try these out A fantastic read hop over to this website offer lovers painting with big discount , the original source Additional info my review here Check out your url , view publisher site Great paintings of flowers by famous artists With The Best Cheap Price Under $20 painting , Wiht 20% Discount Hottest short blonde wig with dark roots Online Store web link You can find out more , Swiss Replicas . Continue cheap diamond painting how to article .

Anesthesia Journals | Clinical Anesthesia Journals | Pain Medicine Journals | Journal of Clinical Anesthesia and Pain Medicine | Scient Open Access
loader
Home/
Journal of Clinical Anesthesia and Pain Medicine

JCAPM

Aabstract

Research Article

Burning Pain in Small Fibre Neuropathy Treated with Topical Phenytoin: Rationale and Case Presentations

Jan M. Keppel Hesselink and David J Kopsky*

Correspondence Address :

David J Kopsky,
Institute Neuropathic Pain,
the Netherlands,
Email: info@neuropathie.nu

Received on: February 20, 2017 , Accepted on: March 10, 017 , Published on: March 17, 017

Citation: Jan M. Keppel Hesselink, David J Kopsky (2017). Burning Pain in Small Fibre Neuropathy Treated with Topical Phenytoin: Rationale and Case Presentations

Copyright: 2017 David J Kopsky, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
This is the first presentation of a number of patients suffering from burning pain related to small fibre neuropathy (SFN), treated successfully with a topical formulation of the sodium channel blocker phenytoin. We present and discuss four patients complaining of severe burning pain, indicative for SFN, and its treatment with topical phenytoin. Burning pain and SFN occur amongst others in chronic idiopathic axonal neuropathy, chemotherapy induced neuropathy and in diabetic neuropathy, and we present for each indication an illustrative case. Burning pain also occurs in idiopathic small fibre neuropathy, and we present separately two patients to illustrate the use of our single blind response test for SFN in order to correct for possible placebo-effects. In all cases the burning pain could be relieved by topical phenytoin cream. 
Burning pain has been related to mutations of the Nav1.7 channel and this channel is one of the targets for phenytoin. In addition phenytoin can also block other sodium and calcium channels. Furthermore, phenytoin downregulates inflammatory cytokines in the skin, of which the production is enhanced in SFN and phenytoin has neuroprotective properties. We formulated a special topical cream, which enabled us to administer phenytoin in high concentrations (5% and 10%), leading to a fast and clinical relevant reduction of burning pain, without local or systemic adverse events. Based on these preliminary positive findings, a dose-finding phase IIb study is under preparation.
Keywords: Dilantin, Cream, Neuropathic, CIAP, Nav1.7, Analgesic, Local, Topiceutical, SFN

Journal Details

Journal Home

Editorial Board

Instructions For Authors

Articles in Press

Current Issue

Archive

Submit Manuscript

Our Journals

INDEXING ABSTRACTING

Latest e-Books

Reprints

© 2019, Copyrights Scient Online. All Rights Reserved AfrizatulCheap cPanel License Provider

Creative Commons License Open Access by Scient Online is licensed.