Hong Kong Project Brings hope to cancer kid

 

Seventeen years old Wei Qunqun from a poor farmer family in rural Shangdong Province, had acoustic neuroma (hearing-nerve cancer). But, thanks to the humanitarian efforts by “Healing Heart Initiative” Charity Program, she could undergo the surgery free of charge in Hong Kong.

A Hong Kong Hospital charity project “Healing Heart Initiative” and charity group Hear Talk Foundation paid Wei’s medical bills.

Since she was 13, acoustic neuroma badly affected Wei’s learning ability and left her almost crippled. Her hearing ability and sense of balance worsened two years ago. She always felt dizzy and could hardly walk.

The disease could have been fatal if the five-centimeter tumor continued to grow.

However, except for a tiny part that is close to her facial nerve, the tumor had been successfully removed last week by a team of volunteer doctors from Hear Talk Foundation. Wei is able to eat, think and walk and is currently undergoing physiotherapy. She will be released from hospital next week.

Reference: http://www.surgery.cuhk.edu.hk/neuro/default.htm

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Are there any screening tools to help diagnose neuropathic pain?

Various screening tools are available to help physicians diagnose neuropathic pain. The European Federation of Neurological Societies (EFNS) has recently published updated guidelines that provide an overview of, and recommendations on, the key screening tools. These tools are: the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)2; Neuropathic Pain Questionnaire (NPQ)3; Douler Neuropathique en 4 questions (DN4)4; PainDETECT5; ID Pain6; and the standardized evaluation of pain (StEP)7. All these screening tools have been validated in various neuropathic pain populations; the LANSS, DN4 and StEP utilize interview questions and physical examination, while the NPQ, PainDETECT and ID Pain use only interview questions. Of relevance to the Hong Kong population, one of the screening tools – the ID Pain – has been translated to and validated. The validity of the 6-item patient-completed questionnaire was assessed in 92 patients with either neuropathic or nociceptive pain. At a score of 3 or more, the questionnaire correctly classified 71% of cases. While screening tools are useful for identifying patients with possible neuropathic pain, particularly by non-specialist physicians, they do have limitations. As noted in the EFNS guidelines, these tools fail to identify 10–20% of patients with physician-diagnosed neuropathic pain; hence, they should be used together with a thorough patient history and physical examination.

ID pain

1 Did the pain feel like pins and needles? 您的痛楚是否好像被針刺般疼痛？

2 Did the pain feel hot/burning? 您的痛楚是否灼熱或好像被火燒一樣？

3 Did the pain feel numb? 您的痛楚是否帶有麻痺？

4 Did the pain feel like electrical shocks? 您的痛楚是否好像觸電一樣？

5 Is the pain made worse with the touch of clothing or bedsheets? 您的痛楚是否因觸碰衣服或床單而加劇？

6 Is the pain limited to your joints? 您的痛楚是否只限於關節部位？

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your doctor immediately.

Introduction of Neuropathic Pain?

Neuropathic pain is an inappropriate physiological response caused by a lesion or dysfunction in the peripheral nervous system or central nervous system. Unlike nociceptive pain, which is an appropriate physiological response to a painful stimulus, neuropathic pain can be either stimulus-independent or stimulus-evoked.

Assessment of Neuropathic Pain

The assessment of neuropathic pain can be challenging, as the aetiology and symptomatology of each neuropathic pain syndrome can vary greatly. Some conditions may also involve both neuropathic and nociceptive pain. Patient descriptions of neuropathic pain symptoms may include:

1. Continuous, burning pain
2. Dysaesthesia (abnormal and unpleasant sensations caused by spontaneous ectopic discharges along Aß fibres. Such sensations may be spontuneous or evoked)
3. Shooting or lancinating pain/sharp, tearing pain
4. Hyperalgesia (an increased response to a stimulus that is normally painful)
5. Allodynia (pain from a stimulus that is not always painful)
6. Paraesthesia (abnormal, but not unpleasant, sensations caused by spontaneous ectopic discharge along Aß fibres. Such sensations may occur in the absence of external stimuli)
7. Electric, shock-like pain

Patients with the same neuropathic pain syndrome often present with different symptoms and respond to the same therapy with varying degrees of success, thus complicating disease management. It has become clear that physicians should adopt a more symptom- and disease mechanism-based approach to selecting therapy.

Reference information: http://www.spineuniverse.com

The information above is used for educational purpose only, for any enquiries, please consult the neurosurgeon for medical advices.