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Neuropathic pain (疼痛機制(刺激→傳輸→背根神經節→(腦)感知→調控) (Physiology of Pain …

- - - - the dorsalhorn
        
        synapsing on interneurons,crossing to the opposite side
        
        traveling to the brain in the anterolateral tract.
  - - - necrosis
      - inflammation
        
        bradykinin
        
        histamine
        
        Prostaglandin E2
        
        Permeability ↑
      - Blood clotting
        
        Ischemia
        
        K+
        
        H+
        
        edema
        
        nociceptors
        
        serotonin
  - - - 5H
        
        Raphe nucleus
        
        central inhbition
        
        nociceptor
    - - NE
    - - enkephalins (which are pentapeptides) and three types of endorphin polypeptides (α-, β-, and γ-endorphin)
        
        Stress-induced analgesia is reversed by naloxone
        
        mu (μ),
        
        大腦中的濃度很高，被認為可以調節疼痛感
        
        kappa (κ),
        
        在脊髓中，在其中它們通過中樞神經系統下降途徑來調節疼痛
        
        sigma (σ),
        
        delta (δ)
- - - - This is a reactivation of the latent virus that has lain dormant along the nerve roots.
    - - Ischemic pain occurs when inadequate blood flow to tissues results in cellular injury and release of chemicals that stimulate and/or damage nociceptors
    - - pathogenetic mechanism is unknown, but this damage is thought to be mediated by occult inflammation and demyelination of the larger peripheral nerves, leaving an excess of smaller myelinated fibers
    - - Referred pain is thought to occur because of the convergence of visceral nociceptor activity with primary somatic afferents in the posterior horn of the cord.
    - - Chronic compression of the trigeminal nerve by a vessel is suspected in most cases. This causes demyelination of the trigeminal nerve and interruption and alteration in nerve signaling