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Summer 2012

Editorial – Complex Pain and Peripheral Nerve Disorders

Dr. Mitchel Berger

Dr. Mitchel Berger

Complex pain and peripheral nerve disorders are among the most difficult conditions for
health care teams to manage.

There is never a one-size-fits-all treatment plan, and we often need to differentiate between the sensory and cognitive components of pain perception to arrive at accurate diagnoses.

Fortunately, at UCSF Medical Center, we have many strategies to provide relief for patients with ongoing and progressive symptoms.

As in many other areas of neuroscience, sophisticated imaging techniques have revolutionized the fields of pain and peripheral nerve disorders. It is possible to obtain excellent representations of 3-D nerve anatomy and pathology using magnetic resonance neurography, which has greatly influenced the management of patients with peripheral neuropathies.

The more widespread use of nerve imaging has led to an increase in documented cases of nerve injury and entrapment syndromes and an increase in demand for surgical intervention. However, clinical examination and electrodiagnostic testing still have important roles in generating a comprehensive treatment plan, as Dr. Michel Kliot explains in this issue.

Dr. Kliot, who recently joined UCSF from the University of Washington, brings with him 20 years of experience in treating patients with peripheral nerve disorders. Part of his role as director of the UCSF Center for Management and Surgery of Peripheral Nerve Disorders will be to lead specialized clinics for adult and pediatric patients with neurofibromatosis.

While our peripheral nerve group focuses on structural problems directly affecting the nerves, our pain program treats patients by blocking painful impulses caused by complex disorders that affect functional nerves. Patients with debilitating conditions such as cluster headache, migraine and trigeminal neuralgia often require lifelong care by a multidisciplinary group that offers ongoing treatments ranging from the psychological to the surgical.

For patients who do not respond to medication or are unable to tolerate its side effects, surgery can produce dramatic results in pain control. At the UCSF Pain Management Center, a multidisciplinary team evaluates patients to provide them relief as soon as possible. It is our mission to ensure that no patient lives with uncontrolled pain.

Mitchel S. Berger, M.D.
Kathleen M. Plant Distinguished Professor and Chair
UCSF Department of Neurological Surgery

 

Neuroscience — Summer 2012 Index.

Related Information

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The longstanding mystery of how selective hearing works — how people can tune in to a single speaker while tuning out their crowded, noisy environs — was solved by two scientists from UCSF, and others at hospitals in the U.S., Canada and Europe. UCSF neurosurgeon Dr. Edward Chang and postdoctoral fellow Nima Mesgarani worked with three patients who were undergoing brain surgery for severe epilepsy.

Donors Support Neurosciences Research and Patient Care
UCSF received a challenge gift of $20 million from the Sandler Foundation that will support for the university's groundbreaking research and clinical care in neurological diseases. In honor of Herbert and Marion Sandler and the Sandler Foundation, the new neurosciences building at the UCSF Mission Bay campus will be named the Sandler Neurosciences Center.