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Prognosis of Neurological Diseases pp 489–505Cite as

Neurological Pain

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Abstract

Neuralgias are short lasting, paroxysmal, electric shock-like pain restricted within the sensory territory of a single peripheral nerve.

Trigeminal neuralgia (TN), trigeminal terminal branches, glossopharyngeal neuralgia (GN), occipital neuralgia

Medical treatment outcome – TN is often progressive with possible spontaneous remission. CBZ obtains 100 % of pain relief in 70 % of patients. In the long term, 50 % of TN patients become refractory to drugs and require surgery.

Surgery outcome – Complete relief in ~ 60 80 % at 1 year.

Chronic low back pain (CLBP) – Acute low back pain commonly improves in the first month; 20–30 % of patients can complain of symptoms after months or years.

Sciatica (lumbar disk herniation) – Fifty percent of patients improve within a month and 90 % within 6–12 weeks. Large herniations can reabsorb better. Discectomy is faintly superior to conservative treatment in the first 2–4 years after surgery.

Complex regional pain syndrome – Prognosis is highly variable: improvement in 6–12 months with minimal sequelae in some patients. Pain, skin trophic changes, and motor symptoms can persist for years.

Phantom pain – Can spontaneously improve or resolve, but it persists over 2 years in 60 % of patients and is referred as severe in 0.5–5 % of cases.

Stroke pain – Difficult to treat with poor outcome.

Postherpetic neuralgia (PHN) – Develops in 10 % of patients aged 60–70, and in 20 % of patients aged ≥70 years.

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Author information

Authors and Affiliations

  1. Neuroalgology and Headache Unit, IRCCS Foundation “Carlo Besta” Neurological Institute, Via Celoria, 11, Milan, 20133, Italy

    Daniele Cazzato & Giuseppe Lauria

Authors
  1. Daniele Cazzato
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  2. Giuseppe Lauria
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Correspondence to Daniele Cazzato .

Editor information

Editors and Affiliations

  1. Fondazione “Giancarlo Quarta”, Milano, Milan, Italy

    Angelo Sghirlanzoni

  2. Istituto Neurologico C. Besta, Milan, Italy

    Giuseppe Lauria

  3. Istituto Neurologico C. Besta, Milan, Italy

    Luisa Chiapparini

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Cazzato, D., Lauria, G. (2015). Neurological Pain. In: Sghirlanzoni, A., Lauria, G., Chiapparini, L. (eds) Prognosis of Neurological Diseases. Springer, Milano. https://doi.org/10.1007/978-88-470-5755-5_40

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  • DOI: https://doi.org/10.1007/978-88-470-5755-5_40

  • Publisher Name: Springer, Milano

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  • Online ISBN: 978-88-470-5755-5

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