Pain relief in intracranial neoplasia

RE: Pain relief in intracranial neoplasia

Bob Russell — Fri, 03 Jun 2016 10:28:34 GMT

Ask the owners if they take anything for a headache? If so it is likely to be a NSAI of some variety. Very odd that they seem to decline common sense medication!

RE: Pain relief in intracranial neoplasia

Matt Hilary — Fri, 03 Jun 2016 09:51:17 GMT

Thanks for replies. Written in a hurry so omitted that anti-inflammatories have been discussed with and rejected by the owner (more than once). I hadn't thought of gabapentin so might be worth adding - I was hoping to use something that could be given occasionally with rapid onset.

Patient is currently behaving normally (between episodes) according to the owner 4m post-diagnosis so PTS premature (though have discussed that may deteriorate rapidly).

RE: Pain relief in intracranial neoplasia

grumpyoldman — Thu, 02 Jun 2016 20:56:25 GMT

I think the problem is that we have no patient side ICP monitor. So its all guess work ,the HSM CKCS patients still have normal mentation generally, their issue appears to be chronic neck pain, the neurology from an intracranial mass is about the direct mass effect, and the inflammation from the tumour "penumbra" the pressure effects on the edge of the mass , because its angry and upset and the BBB is not a factor ,normal meds apply.

RE: Pain relief in intracranial neoplasia

Virginia Campbell — Thu, 02 Jun 2016 20:19:07 GMT

I'd treat as for syringomyelia signs ie this[quote user="grumpyoldman"]Pred 1-2mg/kg frusamide 1mg/kg qid Gabapentin 20mg/kg tid [/quote]

and have the talk Wynne suggests as this[quote user="grumpyoldman"]then a bag , [/quote] may not be far away. I'd worry that there could be episodes of (or continuous?) pain that isn't obvious.

RE: Pain relief in intracranial neoplasia

grumpyoldman — Thu, 02 Jun 2016 18:36:51 GMT

Pred 1-2mg/kg frusamide 1mg/kg qid Gabapentin 20mg/kg tid . then a bag ,

RE: Pain relief in intracranial neoplasia

Hannah Wynne Richards — Thu, 02 Jun 2016 17:45:24 GMT

Is it time for "The talk?"

Wynne

RE: Pain relief in intracranial neoplasia

Anthony Dennison — Thu, 02 Jun 2016 17:44:51 GMT

I think an anti-inflammatory would probably be a good thing - these space occupying lesions can irritate surrounding tissue and themselves. Also would gabapentin or pre-gabalin be useful?