脊髓电刺激在慢性疼痛的应用演示文稿.ppt

神经刺激治疗的其他应用（非脊髓刺激） 脑深部刺激治疗疼痛 迷走神经刺激治疗癫痫 脑深部刺激治疗震颤和肌张力过高 运动皮层刺激治疗肌张力过高、疼痛 骶神经刺激治疗盆腔痛、膀胱痛和失禁 周围神经刺激治疗疼痛 枕部刺激治疗疼痛 * Neuropathic pain is caused by damage to the peripheral or central nervous system or by pathologic changes in neuro-functional relationships within these pain-processing systems. Examples of these pathologic changes in functional relationships causing chronic, persistent pain include sensitization of nociceptors, central sensitization or “wind-up,” abnormal sympathetic somatic nervous system interactions, and abnormal activation of NMDA receptors. Neuropathic pain is most often described by patients as electric-like sensations. 5 5 * Nociceptive pain is defined as pain mediated by nociceptors, widely distributed in the soma of the body. The pain is often described by patients as dull, aching, sharp, or throbbing pain. Nociceptive pain is often responsive to opioid therapies, whether delivered orally, parenterally or spinally. 6 6 * Whatever its cause, chronic pain is real, unrelenting, and demoralizing. People with chronic pain often cannot work. Their families and social lives may deteriorate as their total preoccupation with pain leads to a downward spiral of irritability and depression. 3 3 * A multidisciplinary plan of care is needed to offer a full range of solutions to the patient with chronic pain and efficiently control the delivery of appropriate health care. The continuum of care ranges from the most conservative to the more advanced treatments. However, some therapies will be used in combination, and depending on a patient’s pain diagnosis or response to treatment, therapies may not always be appropriate in the exact sequence shown. Early treatment options focus on conservative, non-invasive treatments such as NSAIDS, physical therapy, and oral opiates. Most people get well using these approaches or corrective surgery, but a subset don’t respond. This subset of patients requires more advanced pain therapies such as Neurostim Pain Therapy or