the only anticonvulsant labeled for the treatment of both postherpetic neuralgia and diabetic peripheral neuropathy. Valproic acid and topiramate are approved for the prevention of migraine headaches. Phenytoin is not frequently used to treat neuropathic pain due to its narrow therapeutic range, adverse effects and lack of demonstrated efficacy. In general, anecdotal reports have suggested that...

Postherpetic neuralgia (PHN) is a devastating, chronic pain syndrome that can develop following an outbreak of herpes zoster and becomes increasingly common as patients age. PHN can be difficult to treat and often requires trials of multiple agents to achieve significant pain relief. Pregabalin is the newest agent to gain approval for PHN. Data suggest efficacy for relief of pain and sleep dist...

Nummular headache (NH) is defined as a focal head pain that is exclusively felt in a small area, which is typically 1-6 cm in diameter. Neurological examinations are normal in all patients, but this report describes a new variant. A patient was identified who presented with focal head pain that was approximately 8 cm in diameter and bitrigeminal hyperalgesia on neurological ...

A 47-year-old man presented to the Emergency department for a strong right shoulder pain with functional disability. This pain had evolved for a few weeks, without traumatic notion and in clear worsening in spite of regular taking of antalgics. The shoulder stump palpation woke the pain. The patient’s medical history included non-insulin-dependent diabetes, osteoporosis, and stomach ulcer. We a...

BACKGROUND The effect of the unilateral stellate ganglion block (SGB) on cardiovascular regulation remains controversial. We wished to evaluate the changes in heart rate variability (HRV) after a unilateral stellate ganglion block in patients with head and neck pain in the present study. METHODS Patients with head and neck pain (n = 89) were studied. HRV was determined before and after a C6 u...

OBJECTIVE To assess head posture using cervical spine X-rays to find out whether forward head posture is related to myofascial pain syndrome (MPS) in neck and shoulder. METHODS Eighty-eight participants who were diagnosed with MPS in neck and shoulder were evaluated in this study. Four parameters (distance among head, cervical spines, and shoulder, and cervical angle) were measured from later...

Intra-articular fractures can produce degenerative changes causing continued pain and disability, therefore optimal surgical care might be indicated. Metatarsal (MT) intra-articular are no exception. While prior literature described mainly of the first MT lateral toes, there is scarce addressing second head, which longest most robust bone. In this case series, we report three cases head fractur...

Myofascial trigger point pain is an extremely prevalent cause of persistent pain disorders in all parts of the body, not just the head, neck, and face. Features include deep aching pain in any structure, referred from focally tender points in taut bands of skeletal muscle (the trigger points). Diagnosis depends on accurate palpation with 2-4 kg/cm2 of pressure for 10 to 20 seconds over the susp...

orofacial pain can arise from different regions and etiologies. some of the most debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). the problem with referred pain is the misdiagnosis and unnecessary therapy directed to the pain location instead of its origin. when cr...