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- W78107079 abstract "The chemical complexity and wide distribution of opioid peptides cause methodological difficulties in evaluation of their function. The two major approaches, use of naloxone as an anagonist or direct chemical measurements in tissue or body fluids, each has its limitations. To evaluate endorphin activity in the CNS, we have used chemical analysis of lumbar cerebrospinal fluid (CSF), particularly appropriate since spinal endorphin mechanisms are important. In patients with acute post-operative pain, the pain level could be assessed indirectly by their demand of narcotic analgesic. This demand was inversely related to the preoperative CSF endorphin levels, indicating that endorphins protect against acute traumatic pain. In patients with chronic pain, endorphin levels are generally low in those cases where pain originates from the nervous system itself - neurogenic pain. The degree of afferent stimulation may be reflected by the CSF levels of substance P. These levels appear increased in patients with chronic pain of peripheral origin (cancer, arthritic pain), and decreased by narcotic analgesic administration. Interestingly, patients with chronic neurogenic pain appear to have very low substance P levels, and also low levels of the serotonin metabolite 5HIAA, probably deriving from descending inhibitory fibers. It is postulated that neurogenic pain is associated with an apparent general lack of activity in pain and pain modulatory pathways and that the origin of pain may be focal, in analogy with epilepsies. This type of pain patient does not respond to morphine but is the one most likely to respond to trans cutaneous nerve stimulation which restores activity in the pain-pain modulatory system. Another area of neurology where endorphins may have a pathogenetic role is respiratory failure. A case history is presented where endorphin hyperactivity was particularly striking." @default.
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- W78107079 date "1982-01-01" @default.
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- W78107079 title "Endorphins — Clinical Relevance in Neurology" @default.
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- W78107079 doi "https://doi.org/10.1016/b978-0-08-028021-9.50010-1" @default.
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