The Role and Treatment Implications of Peripheral and Central Processing of Pain, Pruritus, and Nausea in Heightened Somatic Awareness: A Review

This article reviews the acute neural transmission of pain, pruritus, and nausea symptoms, which can begin in the periphery and/or viscera. The subsequent multiple pathways in the central nervous system that become involved in the processing of these symptoms are also discussed. The authors describe human brain imaging studies that have revealed consistent cortical and subcortical networks  activated by these symptoms, including sensory, limbic, and associative regions. In particular, the authors discuss information revealed by the studies regarding the primary somatosensory cortex, secondary somatosensory cortex, anterior cingulate cortex, insula, prefrontal cortex and thalamus, are the brain areas most commonly activated by noxious stimuli.  Finally, the authors describe treatment options for chronic presentations of these symptoms, which are, in part, based on central nervous processing of these sensations. Introduction Heightened somatic awareness (HSA) refers to a greater than average awareness for a variety of physical sensations and symptoms. Individuals with HSA have a tendency to notice and report nonspecific symptoms, such as shortness of breath, presyncope, and a variety of chronic pain conditions, pruritus, and nausea.1 While each sensation has unique neural transmission pathways to the spinal cord, there appears to be a convergent processing of these sensations at the level of the brain itself. As opposed to acute sensory symptoms, the perpetuation of c...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue Neurologic Systems and Symptoms Neurology Pain Review central processing nausea pruritus Source Type: research

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We report four cases of effective analgesia for intractable secondary headache resistant to medical management with high thoracic ESP blocks. In each case, the ESP block provided instant pain relief. We suggest that the findings of this case series indicate that the ESP block may be a useful intervention in patients with severe secondary headache or posterior cervical pain where conventional therapies have limited success, though more studies are necessary. PMID: 32606918 [PubMed]
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
Authors: Şahiner Y, Yağan Ö, Ekici AA, Ekici M, Demir E PMID: 32606275 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Lee JH PMID: 32606274 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Lee KJ, Doo AR PMID: 32606273 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Wang L, Shen J, Das S, Yang H Abstract Background: Previous studies showed neurography and tractography of the greater occipital nerve (GON). The purpose of this study was determining diffusion tensor imaging (DTI) parameters of bilateral GONs and dorsal root ganglia (DRG) in unilateral cervicogenic headache as well as the grading value of DTI for severe headache. The correlation between DTI parameters and clinical characteristics was evaluated. Methods: The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in bilateral GONs and cervical DRG (C2 and C3) were measured. Grading v...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Cho HS, Kim S, Kim CS, Kim YJ, Lee JH, Leem JG Abstract Background: General anesthesia (GA) has been considered the anesthetic technique which most frequent leads to phantom limb pain (PLP) after a limb amputation. However, these prior reports were limited by small sample sizes. The aims of this study were to evaluate the incidence of PLP according to the various anesthetic techniques used for limb amputation and also to compare the occurrence of PLP according to amputation etiology using the Korean Health Insurance Review and Assessment Service for large-scale demographic information. Methods: The cla...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Conclusions: This study demonstrated that both US-guided and blind GNB, in the treatment of knee OA, were effective in reducing symptoms and improving physical function. GNB wasn't an effective treatment for isokinetic muscle function. USguided injections may yield more effective clinical results than blind injections. PMID: 32606270 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Conclusions: There was a high prevalence of pain and intense pain in individuals with severe obesity and an association with clinical variables, the degree of obesity, and sedentary lifestyle. PMID: 32606269 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons. PMID: 32606268 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Authors: Sencan S, Edipoglu IS, Celenlioglu AE, Yolcu G, Gunduz OH Abstract Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS). Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking d...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
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