Rarely the pain from malignant disease, primary or metastatic, cannot be adequately relieved by conventional analgesics, even with very high dosage opiate drugs. It is now recognized that in many instances this pain, of deafferentation type, is due to actual nerve infiltration or destruction by tumour. Five such cases are reported, in each of whom, a different manipulation of drug therapy was necessary before adequate pain control was achieved. It is concluded that, until a better understanding of the mechanism of deafferentation pain is reached, treatment of such cases will remain unsatisfactory.
Tasker RR, Organ LW, Hawrlyshyn P.Deafferentation and causalgia. In: Bonica JJ ed, Pain, New York: Raven Press, 1980: 305-29.
2.
Zimmermann M.In: Bonica JJ ed, Advance in pain research and therapy. New York: Raven Press , 1983: 661-62.
3.
Tasker RRDeafferentation. In: Wall PD, Melzack R eds, Textbook of pain. Edinburgh: Churchill Livingstone, 1984: 119-32.
4.
Tasker RRThe problem of deafferentation pain in the management of the patient with cancer. Journal of Palliative Care1987 ; 2(2): 8-12.
5.
Glynn CJ, Jamous MA, Teddy PJ, Moore RA, Lloyd JWRole of spinal noradrenergic system in transmission of pain in patients with spinal cord injury. Lancet1986; ii: 1249-50.
6.
Petros AJ, Bowen Wright RMEpidural and oral clonidine in domiciliary control of deafferentation pain . Lancet1987; 1: 1034.
7.
Glynn C.An approach to the management of the patient with deafferentation pain. Palliative Medicine1988; 3: 13-21.
