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Abstract
The Aim Of The Work Is To Highlight On The Old And Recent Concepts Of DiffereChronic Intractable Pain.
The normal pain free state is a balance between noxious inputs to the
nervous system, and modulatory mechanisms generated by these inputs
which tend to suppress these noxious stimuli. Pain occurs with enhanced
inputs or reduced modulation, or both, and the neurosurgical procedures
intended to relieve pain attempt to counteract these states.
To use a pain relieving procedure, the clinician must decide whether
it is appropriate to carry out a procedure, and then must decide which
procedure to use. It must be clear that the pain IS intractable, that no treatable
causative disease exists, that the pain is not predominantly due to
psychological factors, and that even in pam with a clear physical
component the major disability is not derived from psychogenic
magnification.