: http://my.webmd.com/health_topics
Associations and Neuralgia The following is a list of associations that provide information on and resources relating to neuralgia: •
Trigeminal Neuralgia Association Telephone: (352) 376-9955 Fax: (352) 376-8688 Email:
[email protected] Web Site: http://www.tna-support.org Background: The Trigeminal Neuralgia Association is a national voluntary not-forprofit organization dedicated to providing information, mutual aid, support, and encouragement to people with Trigeminal Neuralgia (TN) and their families. Trigeminal Neuralgia (or Tic Douloureux) is a disorder of the trigeminal (fifth) cranial nerve that causes intense, episodic pain in areas of the face supplied by the trigeminal nerve. Founded in 1990, the Association is also committed to increasing public and professional awareness of the disorder and reducing the isolation of those affected by Trigeminal Neuralgia. The organization serves as a resource and information clearinghouse to centralize current data and medical efforts on treatment of TN and encourages medical research to determine the cause of, and effective treatment for, this disorder. The Association's Medical Advisory Board consists of key specialists in the medical and surgical treatment of TN, dentistry, and pain management. The Trigeminal Neuralgia Association also has a network of local support groups that enable affected individuals to share experiences, receive support and encouragement, and obtain current information on the disorder's treatment. In addition, the Association promotes patient advocacy; provides appropriate referrals; and conducts an educational outreach program to medical and dental practitioners and the general public.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to neuralgia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with neuralgia.
Patient Resources 159
The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about neuralgia. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “neuralgia” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “neuralgia”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “neuralgia” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “neuralgia” (or a synonym) into the search box, and click “Submit Query.”
161
APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.25
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
25
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
162 Neuralgia
libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)26: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
26
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 163
•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
164 Neuralgia
•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 165
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
166 Neuralgia
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
167
ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on neuralgia: •
Basic Guidelines for Neuralgia Neuralgias Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001407.htm
•
Signs & Symptoms for Neuralgia Facial pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003027.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm
•
Background Topics for Neuralgia Analgesics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Fractures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm
168 Neuralgia
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
169
NEURALGIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablate: In surgery, is to remove. [NIH] Ablation: The removal of an organ by surgery. [NIH] Acetylcarnitine: An acetic acid ester of carnitine that facilitates movement of acetyl CoA into the matrices of mammalian mitochondria during the oxidation of fatty acids. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acute Disease: Disease having a short and relatively severe course. [NIH] Acyclovir: Functional analog of the nucleoside guanosine. It acts as an antimetabolite, especially in viruses. It is used as an antiviral agent, especially in herpes infections. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent
170 Neuralgia
chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airways: Tubes that carry air into and out of the lungs. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Neurotransmitters: Amino acids released by neurons as intercellular messengers. Among the amino acid neurotransmitters are glutamate (glutamic acid) and GABA which are, respectively, the most common excitatory and inhibitory neurotransmitters in the central nervous system. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH]
Dictionary 171
Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angioma: A tumor composed of lymphatic or blood vessels. [NIH] Angiopathy: Disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. There are two types of angiopathy: macroangiopathy and microangiopathy. In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood. In microangiopathy, the walls
172 Neuralgia
of the smaller blood vessels become so thick and weak that they bleed, leak protein, and slow the flow of blood through the body. Then the cells, for example, the ones in the center of the eye, do not get enough blood and may be damaged. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] Anterior Cruciate Ligament: A strong ligament of the knee that originates from the posteromedial portion of the lateral condyle of the femur, passes anteriorly and inferiorly between the condyles, and attaches to the depression in front of the intercondylar eminence of the tibia. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH]
Dictionary 173
Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antineoplastic Agents: Substances that inhibit or prevent the proliferation of neoplasms. [NIH]
Antitussive: An agent that relieves or prevents cough. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aplastic anemia: A condition in which the bone marrow is unable to produce blood cells. [NIH]
Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteriovenous Fistula: An abnormal communication between an artery and a vein. [NIH] Arteritis: Inflammation of an artery. [NIH] Arthropathy: Any joint disease. [EU] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH]
174 Neuralgia
Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects
Dictionary 175
result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body
176 Neuralgia
fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH]
Dictionary 177
Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Neoplasms: Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Bronchus: A large air passage that leads from the trachea (windpipe) to the lung. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bunion: A swelling of the bursa mucosa of the ball of the great toe, with thickening of the overlying skin and forcing of the toe outward. [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Burning Mouth Syndrome: A group of painful oral symptoms associated with a burning or similar sensation. There is usually a significant organic component with a degree of functional overlay; it is not limited to the psychophysiologic group of disorders. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Calcitonin Gene-Related Peptide: Calcitonin gene-related peptide. A 37-amino acid peptide derived from the calcitonin gene. It occurs as a result of alternative processing of mRNA from the calcitonin gene. The neuropeptide is widely distributed in neural tissue of the brain, gut, perivascular nerves, and other tissue. The peptide produces multiple biological effects and has both circulatory and neurotransmitter modes of action. In particular, it is a potent endogenous vasodilator. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal
178 Neuralgia
functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Callus: A callosity or hard, thick skin; the bone-like reparative substance that is formed round the edges and fragments of broken bone. [NIH] Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardioversion: Electrical reversion of cardiac arrhythmias to normal sinus rhythm, formerly using alternatic current, but now employing direct current. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH]
Dictionary 179
Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudalis: Brain region that controls singing processes. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cephalalgia: Pain in the head; headache. Called also cephalgia and cephalodynia. [EU] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellopontine: Going from the cerebellum (the part of the brain responsible for coordinating movement) to the pons (part of the central nervous system located near the base of the brain.) [NIH]
180 Neuralgia
Cerebellopontine Angle: Junction between the cerebellum and the pons. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Angiography: Radiography of the vascular system of the brain after injection of a contrast medium. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Hemorrhage: Bleeding into a cerebral hemisphere of the brain, including lobar, subcortical white matter, and basal ganglia hemorrhages. Commonly associated conditions include hypertension; intracranial arteriosclerosis; intracranial aneurysm; craniocerebral trauma; intracranial arteriovenous malformations; cerebral amyloid angiopathy; and cerebral infarction. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chamomile: Common name for several daisy-like species native to Europe and Western Asia, now naturalized in the United States and Australia. The dried flower-heads of two species, Anthemis nobilis (Chamaemelum nobile) and Matricaria recutita, have specific use as herbs. They are administered as tea, extracts, tinctures, or ointments. Chamomile contains choline, coumarins, cyanogenic glycosides, flavonoids, salicylate derivatives, tannins, and volatile oils. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chickenpox: A mild, highly contagious virus characterized by itchy blisters all over the body. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Chloroform: A commonly used laboratory solvent. It was previously used as an anesthetic, but was banned from use in the U.S. due to its suspected carcinogenecity. [NIH]
Dictionary 181
Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Choreatic Disorders: Acquired and hereditary conditions which feature chorea as a primary manifestation of the disease process. [NIH] Chromic: Catgut sterilized and impregnated with chromium trioxide. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Cicatrix: The formation of new tissue in the process of wound healing. [NIH] Cicatrization: The formation of a cicatrix or scar. [EU] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clathrin: The main structural coat protein of coated vesicles which play a key role in the intracellular transport between membranous organelles. Clathrin also interacts with
182 Neuralgia
cytoskeletal proteins. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Coated Vesicles: Vesicles formed when cell-membrane coated pits invaginate and pinch off. The outer surface of these vesicles are covered with a lattice-like network of coat proteins, such as clathrin, coat protein complex proteins, or caveolins. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Codons: Any triplet of nucleotides (coding unit) in DNA or RNA (if RNA is the carrier of primary genetic information as in some viruses) that codes for particular amino acid or signals the beginning or end of the message. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire
Dictionary 183
functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine.
184 Neuralgia
Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues. [NIH]
Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic
Dictionary 185
hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Craniotomy: An operation in which an opening is made in the skull. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cysticercus: The larval form of various tapeworms of the genus Taenia. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytoskeletal Proteins: Major constituent of the cytoskeleton found in the cytoplasm of eukaryotic cells. They form a flexible framework for the cell, provide attachment points for organelles and formed bodies, and make communication between parts of the cell possible. [NIH]
Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH]
186 Neuralgia
Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Demyelinating Diseases: Diseases characterized by loss or dysfunction of myelin in the central or peripheral nervous system. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in
Dictionary 187
common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diathesis: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the person more than usually susceptible to certain diseases. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the
188 Neuralgia
extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU]
Dictionary 189
Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [NIH] Electric Stimulation Therapy: Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the threshold of the skin to pain. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroshock: Induction of a stress reaction in experimental subjects by means of an electrical shock; applies to either convulsive or non-convulsive states. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]
Emollient: Softening or soothing; called also malactic. [EU] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles
190 Neuralgia
or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythrina: A genus of leguminous shrubs or trees, mainly tropical, yielding certain alkaloids, lectins, and other useful compounds. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH]
Dictionary 191
Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]
Ethmoid: An unpaired cranial bone which helps form the medial walls of the orbits and contains the themoidal air cells which drain into the nose. [NIH] Eucalyptus: A genus of Australian trees of the Myrtaceae family that yields gums, oils, and resins which are used as flavoring agents, astringents, and aromatics, and formerly to treat diarrhea, asthma, bronchitis, and respiratory tract infections. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH]
192 Neuralgia
Facial Neuralgia: Neuralgic syndromes and other conditions which feature chronic or recurrent facial pain as the primary manifestation of disease. Disorders of the trigeminal and facial nerves are frequently associated with these conditions. [NIH] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fascioliasis: Helminth infection of the liver caused by species of Fasciola. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Femoral: Pertaining to the femur, or to the thigh. [EU] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrositis: Aching, soreness or stiffness of muscles; often caused by inexpedient work postures. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in
Dictionary 193
carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]
Flecainide: A potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias. Paradoxically, however, in myocardial infarct patients with either symptomatic or asymptomatic arrhythmia, flecainide exacerbates the arrhythmia and is not recommended for use in these patients. [NIH] Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fluphenazine: A phenothiazine used in the treatment of psychoses. Its properties and uses are generally similar to those of chlorpromazine. [NIH] Foot Injuries: General or unspecified injuries involving the foot. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma knife: Radiation therapy in which high-energy rays are aimed at a tumor from many angles in a single treatment session. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
194 Neuralgia
Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genes, pol: DNA sequences that form the coding region for retroviral enzymes including reverse transcriptase, protease, and endonuclease/integrase. "pol" is short for polymerase, the enzyme class of reverse transcriptase. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glial Fibrillary Acidic Protein: An intermediate filament protein found only in glial cells or cells of glial origin. MW 51,000. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally
Dictionary 195
occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gp120: 120-kD HIV envelope glycoprotein which is involved in the binding of the virus to its membrane receptor, the CD4 molecule, found on the surface of certain cells in the body. [NIH]
Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Haematemesis: The vomiting of blood. [EU] Hallux Rigidus: A condition caused by degenerative arthritis (osteoarthritis) of the metatarsophalangeal joint of the great toe and characterized by pain and limited dorsiflexion, but relatively unrestricted plantar flexion. [NIH] Hamartoma: A focal malformation resembling a neoplasm, composed of an overgrowth of mature cells and tissues that normally occur in the affected area. [NIH]
196 Neuralgia
Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]
Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the
Dictionary 197
formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Herpes Zoster Ophthalmicus: Virus infection of the Gasserian ganglion and its nerve branches characterized by pain and vesicular eruptions with much swelling. Ocular involvement is usually heralded by a vesicle on the tip of the nose. This area is innervated by the nasociliary nerve. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU]
198 Neuralgia
Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypnotherapy: Sleeping-cure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypotension: Abnormally low blood pressure. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH]
Dictionary 199
Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisional: The removal of a sample of tissue for examination under a microscope. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and
200 Neuralgia
other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Infrared Rays: That portion of the electromagnetic spectrum usually sensed as heat. Infrared wavelengths are longer than those of visible light, extending into the microwave frequencies. They are used therapeutically as heat, and also to warm food in restaurants. [NIH]
Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Instillation: . [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Integrase: An enzyme that inserts DNA into the host genome. It is encoded by the pol gene of retroviruses and also by temperate bacteriophages, the best known being bacteriophage lambda. EC 2.7.7.-. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of
Dictionary 201
diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intracranial Aneurysm: A saclike dilatation of the walls of a blood vessel, usually an artery. [NIH]
Intracranial Arteriosclerosis: Vascular diseases characterized by thickening, hardening, and remodeling of the walls of intracranial arteries. There are three subtypes: (1) atherosclerosis, marked by fatty depositions in the innermost layer of the arterial walls, (2) Monckeberg's sclerosis, which features calcium deposition in the media and (3) arteriolosclerosis, which refers to sclerosis of small caliber arteries. Clinically, this process may be associated with transient ischemic attack, brain infarction, intracranial embolism and thrombosis, or intracranial aneurysm. [NIH] Intracranial Hemorrhages: Bleeding within the intracranial cavity, including hemorrhages in the brain and within the cranial epidural, subdural, and subarachnoid spaces. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial tumors: Tumors that occur in the brain. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique
202 Neuralgia
is used in water purification, in research, and in industry. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Iontophoresis: Therapeutic introduction of ions of soluble salts into tissues by means of electric current. In medical literature it is commonly used to indicate the process of increasing the penetration of drugs into surface tissues by the application of electric current. It has nothing to do with ion exchange, air ionization nor phonophoresis, none of which requires current. [NIH] Ipsilateral: Having to do with the same side of the body. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratosis: Any horny growth such as a wart or callus. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Lacrimal: Pertaining to the tears. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented
Dictionary 203
and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linear accelerator: An accelerator in which charged particles are accelerated along a straight path either by means of a traveling electromagnetic field or through a series of small gaps between electrodes that are so connected to an alternating voltage supply of high frequency. [NIH]
Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH]
204 Neuralgia
Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lumbago: Pain in the lumbar region. [EU] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocele: Cystic mass containing lymph from diseased lymphatic channels or following surgical trauma or other injury. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Angiography: Non-invasive method of vascular imaging and determination of internal anatomy without injection of contrast media or radiation exposure. The technique is used especially in cerebral angiography as well as for studies of other vascular structures. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malaise: A vague feeling of bodily discomfort. [EU] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet.
Dictionary 205
[NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Masseter Muscle: A masticatory muscle whose action is closing the jaws. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU] Maxillary Nerve: The intermediate sensory division of the trigeminal (5th cranial) nerve. The maxillary nerve carries general afferents from the intermediate region of the face including the lower eyelid, nose and upper lip, the maxillary teeth, and parts of the dura. [NIH]
Maxillary Sinus: One of the paired paranasal sinuses, located in the body of the maxilla, communicating with the middle meatus of the nasal cavity. [NIH] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by
206 Neuralgia
means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Memantine: Amantadine derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Meningocele: A congenital or acquired protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the skull or vertebral column. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metatarsal Bones: The five long bones of the metatarsus articulating with the tarsal bones proximally and the toes (phalanges) distally. [NIH] Metatarsophalangeal Joint: The articulation between a metatarsal bone and a phalanx. [NIH] Metatarsus: The part of the foot between the tarsa and the toes. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body
Dictionary 207
functions. It is a chelating agent for heavy metals. [NIH] Mexiletine: Antiarrhythmic agent pharmacologically similar to lidocaine. It may have some anticonvulsant properties. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microsome: One of the specific metabolic pathways of the liver. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH]
208 Neuralgia
Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myelin Sheath: The lipid-rich sheath investing many axons in both the central and peripheral nervous systems. The myelin sheath is an electrical insulator and allows faster and more energetically efficient conduction of impulses. The sheath is formed by the cell membranes of glial cells (Schwann cells in the peripheral and oligodendroglia in the central nervous system). Deterioration of the sheath in demyelinating diseases is a serious clinical problem. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH]
Dictionary 209
Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Cavity: The proximal portion of the respiratory passages on either side of the nasal septum, lined with ciliated mucosa, extending from the nares to the pharynx. [NIH] Nasal Septum: The partition separating the two nasal cavities in the midplane, composed of cartilaginous, membranous and bony parts. [NIH] Nasociliary: A branch of the ophthalmic nerve which receives most of the fibers of general sensation from the eyeball. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU]
210 Neuralgia
Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neurites: In tissue culture, hairlike projections of neurons stimulated by growth factors and other molecules. These projections may go on to form a branched tree of dendrites or a single axon or they may be reabsorbed at a later stage of development. "Neurite" may refer to any filamentous or pointed outgrowth of an embryonal or tissue-culture neural cell. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neurogenic Inflammation: Inflammation caused by an injurious stimulus of peripheral neurons and resulting in release of neuropeptides which affect vascular permeability and help initiate proinflammatory and immune reactions at the site of injury. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system. [NIH] Neuroma: A tumor that arises in nerve cells. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Blockade: The intentional interruption of transmission at the neuromuscular junction by external agents, usually neuromuscular blocking agents. It is distinguished from nerve block in which nerve conduction is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce muscle relaxation as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neuroprotective Agents: Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event,
Dictionary 211
but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neurotrophins: A nerve growth factor. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Nonmalignant: Not cancerous. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normal Distribution: Continuous frequency distribution of infinite range. Its properties are
212 Neuralgia
as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation. [NIH] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligodendroglia: A class of neuroglial (macroglial) cells in the central nervous system. Oligodendroglia may be called interfascicular, perivascular, or perineuronal satellite cells according to their location. The most important recognized function of these cells is the formation of the insulating myelin sheaths of axons in the central nervous system. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Onychomycosis: Mycosis of the nails, possibly due to some extent to humidity. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Open Reading Frames: Reading frames where successive nucleotide triplets can be read as codons specifying amino acids and where the sequence of these triplets is not interrupted by stop codons. [NIH] Ophthalmic: Pertaining to the eye. [EU] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each
Dictionary 213
half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]
Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Oropharynx: Oral part of the pharynx. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteonecrosis: Death of a bone or part of a bone, either atraumatic or posttraumatic. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Pain, Postoperative: Pain during the period after surgery. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH]
214 Neuralgia
Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Paraneoplastic syndrome: A group of symptoms that may develop when substances released by some cancer cells disrupt the normal function of surrounding cells and tissue. [NIH]
Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesia: Subjective cutaneous sensations (e.g., cold, warmth, tingling, pressure, etc.) that are experienced spontaneously in the absence of stimulation. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH]
Dictionary 215
Patient Advocacy: Promotion and protection of the rights of patients, frequently through a legal process. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Peridural: Around or external to the dura mater. [EU] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Perivascular: Situated around a vessel. [EU] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Phallic: Pertaining to the phallus, or penis. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood
216 Neuralgia
and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phonophoresis: Use of ultrasound to increase the percutaneous adsorption of drugs. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Piperidines: A family of hexahydropyridines. Piperidine itself is found in the pepper plant as the alkaloid piperine. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to
Dictionary 217
the formation of a stable hemostatic plug. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH]
218 Neuralgia
Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH]
Dictionary 219
Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]
Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pseudorabies: A highly contagious herpesvirus infection affecting the central nervous system of swine, cattle, dogs, cats, rats, and other animals. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors.
220 Neuralgia
[EU]
Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radicular: Having the character of or relating to a radicle or root. [NIH] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [NIH]
Dictionary 221
Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH]
222 Neuralgia
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Reoperation: A repeat operation for the same condition in the same patient. It includes reoperation for reexamination, reoperation for disease progression or recurrence, or reoperation following operative failure. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH]
Dictionary 223
Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Schwannoma: A tumor of the peripheral nervous system that begins in the nerve sheath (protective covering). It is almost always benign, but rare malignant schwannomas have
224 Neuralgia
been reported. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false
Dictionary 225
negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shoulder Pain: Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin. [NIH] Sick Sinus Syndrome: Dysfunction of the sinoatrial node manifested by persistent sinus bradycardia, sinus arrest, sinoatrial exit block, chronic atrial fibrillation and inability of the heart to resume sinus rhythm following cardioversion for atrial fibrillation. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of
226 Neuralgia
protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinoatrial Node: The small mass of modified cardiac muscle fibers located at the junction of the superior vena cava and right atrium. Contraction impulses probably start in this node, spread over the atrium and are then transmitted by the atrioventricular bundle to the ventricle. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Skull Base: The inferior region of the skull consisting of an internal (cerebral), and an external (basilar) surface. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH]
Dictionary 227
Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphenoid: An unpaired cranial bone with a body containing the sphenoid sinus and forming the posterior part of the medial walls of the orbits. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spirochete: Lyme disease. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Spondylolisthesis: Forward displacement of one vertebra over another. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or
228 Neuralgia
overexertion of some part of the musculature. [NIH] Sprue: A non febrile tropical disease of uncertain origin. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stereotactic: Radiotherapy that treats brain tumors by using a special frame affixed directly to the patient's cranium. By aiming the X-ray source with respect to the rigid frame, technicians can position the beam extremely precisely during each treatment. [NIH] Stereotactic radiosurgery: A radiation therapy technique involving a rigid head frame that is attached to the skull; high-dose radiation is administered through openings in the head frame to the tumor while decreasing the amount of radiation given to normal brain tissue. This procedure does not involve surgery. Also called stereotaxic radiosurgery and stereotactic radiation therapy. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclavian: The direct continuation of the axillary vein at the lateral border of the first rib. It passes medially to join the internal jugular vein and form the brachiocephalic vein on each side. [NIH] Subclavian Artery: Artery arising from the brachiocephalic trunk on the right side and from the arch of the aorta on the left side. It distributes to the neck, thoracic wall, spinal cord, brain, meninges, and upper limb. [NIH] Subclavian Vein: The continuation of the axillary vein which follows the subclavian artery
Dictionary 229
and then joins the internal jugular vein to form the brachiocephalic vein. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraorbital: The branch of the frontal nerve that passes through the supraorbital notch or foramen and is sensory for the upper eyelid, the conjunctiva, the eyebrow, the forehead, and the scalp up to the occipital bone. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or second-
230 Neuralgia
messenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachykinins: A family of biologically active peptides sharing a common conserved Cterminal sequence, -Phe-X-Gly-Leu-Met-NH2, where X is either an aromatic or a branched aliphatic amino acid. Members of this family have been found in mammals, amphibians, and mollusks. Tachykinins have diverse pharmacological actions in the central nervous system and the cardiovascular, genitourinary, respiratory, and gastrointestinal systems, as well as in glandular tissues. This diversity of activity is due to the existence of three or more subtypes of tachykinin receptors. [NIH] Tarsal Bones: The seven bones which form the tarsus - namely, calcaneus, talus, cuboid, navicular, and first, second and third cuneiforms. The tarsus is a skeletal part of the foot. [NIH]
Tarsi: An inflammatory affection of the Meibomian glands. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetanus: A disease caused by tetanospasmin, a powerful protein toxin produced by Clostridium tetani. Tetanus usually occurs after an acute injury, such as a puncture wound or laceration. Generalized tetanus, the most common form, is characterized by tetanic muscular contractions and hyperreflexia. Localized tetanus presents itself as a mild condition with manifestations restricted to muscles near the wound. It may progress to the generalized form. [NIH]
Dictionary 231
Tetracaine: A potent local anesthetic of the ester type used for surface and spinal anesthesia. [NIH]
Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Thalassemia: A group of hereditary hemolytic anemias in which there is decreased synthesis of one or more hemoglobin polypeptide chains. There are several genetic types with clinical pictures ranging from barely detectable hematologic abnormality to severe and fatal anemia. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermal ablation: A procedure using heat to remove tissue or a part of the body, or destroy its function. For example, to remove the lining of the uterus, a catheter is inserted through the cervix into the uterus, a balloon at the end of the catheter is inflated, and fluid inside the balloon is heated to destroy the lining of the uterus. [NIH] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thoracic: Having to do with the chest. [NIH] Thoracic Outlet Syndrome: A neurovascular syndrome associated with compression of the brachial plexus; subclavian artery; and subclavian vein at the superior thoracic outlet. This may result from a variety of anomalies such as a cervical rib (cervical rib syndrome), anomalous fascial bands, and abnormalities of the origin or insertion of the anterior or medial scalene muscles. Clinical features may include pain in the shoulder and neck region which radiates into the arm, paresis or paralysis of brachial plexus innervated muscles, paresthesia, loss of sensation, reduction of arterial pulses in the affected extremity, ischemia, and edema. (Adams et al., Principles of Neurology, 6th ed, pp214-5). [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH]
232 Neuralgia
Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tic: An involuntary compulsive, repetitive, stereotyped movement, resembling a purposeful movement because it is coordinated and involves muscles in their normal synergistic relationships; tics usually involve the face and shoulders. [EU] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Toothache: Pain in the adjacent areas of the teeth. [NIH] Topical: On the surface of the body. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides
Dictionary 233
(ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Trigeminal Ganglion: The semilunar-shaped ganglion containing the cells of origin of most of the sensory fibers of the trigeminal nerve. It is situated within the dural cleft on the cerebral surface of the petrous portion of the temporal bone and gives off the ophthalmic, maxillary, and part of the mandibular nerves. [NIH] Trigeminal Nerve: The 5th and largest cranial nerve. The trigeminal nerve is a mixed motor and sensory nerve. The larger sensory part forms the ophthalmic, mandibular, and maxillary nerves which carry afferents sensitive to external or internal stimuli from the skin, muscles, and joints of the face and mouth and from the teeth. Most of these fibers originate from cells of the trigeminal ganglion and project to the trigeminal nucleus of the brain stem. The smaller motor part arises from the brain stem trigeminal motor nucleus and innervates the muscles of mastication. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trismus: Spasmodic contraction of the masseter muscle resulting in forceful jaw closure. This may be seen with a variety of diseases, including tetanus, as a complication of radiation therapy, trauma, or in association with neoplastic conditions. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for
234 Neuralgia
nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH]
Dictionary 235
Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Varicella: Chicken pox. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vertebral Artery: The first branch of the subclavian artery with distribution to muscles of the neck, vertebrae, spinal cord, cerebellum and interior of the cerebrum. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear
236 Neuralgia
part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Virus Replication: The process of intracellular viral multiplication, consisting of the synthesis of proteins, nucleic acids, and sometimes lipids, and their assembly into a new infectious particle. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]
Wart: A raised growth on the surface of the skin or other organ. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality
Dictionary 237
disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Zoster: A virus infection of the Gasserian ganglion and its nerve branches, characterized by discrete areas of vesiculation of the epithelium of the forehead, the nose, the eyelids, and the cornea together with subepithelial infiltration. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
239
INDEX A Abdominal, 169, 202, 214 Aberrant, 38, 169 Ablate, 169, 189 Ablation, 169 Acetylcarnitine, 96, 169 Acetylcholine, 103, 107, 169, 181, 211 Acoustic, 5, 109, 169, 236 Acrylonitrile, 169, 223 Actin, 169, 208 Activities of Daily Living, 84, 169 Acute Disease, 9, 169 Acyclovir, 21, 24, 51, 118, 169 Adenine, 169, 220 Adenocarcinoma, 144, 169 Adenosine, 79, 107, 169, 216 Adrenal Cortex, 169, 184, 190, 218 Adrenergic, 107, 169, 188, 190, 229 Adverse Effect, 105, 169, 225 Afferent, 10, 16, 18, 19, 104, 169, 191, 227 Affinity, 97, 169, 170, 186, 226 Agonist, 170, 174, 188, 211 Airways, 107, 170 Algorithms, 170, 176 Alimentary, 170, 201, 214 Alkaline, 170, 171, 177 Alkaloid, 170, 178, 208, 211, 216 Allergen, 170, 186, 225 Allylamine, 170 Alpha Particles, 170, 220 Alternative medicine, 119, 170 Ameliorating, 107, 170 Amenorrhea, 170, 172 Amine, 94, 170, 197 Amino Acid Neurotransmitters, 85, 170 Amino Acid Sequence, 170, 172 Amino Acids, 98, 107, 170, 171, 173, 191, 210, 212, 215, 217, 219, 225, 234 Ammonia, 170, 171 Ampulla, 171, 190 Amputation, 115, 171 Amyloid, 171, 180 Anaesthesia, 30, 45, 56, 171, 199 Anaesthetic, 72, 171 Anal, 171, 192 Analgesic, 5, 8, 13, 19, 25, 32, 103, 104, 105, 115, 171, 182, 203, 208, 212 Analog, 169, 171, 186
Analogous, 171, 233 Anatomical, 10, 14, 25, 44, 45, 171, 174, 187, 199, 224 Androgens, 169, 171, 185 Anemia, 135, 171, 231 Anesthesia, 4, 19, 24, 29, 32, 34, 43, 53, 58, 63, 77, 171, 202, 210, 218, 231 Anesthetics, 17, 45, 171, 190 Aneurysm, 22, 171, 235 Angina, 107, 171 Angioma, 27, 50, 64, 171 Angiopathy, 171, 180 Animal model, 7, 9, 16, 85, 91, 96, 102, 172 Anions, 172, 202 Ankle, 13, 115, 144, 147, 148, 150, 151, 152, 156, 172 Anomalies, 172, 231 Anorectal, 144, 172 Anorexia, 100, 101, 172, 234 Anorexia Nervosa, 100, 101, 172 Anterior Cerebral Artery, 172, 180 Anterior Cruciate Ligament, 57, 172 Antiallergic, 172, 185 Antibodies, 105, 172, 196, 198, 204, 216 Antibody, 101, 102, 170, 172, 182, 196, 197, 198, 199, 205, 207, 220, 221, 225, 227 Anticoagulant, 172, 219 Anticonvulsant, 5, 90, 91, 172, 178, 204, 207 Antidepressant, 85, 172 Antigen, 91, 170, 172, 183, 197, 198, 199, 205, 225 Anti-inflammatory, 93, 105, 172, 173, 185, 194, 223 Anti-Inflammatory Agents, 172, 173, 185 Antimetabolite, 169, 173 Antimicrobial, 24, 40, 99, 100, 173 Antineoplastic, 173, 185, 236 Antineoplastic Agents, 173, 185, 236 Antitussive, 85, 173, 186, 212 Antiviral, 8, 9, 51, 84, 169, 173 Anus, 171, 172, 173, 176, 201 Anxiety, 19, 84, 86, 96, 97, 98, 99, 103, 106, 107, 173, 204, 214 Aorta, 173, 184, 228, 235 Aplastic anemia, 5, 173 Aponeurosis, 173, 193 Aqueous, 173, 175, 189, 203
Neuralgia
Arginine, 173, 211 Aromatic, 94, 108, 173, 216, 228, 230 Arrhythmia, 173, 193 Arterial, 10, 49, 101, 170, 173, 180, 194, 198, 201, 219, 230, 231 Arteries, 113, 171, 173, 176, 184, 201, 207, 208 Arterioles, 173, 176, 178, 207 Arteriovenous, 62, 173, 180, 207 Arteriovenous Fistula, 62, 173 Arteritis, 37, 114, 173 Arthropathy, 96, 173 Articular, 173, 213 Articulation, 173, 206 Aspartate, 103, 173, 186, 202 Aspartic, 17, 173, 191 Aspartic Acid, 17, 173 Aspirin, 23, 39, 173 Assay, 13, 98, 173, 198 Asthenia, 96, 173 Astringents, 174, 191 Asymptomatic, 174, 193, 214 Ataxia, 99, 104, 134, 135, 174, 197, 231 Atrial, 141, 174, 193, 225 Atrial Fibrillation, 141, 174, 225 Atrium, 174, 226, 235 Atrophy, 134, 174, 210 Attenuated, 9, 11, 85, 91, 174 Attenuation, 19, 174 Atypical, 22, 26, 41, 53, 58, 70, 71, 111, 114, 116, 174, 200, 212 Auditory, 77, 174, 191, 205, 235 Auricular, 38, 174 Autodigestion, 174, 214 Autoimmune disease, 93, 174, 208 Autonomic, 49, 60, 92, 169, 174, 194, 211, 215, 227 Autonomic Nervous System, 174, 215 Autosuggestion, 174, 198 Axonal, 18, 174 Axons, 16, 174, 208, 209, 212, 213, 215, 218, 222, 227 B Back Pain, 152, 174 Baclofen, 4, 79, 83, 124, 125, 174 Bacteria, 172, 175, 190, 192, 193, 207, 227, 233, 234 Bacteriophage, 175, 200, 233 Basal Ganglia, 174, 175, 177, 180, 181, 193 Basal Ganglia Diseases, 174, 175, 181 Base, 169, 175, 179, 186, 202, 230, 234 Benign, 5, 175, 177, 193, 196, 209, 221, 223
240
Benign tumor, 5, 175 Benzene, 98, 175 Benzodiazepines, 92, 175 Bilateral, 26, 175, 214, 225 Bile, 175, 193, 199, 203, 228 Biliary, 175, 178, 214 Biliary Tract, 175, 178, 214 Bioavailability, 98, 175 Biochemical, 173, 175, 203, 213, 225 Biological therapy, 175, 195 Biomarkers, 15, 175 Biopsy, 15, 41, 46, 176, 215 Biosynthesis, 176, 225 Biotechnology, 21, 22, 119, 131, 133, 134, 135, 176 Bipolar Disorder, 99, 101, 176 Bladder, 176, 199, 208, 210, 219, 234 Blood Coagulation, 176, 178, 231 Blood Platelets, 176, 225 Blood pressure, 10, 109, 176, 194, 198, 226 Blood vessel, 113, 140, 171, 176, 178, 181, 190, 196, 201, 202, 226, 228, 230, 231, 235 Body Fluids, 176, 188, 226, 234 Bone Marrow, 173, 175, 176, 198, 204, 207 Bowel, 171, 176, 187, 200, 228 Bowel Movement, 176, 187, 228 Brachial, 51, 176, 205, 231 Brachial Plexus, 176, 205, 231 Brachytherapy, 176, 201, 220 Bradycardia, 176, 225 Bradykinin, 177, 211 Brain Neoplasms, 177, 197, 231 Brain Stem, 10, 177, 180, 233 Branch, 165, 177, 189, 205, 209, 214, 227, 229, 231, 232, 235 Bronchial, 177, 197 Bronchitis, 177, 191 Bronchoconstriction, 97, 177 Bronchus, 177 Buccal, 24, 177, 204 Bunion, 152, 177 Bupivacaine, 41, 56, 66, 177, 203 Burning Mouth Syndrome, 46, 177 Burns, 96, 108, 177 Burns, Electric, 177 Bursitis, 115, 177 C Cachexia, 96, 177 Calcitonin Gene-Related Peptide, 10, 11, 177 Calcium, 11, 99, 103, 177, 178, 183, 201, 219, 225
241
Calcium Channels, 11, 178 Calculi, 178, 195 Callus, 178, 202 Cannula, 17, 178 Capillary, 101, 177, 178, 235 Capsaicin, 17, 18, 27, 66, 67, 84, 92, 93, 103, 111, 124, 178 Carbamazepine, 4, 20, 21, 31, 45, 58, 70, 92, 124, 178 Carbohydrate, 178, 185, 194, 195, 217 Carbon Dioxide, 178, 186, 193, 216, 235 Carcinogenic, 175, 178, 200, 218, 228 Carcinogens, 178, 181, 212 Carcinoma, 12, 61, 141, 178 Cardiac, 27, 38, 54, 92, 170, 174, 178, 189, 190, 203, 208, 226, 228 Cardiac arrest, 54, 178 Cardiovascular, 10, 102, 155, 178, 225, 230 Cardioversion, 178, 225 Carnitine, 169, 178 Carpal Tunnel Syndrome, 151, 154, 178 Case report, 5, 22, 25, 26, 27, 29, 33, 38, 50, 51, 54, 58, 61, 62, 74, 78, 112, 179, 182 Case series, 41, 50, 72, 179, 182 Catecholamine, 179, 187, 215 Cathode, 179, 189 Cations, 103, 179, 202 Cauda Equina, 179, 224 Caudal, 10, 179, 217 Caudalis, 16, 179 Cell Differentiation, 179, 225 Cell Division, 134, 175, 179, 195, 205, 216, 219 Cell membrane, 178, 179, 186, 208, 217, 226, 236 Cell proliferation, 179, 225 Cell Survival, 179, 195 Central Nervous System Infections, 179, 196, 197 Cephalalgia, 49, 59, 60, 179 Cerebellar, 174, 179, 221 Cerebellopontine, 5, 27, 48, 179, 180 Cerebellopontine Angle, 5, 48, 180 Cerebellum, 177, 179, 180, 217, 221, 235 Cerebral, 102, 172, 174, 175, 177, 180, 184, 190, 191, 193, 197, 204, 220, 226, 230, 233 Cerebral Angiography, 180, 204 Cerebral hemispheres, 175, 177, 180 Cerebral Hemorrhage, 102, 180 Cerebral Infarction, 102, 180, 197 Cerebrospinal, 27, 101, 180, 197 Cerebrospinal fluid, 27, 101, 180, 197
Cerebrum, 180, 234, 235 Cervical, 50, 51, 56, 73, 96, 101, 113, 143, 146, 176, 180, 205, 231, 232 Cervix, 180, 193, 231 Chamomile, 108, 180 Character, 180, 186, 220 Chest Pain, 147, 180 Chickenpox, 9, 91, 180 Chiropractic, 111, 153, 180 Chloroform, 39, 180 Chlorpromazine, 124, 181, 193 Cholesterol, 95, 175, 181, 228 Choline, 180, 181 Cholinergic, 181, 211 Chorea, 109, 181 Choreatic Disorders, 181 Chromic, 20, 181 Chromium, 181 Chronic Disease, 177, 181, 182 Chronic Fatigue Syndrome, 100, 101, 181 Chronic renal, 181, 217, 234 Cicatrix, 181 Cicatrization, 96, 181 Circadian, 109, 181 Circadian Rhythm, 109, 181 Circulatory system, 94, 181 Clamp, 90, 181 Clathrin, 9, 181, 182 Clinical study, 59, 182 Clinical trial, 7, 8, 11, 39, 83, 85, 87, 92, 131, 182, 184, 188, 215, 219, 221 Cloning, 176, 182 Coal, 175, 182 Coated Vesicles, 181, 182 Cochlear, 182, 232, 235, 236 Cochlear Diseases, 182, 232 Codeine, 182, 186, 212 Codons, 182, 212 Cofactor, 182, 219, 231 Colitis, 107, 182, 200, 202 Collagen, 107, 182, 194, 217, 218 Collagen disease, 107, 182 Combination Therapy, 40, 182 Comorbidity, 85, 182 Complement, 182, 183, 225 Complementary and alternative medicine, 69, 81, 183 Complementary medicine, 69, 183 Complete remission, 183, 222 Compress, 4, 183 Computational Biology, 131, 133, 183 Computed tomography, 5, 63, 183, 184
Neuralgia
Computerized axial tomography, 183, 184 Computerized tomography, 183 Conduction, 13, 14, 184, 208, 210 Conjunctiva, 184, 229, 233 Connective Tissue, 93, 176, 182, 184, 192, 193, 194, 204, 215, 222, 223, 230 Connective Tissue Cells, 184 Consciousness, 171, 184, 186, 187, 230 Constipation, 92, 184, 193, 202 Constitutional, 95, 184, 208 Constriction, 14, 184, 202 Contraindications, ii, 184 Contralateral, 14, 18, 33, 184, 213, 221 Contrast Media, 184, 204 Controlled study, 28, 29, 35, 184 Convulsions, 172, 184, 210 Convulsive, 184, 189 Coordination, 180, 184, 208 Cornea, 120, 184, 237 Coronary, 57, 184, 207, 208 Coronary Artery Bypass, 57, 184 Coronary Thrombosis, 184, 207, 208 Cortex, 174, 184, 191 Cortical, 184, 191, 224, 231 Corticosteroid, 115, 184 Cortisone, 93, 185 Coumarins, 180, 185 Craniocerebral Trauma, 175, 180, 185, 196, 197, 231, 232 Craniotomy, 109, 185 Curative, 108, 185, 211, 231 Cutaneous, 18, 44, 55, 92, 96, 185, 198, 204, 214 Cyclic, 185, 195, 211, 216, 224 Cysteine, 107, 185 Cysticercus, 27, 185 Cystine, 185 Cytokine, 44, 100, 101, 185 Cytomegalovirus, 107, 185 Cytoskeletal Proteins, 182, 185 Cytotoxic, 178, 185, 221, 225 D Databases, Bibliographic, 131, 185 Decarboxylation, 186, 197 Decompression, 3, 4, 25, 28, 29, 31, 38, 39, 43, 46, 47, 48, 49, 51, 53, 55, 57, 75, 111, 118, 120, 141, 186 Decompression Sickness, 186 Degenerative, 93, 109, 147, 155, 186, 195, 196, 213 Deletion, 98, 186 Delusions, 186, 220
242
Dementia, 107, 186, 211 Demyelinating Diseases, 186, 208 Dendrites, 186, 210 Density, 15, 186, 212, 226 Depolarization, 186, 225 Dermal, 13, 84, 186 Dermatitis, 102, 186, 188 Dermatology, 23, 24, 34, 55, 66, 186 Desensitization, 17, 186 Deuterium, 186, 197 Dextromethorphan, 23, 30, 85, 86, 186 Diabetes Mellitus, 15, 186, 187, 195, 196 Diabetic Retinopathy, 102, 187 Diagnostic procedure, 89, 119, 187 Diarrhea, 187, 191, 193, 202 Diastolic, 187, 198 Diathesis, 105, 187 Digestion, 170, 175, 176, 187, 203, 215, 228, 235 Digestive system, 88, 187 Dilatation, 171, 187, 201, 218, 235 Dilatation, Pathologic, 187, 235 Dilation, 177, 187, 197, 235 Dimethyl, 109, 187 Direct, iii, 16, 20, 123, 178, 187, 188, 221, 228, 229 Discrimination, 14, 187 Disease Progression, 187, 222 Dissociation, 170, 187, 202 Distal, 13, 85, 174, 184, 187, 189, 215, 218, 219 Dizziness, 5, 104, 187, 235 Dopamine, 107, 181, 187, 216 Dorsal, 16, 56, 91, 92, 188, 217, 227 Dorsum, 188, 193 Double-blinded, 21, 188 Drive, ii, vi, 5, 20, 65, 86, 114, 116, 140, 188 Drug Interactions, 124, 188 Drug Tolerance, 188, 232 Duct, 171, 178, 188, 199, 223 Duodenum, 175, 188, 190, 215, 228 Dura mater, 188, 206, 213, 215 Dysmenorrhea, 155, 188 Dysphagia, 142, 188 Dysphoria, 104, 188 Dysplasia, 135, 188 Dystrophy, 66, 100, 101, 107, 115, 134, 145, 155, 188 E Eczema, 107, 188 Edema, 187, 188, 201, 231, 234 Effector, 107, 169, 183, 188, 210, 211, 216
243
Effector cell, 188, 210, 211 Efficacy, 5, 13, 17, 21, 24, 30, 34, 66, 67, 83, 84, 85, 92, 97, 110, 188, 233 Effusion, 188, 230 Elastin, 182, 188 Elective, 188 Electric shock, 140, 189 Electric Stimulation Therapy, 105, 189 Electrocoagulation, 141, 189 Electrode, 71, 179, 189 Electrolysis, 172, 179, 189 Electrolyte, 185, 189, 207, 217, 226, 234 Electrons, 175, 179, 189, 202, 213, 220, 221 Electrophysiological, 10, 14, 16, 17, 189 Electroshock, 91, 189 Emergency Treatment, 114, 189 Emesis, 94, 95, 96, 98, 106, 189 Emollient, 189, 195, 212 Emulsion, 189, 193 Encephalitis, 12, 189 Encephalitis, Viral, 189 Endocytosis, 9, 189 Endoscope, 190 Endoscopic, 63, 190 Endothelium, 190, 211 Endothelium-derived, 190, 211 Endotoxin, 190, 234 End-stage renal, 181, 190, 217 Environmental Exposure, 190, 212 Environmental Health, 130, 132, 190 Enzymatic, 178, 183, 190, 197, 222 Enzyme, 17, 188, 190, 194, 195, 200, 206, 215, 216, 217, 219, 225, 231, 232, 236, 237 Eosinophilic, 107, 190 Epidural, 22, 29, 41, 66, 71, 100, 101, 190, 201 Epinephrine, 169, 187, 190, 211, 234 Epithelial, 99, 169, 190, 196 Epithelium, 190, 202, 237 Erythema, 190, 229 Erythrina, 80, 190 Erythrocytes, 171, 176, 190, 225 Escalation, 86, 190 Esophagus, 187, 190, 215, 216, 228 Essential Tremor, 134, 190 Estradiol, 16, 190 Estrogen, 16, 191 Estrogen receptor, 17, 191 Ethmoid, 191, 214 Eucalyptus, 108, 191 Evacuation, 184, 191 Evoke, 191, 228
Evoked Potentials, 43, 58, 191 Excitation, 17, 191 Excitatory, 85, 170, 175, 191, 195, 211 Excitatory Amino Acids, 191, 211 Exfoliation, 60, 191 Exogenous, 105, 188, 191 Extensor, 191, 219 External-beam radiation, 191, 220 Extracellular, 99, 107, 171, 184, 189, 191, 226 Extracellular Matrix, 184, 191 Extraction, 109, 191 Extrapyramidal, 188, 191 Extremity, 29, 156, 176, 191, 205, 214, 224, 231 F Facial Nerve, 3, 22, 191, 192, 214 Facial Neuralgia, 23, 32, 70, 71, 86, 192 Facial Pain, 4, 15, 17, 26, 41, 86, 109, 110, 113, 114, 140, 192 Family Planning, 131, 192 Fascioliasis, 107, 192 Fat, 171, 176, 185, 192, 194, 203, 208, 222, 226 Fatigue, 84, 181, 192, 196 Fatty acids, 96, 169, 192 Febrile, 192, 228 Feces, 184, 192, 228 Femoral, 44, 192 Femur, 172, 192 Fibrillation, 192, 225 Fibrin, 176, 192, 231 Fibrinogen, 192, 231 Fibrosis, 135, 170, 192, 224 Fibrositis, 107, 192 Fixation, 56, 192, 225 Flavoring Agents, 191, 193 Flecainide, 25, 193 Flexion, 193, 195 Fluphenazine, 24, 193 Foot Injuries, 115, 193 Foramen, 61, 193, 205, 229 Forearm, 176, 193, 205 Fossa, 46, 53, 59, 180, 193 Fovea, 193 Frontal Lobe, 172, 180, 193, 208 Functional Disorders, 105, 193 G Gallbladder, 169, 175, 187, 193 Gamma knife, 25, 34, 35, 36, 37, 45, 56, 57, 60, 63, 120, 141, 193 Gamma Rays, 193, 220, 221
Neuralgia
Ganglia, 9, 19, 91, 169, 175, 193, 209, 215, 227 Ganglion, 14, 16, 26, 52, 54, 66, 67, 71, 76, 92, 193, 197, 213, 222, 233, 236, 237 Gas, 171, 178, 186, 193, 197, 202, 211, 235 Gasoline, 175, 193 Gastric, 174, 178, 193, 197, 215 Gastric Juices, 193, 215 Gastrin, 194, 197 Gastrointestinal, 97, 177, 190, 194, 225, 229, 230, 234 Gastrointestinal tract, 194, 225, 234 Gelatin, 194, 195, 231 Gels, 10, 194 Gene, 9, 13, 102, 105, 107, 135, 136, 176, 177, 194, 200, 212 Gene Expression, 13, 135, 194 Genes, pol, 105, 194 Genetics, 12, 194 Genital, 12, 194, 234 Genitourinary, 141, 194, 230, 234 Gland, 109, 114, 169, 185, 194, 204, 214, 216, 219, 224, 228, 231 Glial Fibrillary Acidic Protein, 14, 194 Glomerular, 194 Glomeruli, 194 Glomerulonephritis, 102, 194 Glossopharyngeal Nerve, 192, 194 Glucocorticoids, 169, 185, 194 Glucose, 96, 134, 181, 186, 194, 195, 196, 200, 223 Glucose Intolerance, 186, 195 Glutamate, 103, 170, 186, 195 Glutamic Acid, 170, 195, 218 Glycerol, 4, 5, 74, 75, 120, 141, 195 Glycine, 195, 225 Glycoprotein, 9, 192, 195, 231, 234 Gonad, 195 Gonadal, 16, 195, 228 Gout, 102, 195 Governing Board, 195, 218 Gp120, 9, 195 Graft, 57, 195, 197, 199 Grafting, 57, 184, 195 Granulocytes, 195, 225, 236 Growth factors, 96, 107, 195, 210 Guanylate Cyclase, 195, 211 H Haematemesis, 189, 195 Hallux Rigidus, 150, 195 Hamartoma, 49, 195 Haptens, 170, 196
244
Headache Disorders, 196 Heart failure, 102, 150, 196 Hemicrania, 114, 196 Hemoglobin, 171, 190, 196, 231 Hemoglobinuria, 134, 196 Hemolytic, 196, 231 Hemorrhage, 10, 185, 189, 196, 228, 236 Hemostasis, 196, 225 Hepatic, 5, 96, 107, 196, 203 Hepatitis, 102, 196, 200 Hepatocytes, 196 Hepatomegaly, 196, 200 Hereditary, 181, 195, 196, 210, 222, 231 Heredity, 194, 196 Hernia, 96, 196 Herpes Zoster Ophthalmicus, 57, 66, 197 Heterogeneity, 170, 197 Histamine, 107, 197 Histidine, 197 Homeostasis, 99, 100, 197 Homologous, 197, 225, 229 Hormonal, 174, 185, 197 Hormone, 16, 96, 107, 181, 185, 190, 194, 197, 200, 206, 218, 223, 224, 225, 230, 231 Host, 9, 93, 102, 175, 197, 198, 199, 200, 234, 236 Hybrid, 197 Hybridization, 16, 197 Hydrocephalus, 41, 197, 201 Hydrogen, 91, 94, 106, 170, 175, 178, 186, 197, 207, 211, 212, 213, 219 Hydrolysis, 173, 197, 216, 217 Hydrophilic, 107, 197 Hydrophobic, 107, 198 Hydroxylysine, 182, 198 Hydroxyproline, 182, 198 Hyperalgesia, 17, 18, 19, 198 Hypersensitivity, 107, 170, 186, 198, 223, 225 Hypertension, 3, 49, 103, 180, 198, 201, 234 Hyperuricemia, 195, 198 Hypesthesia, 24, 198, 210 Hypnotherapy, 77, 198 Hypnotic, 70, 198, 204 Hypotension, 92, 103, 184, 198 I Iatrogenic, 115, 198 Idiopathic, 5, 25, 28, 35, 41, 54, 58, 110, 198 Illusion, 198, 235 Immune response, 13, 44, 172, 174, 185, 196, 198, 199, 225, 229, 234, 236 Immune Sera, 198
245
Immune system, 93, 97, 175, 188, 198, 199, 204, 208, 234, 236 Immunization, 9, 11, 91, 148, 198, 199, 225 Immunoassay, 17, 198 Immunocompromised, 9, 198 Immunodeficiency, 9, 134, 198 Immunoglobulin, 21, 172, 198, 207 Immunologic, 198, 199, 221 Immunology, 8, 12, 44, 170, 199 Immunosuppressive, 7, 199 Immunosuppressive therapy, 7, 199 Immunotherapy, 175, 186, 199 Impaction, 38, 199 Impairment, 92, 174, 199, 206, 220 Implant radiation, 199, 201, 220 In situ, 7, 199 In vitro, 10, 96, 199, 232 In vivo, 98, 199 Incision, 111, 199, 201 Incisional, 109, 199 Incontinence, 103, 107, 197, 199 Indicative, 112, 199, 214, 235 Induction, 171, 189, 199, 202 Infancy, 199 Infantile, 91, 199 Infarction, 180, 199, 201, 222 Infectious Mononucleosis, 12, 199 Infiltration, 194, 200, 218, 237 Inflammatory bowel disease, 102, 107, 200 Infrared Rays, 95, 200 Initiation, 8, 13, 200 Innervation, 113, 176, 191, 200, 205, 215, 224, 232 Inotropic, 188, 200 Insight, 10, 44, 200 Insomnia, 109, 200 Instillation, 101, 200 Insulator, 200, 208 Insulin, 96, 200 Insulin-dependent diabetes mellitus, 200 Insulin-like, 96, 200 Integrase, 194, 200 Interleukin-1, 100, 101, 200 Interleukin-2, 200 Intermittent, 3, 151, 200, 203 Internal Medicine, 33, 100, 200 Internal radiation, 201, 220 Intervertebral, 96, 100, 201, 204, 220, 224 Intervertebral Disk Displacement, 201, 204, 220, 224 Intestinal, 96, 201, 204 Intestines, 169, 192, 194, 201, 224
Intoxication, 201, 237 Intracellular, 16, 17, 181, 199, 201, 206, 211, 217, 221, 224, 225, 236 Intracellular Membranes, 201, 206 Intracranial Aneurysm, 180, 201 Intracranial Arteriosclerosis, 180, 201 Intracranial Hemorrhages, 197, 201, 231 Intracranial Hypertension, 196, 197, 201, 232 Intracranial tumors, 5, 201 Intramuscular, 100, 101, 201, 214 Intrathecal, 29, 42, 43, 100, 101, 118, 201 Intravenous, 21, 24, 34, 201, 214 Intrinsic, 20, 109, 170, 201 Invasive, 4, 6, 32, 46, 62, 201, 204 Involuntary, 175, 181, 190, 192, 201, 208, 221, 227, 232 Ion Channels, 17, 99, 201, 211, 229 Ion Exchange, 201, 202 Ionization, 202 Ions, 99, 103, 175, 178, 187, 189, 197, 201, 202, 207, 217, 219, 226 Iontophoresis, 34, 67, 70, 72, 76, 202 Ipsilateral, 14, 202, 221 Iris, 184, 202, 220 Irritable Bowel Syndrome, 193, 202 Ischemia, 102, 174, 202, 210, 222, 231 J Joint, 4, 10, 16, 19, 93, 100, 109, 114, 115, 147, 173, 186, 202, 213, 227, 229, 230 K Kb, 130, 202 Keratosis, 152, 202 Ketamine, 56, 66, 103, 202 Kidney Disease, 22, 88, 130, 135, 151, 152, 202 Kinetics, 7, 178, 202 L Lacrimal, 191, 202 Large Intestine, 187, 201, 202, 221, 226 Laryngeal, 58, 202 Larynx, 202, 232, 235 Latency, 9, 13, 91, 202 Latent, 9, 26, 91, 203 Lectin, 203, 206 Lens, 25, 203 Lesion, 31, 61, 184, 203 Lethargy, 197, 203 Leukemia, 134, 203 Leukocytes, 176, 195, 203, 207, 234 Levorphanol, 186, 203 Library Services, 164, 203
Neuralgia
Lidocaine, 13, 24, 44, 60, 92, 118, 125, 203, 207 Ligament, 172, 203, 219, 227 Ligands, 99, 203 Linear accelerator, 30, 44, 203 Lip, 203, 205 Lipid, 181, 195, 200, 203, 208 Liver, 102, 107, 169, 175, 178, 185, 187, 189, 192, 193, 194, 196, 203, 207 Liver Cirrhosis, 102, 203 Lobe, 172, 180, 203 Localization, 11, 203 Localized, 13, 17, 19, 100, 101, 192, 199, 203, 216, 224, 230 Longitudinal Studies, 18, 203 Long-Term Care, 145, 203 Loop, 196, 203 Lorazepam, 86, 204 Low Back Pain, 79, 100, 101, 103, 142, 143, 149, 156, 204 Lumbago, 90, 100, 204 Lumbar, 90, 101, 146, 147, 149, 174, 179, 201, 204, 224, 232 Lumen, 178, 204 Lupus, 204, 230 Lymph, 180, 181, 190, 200, 204 Lymph node, 180, 204 Lymphadenopathy, 200, 204 Lymphatic, 101, 171, 190, 199, 204, 217, 227, 231 Lymphocele, 25, 204 Lymphocyte, 172, 204, 205 Lymphoid, 172, 204 Lymphoma, 12, 134, 204 Lytic, 155, 204, 225 M Macrophage, 200, 204 Magnetic Resonance Angiography, 41, 48, 64, 204 Magnetic Resonance Imaging, 30, 53, 64, 204 Malabsorption, 134, 204 Malaise, 188, 204 Malformation, 26, 27, 62, 195, 204 Malignant, 134, 145, 169, 173, 177, 204, 209, 221, 223 Malnutrition, 174, 177, 204, 208 Mammary, 184, 205 Mandible, 4, 205, 222 Mandibular Nerve, 45, 63, 205, 233 Manic, 176, 205, 220 Manic-depressive psychosis, 205, 220
246
Manifest, 174, 205 Masseter Muscle, 3, 205, 233 Mastication, 205, 233 Maxillary, 63, 114, 205, 214, 233 Maxillary Nerve, 63, 205, 233 Maxillary Sinus, 114, 205 Maximum Tolerated Dose, 86, 188, 205 Meatus, 205, 235 Medial, 191, 205, 212, 223, 227, 231, 232 Median Nerve, 178, 205 Mediate, 188, 205 Mediator, 200, 205, 225 Medical Staff, 188, 205 Medicament, 102, 205 MEDLINE, 131, 133, 135, 205 Medullary, 10, 17, 186, 205 Meiosis, 205, 229 Melanin, 202, 206, 216, 234 Melanocytes, 206 Melanoma, 134, 206 Memantine, 30, 85, 206 Membrane Glycoproteins, 206 Membrane Proteins, 13, 206 Memory, 99, 172, 186, 206 Meninges, 179, 185, 188, 206, 228 Meningitis, 12, 206 Meningocele, 38, 206 Menstruation, 170, 188, 206 Mental Disorders, 88, 206, 219, 220 Mental Retardation, 12, 136, 206 Metabolic disorder, 109, 195, 206 Metabolite, 187, 206, 212, 218 Metastasis, 102, 206 Metatarsal Bones, 115, 206 Metatarsophalangeal Joint, 147, 195, 206 Metatarsus, 206 Methionine, 187, 206 Mexiletine, 92, 207 MI, 74, 75, 97, 168, 207 Microbiology, 8, 12, 174, 207 Microcirculation, 203, 207 Microorganism, 182, 207, 214, 236 Microscopy, 10, 207 Microsome, 107, 207 Mineralocorticoids, 169, 185, 207 Mitochondria, 169, 207, 213 Mitochondrial Swelling, 207, 209 Mobility, 104, 207 Modification, 98, 207, 220 Molecular, 12, 16, 96, 131, 133, 176, 183, 192, 207, 221, 223, 233, 234 Molecular Structure, 207, 233
247
Monoclonal, 101, 207, 220 Monocytes, 200, 203, 207 Mononuclear, 21, 49, 199, 207, 234 Monotherapy, 43, 207 Mood Disorders, 99, 207 Morphine, 17, 56, 66, 85, 182, 208, 209, 212 Motility, 193, 208, 225 Motor Cortex, 71, 208, 221 Mucinous, 193, 208 Mucociliary, 208, 226 Mucosa, 177, 204, 208, 209 Multiple sclerosis, 32, 36, 43, 45, 47, 48, 57, 77, 102, 107, 115, 142, 208 Muscle Contraction, 99, 208 Muscle Fibers, 208, 226 Muscle Relaxation, 208, 210 Muscular Atrophy, 134, 208 Muscular Dystrophies, 188, 208 Myasthenia, 96, 208 Myelin, 140, 186, 208, 212, 225 Myelin Sheath, 140, 208, 212 Myocardial infarction, 156, 184, 207, 208 Myocarditis, 102, 208 Myocardium, 207, 208 Myosin, 208 Myotonic Dystrophy, 134, 209 N Narcolepsy, 109, 209 Narcosis, 209 Narcotic, 92, 100, 101, 203, 208, 209 Nasal Cavity, 113, 205, 209, 214 Nasal Septum, 209 Nasociliary, 197, 209 NCI, 1, 87, 129, 209 Necrosis, 11, 96, 180, 199, 207, 208, 209, 222 Need, 3, 9, 19, 96, 111, 113, 119, 125, 159, 181, 209, 232 Neoplasia, 134, 209 Neoplasm, 195, 209, 223, 234 Neoplastic, 192, 204, 209, 233 Nephropathy, 102, 202, 209 Nerve Endings, 15, 104, 209, 211 Nerve Fibers, 6, 18, 92, 176, 209, 227, 232 Nerve Growth Factor, 14, 209, 211 Nervous System, 7, 15, 51, 85, 94, 97, 101, 103, 104, 105, 108, 114, 134, 169, 170, 174, 175, 177, 178, 179, 191, 193, 194, 195, 205, 208, 209, 210, 211, 212, 213, 215, 217, 219, 225, 229, 230 Neural, 9, 10, 15, 16, 18, 91, 108, 169, 171, 177, 206, 209, 210, 226
Neurites, 15, 210 Neuritis, 102, 115, 116, 210, 236 Neuroanatomy, 10, 210 Neurodegenerative Diseases, 100, 175, 210 Neuroeffector Junction, 209, 210 Neurogenic, 97, 115, 210 Neurogenic Inflammation, 97, 210 Neurologic, 101, 109, 197, 210 Neurologist, 51, 115, 210 Neuroma, 5, 63, 109, 115, 151, 210 Neuromuscular, 146, 169, 210, 234 Neuromuscular Blockade, 146, 210 Neuromuscular Junction, 169, 210 Neuronal, 13, 18, 20, 49, 97, 109, 178, 209, 210, 215 Neuropathy, 13, 15, 20, 25, 30, 32, 85, 92, 102, 107, 115, 210, 215, 224 Neuropeptide, 98, 177, 210 Neuroprotective Agents, 99, 210 Neurosyphilis, 211, 214 Neurotoxicity, 103, 186, 211 Neurotoxin, 104, 211 Neurotransmitters, 107, 170, 191, 210, 211, 218 Neurotrophins, 14, 211 Neutrons, 170, 211, 220 Niacin, 211, 234 Nicotine, 100, 101, 211 Nitric Oxide, 102, 211 Nitrogen, 94, 170, 171, 186, 193, 211, 234 Nociceptors, 17, 211 Nonmalignant, 5, 211 Norepinephrine, 169, 187, 211 Normal Distribution, 20, 211 Nortriptyline, 85, 212 Nuclear, 154, 175, 189, 193, 209, 212, 222 Nuclei, 170, 172, 189, 204, 211, 212, 213, 219, 236 Nucleic acid, 197, 211, 212, 220, 236 Nucleic Acid Hybridization, 197, 212 Nucleus, 10, 16, 20, 172, 174, 175, 185, 186, 193, 201, 206, 207, 211, 212, 219, 231, 233, 236 O Ocular, 109, 197, 212 Odour, 173, 212, 234 Ointments, 180, 212 Oligodendroglia, 208, 212 Oncogene, 134, 212 Onychomycosis, 116, 212 Opacity, 186, 212 Open Reading Frames, 9, 212
Neuralgia
Ophthalmic, 53, 74, 209, 212, 233 Ophthalmology, 66, 154, 193, 212 Opium, 208, 212 Optic Chiasm, 212, 213 Optic Disk, 187, 213 Optic Nerve, 96, 212, 213, 222 Organ Transplantation, 102, 213 Organelles, 181, 185, 206, 207, 213 Orofacial, 4, 5, 14, 46, 86, 113, 114, 116, 192, 213 Oropharynx, 38, 213 Orthostatic, 92, 213 Osteoarthritis, 79, 102, 103, 153, 155, 195, 213 Osteonecrosis, 27, 60, 213 Osteoporosis, 96, 102, 213 Otitis, 147, 213 Otitis Media, 147, 213 Outpatient, 85, 149, 213 Ovary, 190, 195, 213 Oxidation, 169, 185, 213 P Pachymeningitis, 206, 213 Pain, Postoperative, 103, 213 Palliative, 74, 113, 152, 153, 213, 231 Palsy, 22, 62, 108, 113, 116, 213 Pancreas, 169, 176, 187, 200, 214, 234 Pancreatic, 134, 144, 178, 214 Pancreatic cancer, 134, 214 Pancreatitis, 102, 144, 214 Panic, 97, 214 Paralysis, 96, 214, 231 Paranasal Sinuses, 113, 205, 214, 226 Paraneoplastic syndrome, 151, 214 Parenteral, 100, 101, 214 Paresis, 5, 210, 214, 231 Paresthesia, 93, 94, 106, 214, 231 Parotid, 109, 194, 214 Paroxysmal, 15, 24, 26, 32, 114, 116, 134, 196, 214 Partial remission, 214, 222 Particle, 214, 226, 233, 236 Patch, 99, 100, 125, 214 Pathogen, 12, 214 Pathogenesis, 13, 62, 96, 112, 214 Pathologic, 176, 184, 198, 214, 219, 222, 225 Pathophysiology, 4, 14, 113, 214 Patient Advocacy, 158, 215 Patient Education, 139, 162, 164, 168, 215 Patient Selection, 94, 106, 215 Pelvic, 90, 215, 219 Pepsin, 215
248
Peptic, 102, 215 Peptic Ulcer, 102, 215 Peptide, 102, 177, 215, 217, 219 Percutaneous, 4, 6, 16, 29, 41, 45, 51, 52, 62, 74, 93, 106, 215, 216 Perforation, 193, 215 Pericardium, 215, 230 Peridural, 100, 101, 215 Peripheral blood, 49, 215 Peripheral Nerves, 20, 93, 106, 114, 215, 227 Peripheral Nervous System, 16, 83, 84, 99, 186, 208, 210, 213, 215, 218, 223, 229 Peripheral Neuropathy, 13, 107, 215 Perivascular, 177, 212, 215 Peroneal Nerve, 215, 224 Phallic, 192, 215 Pharmacokinetic, 98, 215 Pharmacologic, 171, 215, 232 Pharmacotherapy, 12, 52, 73, 215 Pharynx, 209, 213, 216, 235 Phenyl, 97, 216 Phenylalanine, 216, 234 Phonophoresis, 202, 216 Phosphodiesterase, 107, 216 Phospholipases, 216, 225 Phosphorus, 177, 216 Phosphorylation, 9, 216 Physical Examination, 86, 115, 216 Physical Therapy, 105, 216 Physiologic, 170, 176, 206, 216, 221, 222 Physiology, 32, 71, 75, 189, 216 Pigment, 206, 216 Piperidines, 97, 216 Pituitary Gland, 185, 216 Placenta, 190, 216, 218 Plants, 170, 173, 178, 181, 195, 203, 211, 216, 223, 232, 233 Plasma, 74, 172, 179, 192, 194, 195, 196, 207, 216, 219, 224 Plasma cells, 172, 216 Platelet Activation, 216, 226 Platelet Aggregation, 211, 217 Platelets, 211, 216, 217 Plexus, 176, 217, 224, 231 Polycystic, 22, 135, 217 Polymerase, 194, 217 Polymorphism, 26, 217 Polypeptide, 102, 170, 182, 192, 197, 217, 231, 237 Polysaccharide, 172, 217 Pons, 41, 177, 179, 180, 217
249
Pontine, 31, 44, 217 Posterior, 22, 46, 50, 53, 115, 171, 174, 180, 188, 194, 202, 214, 217, 224, 227 Postmenopausal, 213, 217 Postoperative, 6, 145, 217 Postsynaptic, 210, 217, 225, 229, 230 Post-traumatic, 74, 196, 217 Potassium, 17, 99, 207, 217 Potassium Channels, 17, 99, 217 Potentiates, 200, 217 Potentiation, 217, 225 Practicability, 217, 233 Practice Guidelines, 132, 141, 145, 146, 148, 151, 155, 218 Precipitating Factors, 116, 196, 218 Preclinical, 91, 218 Precursor, 181, 187, 188, 190, 211, 216, 218, 219, 234 Presynaptic, 209, 210, 218, 229 Presynaptic Terminals, 209, 218 Prevalence, 8, 21, 23, 53, 218 Probe, 18, 218 Procaine, 203, 218 Prodrug, 218 Progesterone, 218, 228 Prognostic factor, 54, 57, 218 Progression, 172, 218 Progressive, 32, 179, 181, 186, 188, 190, 195, 208, 209, 210, 213, 216, 218, 234 Projection, 10, 211, 213, 218, 221 Proline, 182, 198, 218 Promoter, 26, 218 Prophase, 219, 229 Prophylaxis, 96, 109, 219, 234 Prospective study, 21, 25, 53, 219 Prostate, 134, 176, 219, 234 Protease, 182, 194, 219 Protein C, 107, 170, 175, 182, 219 Protein S, 9, 97, 107, 135, 176, 219 Prothrombin, 219, 231 Protocol, 8, 21, 219 Protons, 170, 197, 219, 220 Proximal, 187, 209, 218, 219 Pruritic, 188, 219 Pseudorabies, 13, 219 Psoriasis, 107, 219 Psychiatric, 18, 85, 86, 206, 219 Psychiatry, 31, 43, 45, 47, 58, 61, 192, 219, 228 Psychic, 219, 220, 224 Psychogenic, 113, 114, 219 Psychomotor, 178, 220
Psychosis, 107, 220 Psychotomimetic, 104, 220 Public Policy, 131, 220 Publishing, 5, 21, 113, 114, 116, 220 Pulmonary, 176, 190, 220, 235 Pulmonary Artery, 176, 220, 235 Pulse, 45, 220 Pupil, 184, 187, 220 Purines, 220, 225 Q Quality of Life, 18, 32, 55, 104, 220 R Radiation, 31, 36, 54, 55, 109, 190, 191, 193, 201, 204, 220, 221, 228, 229, 233, 237 Radiation therapy, 109, 191, 193, 201, 220, 228, 233 Radicular, 220 Radiculopathy, 34, 100, 101, 142, 220, 224 Radioactive, 197, 199, 201, 202, 212, 220, 221 Radiolabeled, 220, 221 Radiological, 138, 215, 221 Radiotherapy, 176, 220, 221, 228 Randomized, 23, 28, 29, 31, 43, 50, 61, 63, 72, 77, 83, 85, 188, 221 Randomized Controlled Trials, 77, 221 Reactivation, 8, 13, 91, 221 Reagent, 104, 221 Reality Testing, 220, 221 Receptor, 9, 17, 85, 97, 98, 102, 103, 106, 107, 172, 186, 188, 191, 195, 221, 225 Receptors, Serotonin, 221, 225 Recombinant, 9, 13, 20, 105, 221, 235 Rectum, 57, 75, 172, 173, 176, 187, 193, 199, 200, 202, 219, 221 Recurrence, 6, 24, 43, 53, 99, 120, 176, 181, 205, 221, 222 Red Nucleus, 174, 221 Refer, 1, 177, 182, 187, 192, 197, 203, 210, 211, 220, 221, 235 Reflex, 66, 100, 101, 107, 115, 145, 155, 221 Refractory, 3, 7, 8, 21, 34, 56, 57, 83, 189, 221 Regeneration, 96, 221 Regimen, 188, 215, 221 Remission, 78, 141, 176, 205, 221, 222 Reoperation, 6, 222 Reperfusion, 96, 222 Reperfusion Injury, 222 Resection, 109, 222 Resorption, 197, 222 Respiratory distress syndrome, 102, 222
Neuralgia
Restoration, 216, 221, 222 Retina, 187, 203, 212, 213, 222, 223 Retinal, 187, 212, 213, 222 Retinal Ganglion Cells, 213, 222 Retinoblastoma, 134, 222 Retrospective, 5, 24, 222 Rheumatic Diseases, 107, 222 Rheumatism, 25, 222, 223 Rheumatoid, 93, 102, 103, 153, 182, 223 Rheumatoid arthritis, 93, 102, 153, 182, 223 Rhinitis, 107, 223 Ribose, 169, 223 Rigidity, 109, 216, 223 Risk factor, 8, 18, 140, 219, 223 Rod, 181, 223 Rubber, 90, 169, 223 S Sagittal, 58, 223 Salicylate, 180, 223 Saline, 70, 72, 223 Saliva, 223 Salivary, 114, 185, 187, 191, 214, 223 Salivary glands, 185, 187, 191, 223 Saphenous, 57, 184, 223 Saphenous Vein, 184, 223 Saponins, 223, 228 Sarcoma, 12, 223 Schizoid, 223, 236 Schizophrenia, 97, 101, 103, 109, 223, 236 Schizotypal Personality Disorder, 223, 237 Schwannoma, 49, 58, 223 Sciatic Nerve, 15, 215, 224, 232 Sciatica, 57, 75, 152, 224 Scleroderma, 107, 224 Sclerosis, 32, 96, 100, 101, 134, 182, 201, 208, 224 Screening, 98, 102, 182, 224 Second Messenger Systems, 211, 224 Secondary tumor, 206, 224 Secretion, 99, 181, 185, 194, 197, 200, 207, 224, 235 Sedative, 182, 204, 224 Segmental, 11, 14, 224, 227 Segmentation, 224 Seizures, 32, 91, 99, 178, 214, 224 Self Care, 169, 224 Semen, 219, 224 Senile, 213, 224 Sensibility, 18, 171, 198, 224 Sensitization, 19, 85, 225 Sensory loss, 113, 116, 220, 225, 231
250
Serine, 9, 225 Serologic, 198, 225 Serotonin, 58, 107, 215, 221, 225, 234 Serum, 96, 182, 198, 207, 225, 234 Sex Characteristics, 171, 225, 230 Sex Determination, 135, 225 Shock, 102, 189, 225, 233 Shoulder Pain, 100, 141, 225 Sick Sinus Syndrome, 46, 225 Side effect, 4, 5, 13, 17, 74, 86, 92, 93, 100, 104, 118, 123, 125, 169, 175, 198, 204, 225, 232 Signal Transduction, 107, 225 Signs and Symptoms, 13, 140, 222, 226, 234 Sinoatrial Node, 225, 226 Sinusitis, 4, 28, 114, 143, 148, 226 Skeletal, 93, 103, 171, 181, 208, 226, 227, 230 Skeleton, 93, 169, 192, 202, 226 Skull, 61, 109, 110, 113, 185, 206, 226, 228, 230 Skull Base, 61, 109, 110, 226 Small intestine, 188, 197, 201, 226, 236 Smooth muscle, 97, 170, 184, 197, 208, 226, 227, 229 Social Environment, 220, 226 Sodium, 17, 20, 99, 195, 207, 226 Sodium Channels, 20, 226 Soft tissue, 176, 226 Solvent, 175, 180, 195, 226 Soma, 226 Somatic, 19, 107, 108, 194, 206, 215, 226, 235 Sound wave, 184, 226 Spasm, 3, 30, 33, 46, 48, 51, 58, 104, 184, 227 Spasmodic, 110, 227, 233 Spasticity, 99, 109, 174, 227 Spatial disorientation, 187, 227 Specialist, 115, 159, 187, 227 Species, 178, 180, 190, 192, 197, 206, 207, 213, 227, 233, 234, 236, 237 Specificity, 170, 178, 227 Spectrum, 200, 227 Sphenoid, 214, 227 Spinal cord, 10, 15, 58, 93, 101, 103, 104, 106, 174, 176, 177, 179, 180, 181, 188, 190, 193, 201, 205, 206, 209, 210, 213, 215, 220, 221, 224, 227, 228, 235 Spinal Cord Injuries, 220, 227 Spinal Nerve Roots, 220, 224, 227
251
Spinal Nerves, 215, 227 Spirochete, 227, 230 Spleen, 185, 204, 227 Splenomegaly, 200, 227 Spondylolisthesis, 155, 227 Sporadic, 210, 222, 227 Sprains and Strains, 204, 227 Sprue, 144, 228 Stasis, 100, 228 Steel, 181, 228 Stereotactic, 4, 6, 26, 28, 36, 37, 48, 49, 51, 54, 57, 58, 59, 71, 75, 141, 228 Stereotactic radiosurgery, 4, 28, 37, 54, 57, 58, 59, 228 Steroid, 17, 43, 185, 223, 228 Stimulant, 197, 228 Stimulus, 14, 188, 189, 191, 200, 201, 202, 210, 221, 228, 231 Stomach, 169, 174, 187, 190, 193, 194, 197, 201, 215, 216, 226, 227, 228 Stool, 199, 202, 228 Stress, 107, 174, 179, 189, 193, 202, 223, 228 Stroke, 85, 88, 99, 103, 114, 116, 130, 138, 139, 140, 157, 210, 228 Stupor, 203, 209, 228 Styrene, 223, 228 Subacute, 199, 226, 228 Subarachnoid, 196, 201, 228 Subclavian, 228, 231, 235 Subclavian Artery, 228, 231, 235 Subclavian Vein, 228, 231 Subclinical, 199, 224, 229 Subcutaneous, 93, 100, 101, 106, 188, 214, 229 Substance P, 107, 206, 224, 229 Sunburn, 108, 229 Support group, 141, 158, 229 Suppression, 99, 100, 107, 185, 229 Supraorbital, 28, 34, 59, 66, 70, 229 Supraspinal, 175, 229 Sympathomimetic, 188, 190, 211, 229 Symphysis, 219, 229 Symptomatic, 16, 56, 60, 61, 93, 103, 108, 193, 214, 229 Symptomatic treatment, 56, 108, 229 Synapses, 210, 211, 229 Synapsis, 229 Synaptic, 16, 211, 225, 229 Synaptic Transmission, 211, 229 Syncope, 27, 38, 230 Synergistic, 230, 232 Synovial, 230
Synovial Membrane, 230 Synovitis, 102, 230 Syphilis, 141, 211, 230 Systemic lupus erythematosus, 102, 107, 156, 182, 230 Systolic, 150, 198, 230 T Tachykinins, 94, 95, 96, 98, 107, 230 Tarsal Bones, 206, 230 Tarsi, 115, 230 Telangiectasia, 135, 230 Temporal, 10, 46, 109, 196, 205, 230, 233 Testis, 190, 230 Testosterone, 16, 230 Tetanus, 230, 233 Tetracaine, 40, 231 Thalamic, 174, 231 Thalamic Diseases, 174, 231 Thalassemia, 3, 231 Therapeutics, 60, 63, 78, 125, 146, 231 Thermal, 6, 18, 51, 104, 118, 187, 211, 231 Thermal ablation, 6, 231 Thigh, 192, 231 Thoracic, 57, 156, 174, 176, 205, 228, 231, 236 Thoracic Outlet Syndrome, 156, 231 Thorax, 204, 231, 235 Threonine, 9, 225, 231 Threshold, 15, 103, 189, 198, 231 Thrombin, 107, 192, 217, 219, 231 Thrombomodulin, 219, 231 Thrombosis, 201, 219, 228, 231 Thymus, 198, 204, 231 Thyroid, 141, 149, 231, 234 Tibial Nerve, 224, 232 Tic, 6, 111, 138, 140, 158, 232 Tin, 5, 94, 106, 115, 178, 214, 215, 232 Tinnitus, 5, 15, 51, 109, 213, 232, 236 Tissue Culture, 210, 232 Tolerance, 19, 83, 120, 195, 232 Tomography, 57, 232 Toothache, 4, 16, 232 Topical, 13, 17, 23, 60, 67, 75, 92, 93, 108, 118, 124, 174, 232 Torticollis, 110, 232 Toxic, iv, 175, 190, 210, 211, 228, 232 Toxicity, 188, 205, 232 Toxicology, 132, 232 Toxins, 172, 178, 189, 199, 232 Trace element, 181, 232 Trachea, 177, 202, 216, 231, 232 Traction, 181, 232
Neuralgia
Transcriptase, 194, 232 Transcutaneous, 67, 76, 78, 110, 112, 233 Transduction, 107, 225, 233 Transfection, 10, 176, 233 Transfer Factor, 198, 233 Translational, 15, 233 Transmitter, 169, 187, 191, 201, 205, 211, 229, 233 Transplantation, 181, 198, 233 Trauma, 4, 7, 109, 114, 115, 142, 143, 204, 209, 210, 214, 233 Treatment Failure, 78, 233 Treatment Outcome, 55, 233 Trees, 190, 191, 223, 233 Tricyclic, 8, 18, 85, 92, 233 Trigeminal Ganglion, 6, 11, 14, 16, 20, 22, 29, 52, 233 Trigeminal Nerve, 4, 5, 14, 20, 36, 40, 41, 60, 61, 64, 86, 96, 120, 140, 158, 233 Trigger zone, 16, 31, 233 Trismus, 3, 233 Tryptophan, 98, 182, 225, 233 Tubercle, 59, 234 Tuberculosis, 204, 234 Tuberous Sclerosis, 135, 234 Tumor marker, 176, 234 Tumor Necrosis Factor, 100, 101, 234 Tumour, 193, 234 Tyrosine, 9, 14, 187, 234 U Ulceration, 215, 234 Unconscious, 171, 198, 234 Uraemia, 214, 234 Urethra, 219, 234 Uric, 195, 198, 220, 234 Urinary, 107, 178, 194, 197, 199, 234 Urine, 176, 196, 199, 234 Urogenital, 103, 194, 234 Uterus, 180, 193, 206, 218, 231, 234 V Vaccination, 13, 85, 91, 234 Vaccine, 9, 11, 21, 91, 219, 234 Vacuoles, 189, 213, 235 Vagal, 22, 63, 235 Vagus Nerve, 235 Varicella, 8, 9, 11, 21, 28, 34, 49, 54, 63, 85, 91, 235 Vasculitis, 214, 235 Vasodilation, 97, 235 Vasodilator, 177, 188, 197, 235
252
Vector, 9, 233, 235 Vein, 171, 173, 201, 212, 214, 223, 228, 235 Venereal, 230, 235 Venous, 48, 64, 101, 173, 180, 219, 235 Venous blood, 180, 235 Ventral, 217, 227, 235 Ventricle, 220, 226, 230, 235 Ventricular, 193, 197, 235 Venules, 176, 178, 207, 235 Vertebrae, 90, 201, 227, 235 Vertebral, 56, 100, 101, 206, 235 Vertebral Artery, 56, 235 Vertigo, 51, 213, 235, 236 Vesicular, 197, 235 Vestibular, 5, 235, 236 Vestibule, 235 Vestibulocochlear Nerve, 232, 235, 236 Vestibulocochlear Nerve Diseases, 232, 236 Veterinary Medicine, 105, 131, 236 Villi, 197, 236 Vinca Alkaloids, 67, 76, 236 Vincristine, 43, 70, 72, 236 Viral, 9, 19, 108, 189, 233, 236 Virulence, 174, 232, 236 Virus, 8, 9, 13, 19, 21, 26, 28, 49, 63, 91, 175, 179, 180, 195, 197, 199, 233, 236, 237 Virus Replication, 49, 236 Viscera, 226, 236 Visceral, 108, 174, 194, 235, 236 Vitreous Hemorrhage, 187, 236 Vitro, 16, 236 Vivo, 236 Voltage-gated, 11, 17, 236 W Wart, 202, 236 White blood cell, 172, 199, 203, 204, 216, 236 Windpipe, 177, 216, 231, 236 Withdrawal, 100, 101, 236 X Xenograft, 172, 237 X-ray, 179, 183, 193, 212, 220, 221, 228, 237 Z Zoster, 8, 9, 11, 13, 15, 18, 21, 23, 24, 28, 31, 34, 39, 40, 44, 45, 49, 51, 53, 54, 55, 58, 60, 66, 71, 72, 76, 83, 84, 85, 91, 92, 112, 116, 118, 197, 237 Zymogen, 219, 237
