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The therapeutic potential of cannabinoids in neuropathic pain has recently generated much interest. In this Viewpoint, Andrew Rice reports on the possible efficacy of cannabinoids in the treatment of pain in conditions including multiple sclerosis and HIV neuropathy. However, he warns that long-term therapeutic cannabinoid administration could be associated with psychosis, schizophrenia, and other mental illnesses.
Despite remarkable success in the fight against leprosy, the disease remains an important public health problem. This Review focuses on the neurological manifestations of leprosy and the pathophysiology of nerve damage. Special emphasis is given to developments in the early detection and treatment of leprosy-related nerve impairment.
Multiple sclerosis is characterized by both demyelination and neurodegeneration. The lack of myelin in the retina makes this an ideal structure in which to visualize the latter process. In this Review, Frohman et al. describe the novel use of retinal imaging technology, and in particular optical coherence tomography (OCT), to model the disease process in multiple sclerosis. They suggest that OCT could ultimately be used to identify strategies aimed at neuroprotection in the CNS.
The management of pain that is refractory to conventional treatments represents a considerable challenge for clinicians. Botulinum toxin has recently emerged as a potential novel approach to the control of refractory pain, and in this article Bahman Jabbari weighs up the available evidence for the efficacy of botulinum toxin therapy in various pain syndromes, including cervical dystonia, headache, neuropathic pain and postoperative pain.
Creange et al. describe the case of a woman who presented with sudden-onset neuropathy, elevated levels of vascular endothelial growth factor, thrombocytosis, leukocytosis, and thrombosis. Diagnosed with POEMS syndrome, the patient was successfully treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation.
