Tag Archives: Baclofen

Selected Chronic Pain Conditions

Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »

Delirium: Etiology

Delirium has a wide variety of etiologies, which may occur alone or in combination (). These include primary cerebral disorders, systemic disturbances that affect cerebral function, drug and toxin exposure (including intoxication and withdrawal), and a range of factors that can contribute to delirium but have an uncertain role as etiological factors by themselves (psychological… Read More »

Multiple Sclerosis and Pain

Multiple sclerosis () is a progressive disease. It is characterized by initial destruction of myelin and eventually axons and cell bodies. It can affect any part of the central nervous system (CNS). It is well established that multiple sclerosis is a painful condition. There are varying reports of the incidence of pain such as: •… Read More »

Neuralgia — Trigeminal and Glossopharyngeal

There are now recognized a number of neurovascular compression syndromes of which trigeminal neuralgia () is the best understood. Since this is the one most relevant to a pain practice it is discussed in more detail; of the other conditions glossopharyngeal neuralgia is worth mentioning. Trigeminal neuralgia This is an unusual example of a neuropathic… Read More »

Neurosurgical Techniques

This post is not intended as a comprehensive account of all the neurosurgical procedures for pain; rather it is intended to explain the rationale of neurosurgery for pain, and illustrate some of its potential. One of the most important roles of a neurosurgeon involved in surgery for pain is to be certain that surgically remediable… Read More »

Intrathecal drug delivery systems

There is increasing use of such systems. Indications These may be divided into two and it is convenient to consider them separately. 1. Baclofen for the management of spasticity. The indication is provoked by pain from the continuing muscle spasm; additional benefits are improvement in function and for disabled bed-bound patients ease of nursing care.… Read More »

Management of Periodic Limb Movement Disorder

Periodic limb movements in sleep represent a habitual motor accompaniment of restless legs syndrome, found in over 80% of the cases on polysomnography. The recent finding that genes associated with restless legs syndrome are highly associated with periodic limb movements in sleep also indicates the close, but poorly understood relationship between the two. Periodic limb… Read More »


Several types of headaches are unique to sleep and its disorders. Thus, evaluation of headache should also include temporal information during the 24-hour cycle, which may offer clues to the diagnosis. Key headaches that are classically associated with sleep include cluster headaches, migraines, chronic paroxysmal hemicrania, and hypnic headaches. Additionally, sleep apnea can help trigger… Read More »