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Anxiety
Although everybody had and will experience anxiety, its intensity, frequency and characteristics may vary from what can be considered as "normal" to pathological. The development of benzodiazepine as anxiolytics has been a major step firstly in therapeutics and secondly in the understanding of the associated biological mechanisms. Recently, new drugs without secondary effects of benzodiazepines have been developed. The purpose of the book was to take stock of the present knowledge: clinical aspects of pathological anxiety, neurobiological mechanisms associated with stress and anxiety, molecular targets of potent anxiolytic drugs, new issues and directions.
Neurosurgery for Spasticity
"Spasticity is one of the commonest sequelae of neurological disease and during the last few years many advances have been made in the treatment of this complaint by functional neurosurgery. This book ... will appeal to neurosurgeons, orthopaedic surgeons and neurologists amongst others.” Annals of the Royal College of Surgeons of England
Hemifacial Spasm
Idiopathic Hemifacial Spasm constitutes a severe disability both from a cosmetic and psychological point of view and functionally for the daily life. Until recently this peculiar disease had remained enigmatous and was resistant to any kinds of treatments. Over the last two decades important advances have been made in the comprehension of its mechanisms and the efficacy of its treatment. Botulinic toxin revealed to be helpful although its effects are most often transient. Microvascular decompression – suppressing the neuro-vascular conflict almost constantly found at the root exit zone of the facial nerve from the brain stem – has been recognized as the curative treatment of this disease. A wide range of specialists, namely neurologists, ophthalmologists, ENT-surgeons, clinical neurophysiologists, neuroradiologists and of course neurosurgeons are involved in the diagnosis and the management of Hemifacial Spasm and will be interested in this multidisciplinary review of the topic.
The Pain System in Normal and Pathological States
The last decade has seen much progress in understanding the mechanisms of pain and advances in basic science have seen translational research leading to volunteer studies and clinical trials. Despite this drawing together of molecules and maladies, the basic science can appear overly complex and impenetrabie for clinicians. This book aims to cover key topical molecular, anantomical, physiological, and pharmacological studies on the basic science in a straightforward and accessible manner for all medical and allied professionals with an interest in pain. The book is dedicatod to lean-Marie Besson, who has always allempted to further dialogus between clinicians and basic scientists.
Lesions of Primary Afferent Fibers as a Tool for the Study of Clinical Pain
Some of the most dramatic and most difficult pains to treat result from injury to primary afferent fibers. The validity of the models used in researching neuropathic pains by creating primary afferent lesions in animals is the controversial basis of this volume. The clinical and morphological aspects induced by these lesions are complex, leading to frequent mismatches between the injury and the clinical signs. Nomenclature is crucial to enable a good evaluation of sensory dysfunction. The relieving effect of sympathetic blockade is addressed, as well as the significance of autotomy and scratching behaviour after large injury, whether ethical rules are taken into account or not. Further, rat models with less dramatic injuries are described as useful tools for the study of neuropathic pain. Several classical techniques remain essential as tools of study but new state-of-the-art techniques are also emphasized. A very hot point is the question of opioid efficacy for relieving neuropathetic pain.
Serotonin and Pain
Serotonin (5-HT), at the peripheral level, is known to be an algogen capable of directly or indirectly (via sensitization) activating nociceptive afferent fibers. This may provide a novel approach to the production of novel analgesic drugs since some serotonin antagonists, unable to cross the blood brain barrier, have been shown to have analgesic properties in a model of inflammatory pain in the rat. The central serotinin systems have been the subject of considerable research over the last twenty years, and it is hoped that the critical aspects arising from this book will be instrumental in refining the experimental protocols used in allowing the roles of serotonin in nociception to be unmasked.
