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painful scar neuropathy:principles of diagnosis and treatment

Plastic and Aesthetic Research 2015年第1期2卷 156-164页

作者： Pierluigi Tos Alessandro Crosio Pierfrancesco Pugliese Roberto Adani Francesca Toia Stefano Artiaco Department of Orthopedics Reconstructive Microsurgery UnitCity of Health and Sciences of TurinTrauma Hospital10100 TorinoItaly Department of Hand Surgery and Microsurgery University Hospital of Verona37126 VeronaItaly Plastic and Reconstructive Surgery Department of SurgicalOncological and Oral SciencesUniversity of Palermo90127 PalermoItaly

Nerve-tissue interactions are *** nerve injuries may involve intraneural and extraneural scar formation and affect nerve gliding planes,sometimes leading to complex clinical *** of these pathological entities involve pain as the main clinical symptom and can be subsumed under the term“painful scar neuropathy”.The authors review the literature on treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis-associated procedures and propose a simple classification and a therapeutic approach to scar *** search retrieved twenty-one papers,twenty of which reported pain reduction or resolution with various *** is no consensus on the best therapeutic approach to neuropathic pain due to scar *** authors report good or excellent results with different techniques,from nerve wrapping with anti-adhesion devices to nerve coverage or wrapping with vascularized *** authors’classification of and therapeutic approach to peripheral nerve scar lesions aims at promoting a logical approach based on the analysis of lesion type(perineural,or endoneural and perineural),pain type(due to traction or external trauma,pain at rest),and number of previous *** need to be informed that multiple procedures may be required,that outcomes may be partial,and that surgery can potentially worsen preoperative *** review found no evidence for the best therapeutic approach to scar neuropathy,but there is consensus on a multidisciplinary approach.

关键词： Complex regional pain syndrome type II painful neuropathy painful scar neuropathy scar neuritis traction neuropathy

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High energy diets-induced metabolic and prediabetic painful polyneuropathy in rats

High energy diets-induced metabolic and prediabetic painful ...

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中国神经科学学会第十届全国学术会议

作者： Han FU Fang XIE Jun-Feng HOU Kai JIAO Michael COSTIGAN Jun CHEN Institute for Biomedical Sciences of Pain Tangdu HospitalThe Fourth Military Medical University Department of Endocrinology Tangdu HospitalThe Fourth Military Medical University F.M.Kirby Neurobiology Center Children's Hospital Boston

Objective Peripheral neuropathy,with clinical manifestations of pain,sensory,autonomic and even motor dysfunctions,is a major common complication of both diabetes and ***,the link between prediabetes and polyneuropathy is *** establish the role of the metabolic state in the pathogenesis of polyneuropathy,an age- and sex-matched,longitudinal study in rats fed high-fat and high-sucrose diets（HFSD） or high-fat,high-sucrose and high-salt diets（HFSSD） relative to controls was *** Time courses of body weight,systolic blood pressure,fasting plasma glucose（FPG）,insulin,free fatty acids（FFA）,homeostasis model assessment-insulin resistance index（HOMA-IR）,thermal and mechanical sensitivity and motor coordination were measured in ***,large and small myelinated fibers（LMF,SMF） as well as unmyelinated fibers（UMF） in the sciatic nerves and ascending fibers in the spinal dorsal column were quantitatively assessed under electron *** The results showed that early metabolic syndrome（hyperinsulinemia,dyslipidemia,and hypertension） and prediabetic conditions（impaired fasting glucose） could be induced by high energy diet,and these animals later developed painful polyneuropathy characterized by myelin breakdown and LMF loss in both peripheral and central nervous *** contrast SMF and UMF in the sciatic nerves were changed little,in the same *** the phenomenon that high energy diets induce bilateral mechanical,but not thermal,pain hypersensitivity is reflected by severe damage to LMF,but mild damage to SMF and ***,dietary sodium（high-salt） deteriorates the neuropathic pathological process induced by high energy diets,but paradoxically high salt consumption,may reduce,at least temporarily,chronic pain perception in these *** High energy diet can result in prediabetes and metabolic syndrome that cause myelin damage and axonal degeneration in LMF and slight changes in UMF,which may cont

关键词： high energy diets painful neuropathy metabolic syndrome insulin resistance prediabetes neuropathic pain myelin breakdown axonal loss

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