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Pruritus: Imhundlgeical and neurophysiological mechanisms
S192
WORKSHOP
ON:
TREATMENT
1.
Introduction:
2.
History: Orthodox
5 minutes
289 Workshop Sun 4:00 Vashon
5 minutes
t
OF HEAD AND NECK PAIN BY ACUPUNCTURE
Dr. S. Lipton,
UK
Dr. J. Mumford, UK methods of treating orofacial Dr. D. Bowsher,
pa in
3.
Physiology:
4.
Animal Models for Acupuncture, Dr. B. Pomeranz, Canada
UK
5-10 minutes
5.
Acupuncture - Sense and Nonsense Dr. G. A. Ulett, USA
10 minutes
GENERAL Areas
5 minutes
DISCUSSION
to be covered:
1.
Ear acupuncture
2.
T.N.S.
and acupuncture
3.
Migraine
4.
Value
and acupuncture
5.
Value of other forms of acupuncture, dry needling; moxibustion.
in spondylitis;
- (initiated
rotator
by Dr. P. Nathan,
cuff pain; trigger e.g.:
UK)
point pain
"pecking",
Ryodoraku;
N.B.: Participants who wish to speak, please notify Dr. S. Lipton of the Please remember that, to widen the discussion and aspect and time wanted. involve the maximum number of those present, 5 minutes is the maximum time (Dr. S. Lipton; Pain Relief Foundation; allowed, and preferably half this. Walton Hospital; Liverpool L9 lAE, England UK Tel: 051-523-1486). PRURITUS: Chairman: Speakers:
IMMUNOLOGICAL AND NEUROPHYSIOLOGICAL MECHANISMS [E;T] H. Fruhstorfer J.E. Bernstein, 6. Fjellner, J.M. Hanifin, H.E. Torebjdrk Pruritus is an unpleasant cutaneous sensation evoked by a variety of external stimuli or internal processes. It is relieved by scratching or thermal stimulation of the skin. Animals also suffer from itch as can be deduced from their scratching behaviour. Although pruritus has similar characteristics as pair! it does not seem to be just a submodality of pain. Its biological value seems to be as low as that of paraesthesia. The key substance eliciting itch is histamine normally released from mast cells. This release is caused by a great variety of mediators such as certain proteinases, opiates and peptides (enkephalin, VIP, NT, SP). Interesting enough peptides are released by sensory as well as by sympathetic nerve fibres, and a sympathetic dysfunction has indeed been observed in certain cases of chronic itch. Another class of substances eliciting itch without releasing histamine are other proteinases of which kallikrein and mucunain, the active substance of cowhage, are two potent examples. Whether histamine or proteinases directly stimulate nerve endings or whether there are additional intermediate processes is not known. Similarly the types of receptor neurones are unknown, though it is probable that they have unmyelinated axons. Like pain itch can also arise from abnormal activity within the CNS as it may be observed in multiple sclerosis. Furthermore, there are some indications that q piods have a central pruritogenic action. Pruritus is still a huge puzzle of which only a few fragments have beThis workshop is intended to bring together scientist come recognizable. from the different fields of pruritus research in an attempt to initiate the development of a comprehensive concept of pruritus.
I
WORKSHOP
ON:
TREATMENT
1.
Introduction:
2.
History: Orthodox
5 minutes
289 Workshop Sun 4:00 Vashon
5 minutes
t
OF HEAD AND NECK PAIN BY ACUPUNCTURE
Dr. S. Lipton,
UK
Dr. J. Mumford, UK methods of treating orofacial Dr. D. Bowsher,
pa in
3.
Physiology:
4.
Animal Models for Acupuncture, Dr. B. Pomeranz, Canada
UK
5-10 minutes
5.
Acupuncture - Sense and Nonsense Dr. G. A. Ulett, USA
10 minutes
GENERAL Areas
5 minutes
DISCUSSION
to be covered:
1.
Ear acupuncture
2.
T.N.S.
and acupuncture
3.
Migraine
4.
Value
and acupuncture
5.
Value of other forms of acupuncture, dry needling; moxibustion.
in spondylitis;
- (initiated
rotator
by Dr. P. Nathan,
cuff pain; trigger e.g.:
UK)
point pain
"pecking",
Ryodoraku;
N.B.: Participants who wish to speak, please notify Dr. S. Lipton of the Please remember that, to widen the discussion and aspect and time wanted. involve the maximum number of those present, 5 minutes is the maximum time (Dr. S. Lipton; Pain Relief Foundation; allowed, and preferably half this. Walton Hospital; Liverpool L9 lAE, England UK Tel: 051-523-1486). PRURITUS: Chairman: Speakers:
IMMUNOLOGICAL AND NEUROPHYSIOLOGICAL MECHANISMS [E;T] H. Fruhstorfer J.E. Bernstein, 6. Fjellner, J.M. Hanifin, H.E. Torebjdrk Pruritus is an unpleasant cutaneous sensation evoked by a variety of external stimuli or internal processes. It is relieved by scratching or thermal stimulation of the skin. Animals also suffer from itch as can be deduced from their scratching behaviour. Although pruritus has similar characteristics as pair! it does not seem to be just a submodality of pain. Its biological value seems to be as low as that of paraesthesia. The key substance eliciting itch is histamine normally released from mast cells. This release is caused by a great variety of mediators such as certain proteinases, opiates and peptides (enkephalin, VIP, NT, SP). Interesting enough peptides are released by sensory as well as by sympathetic nerve fibres, and a sympathetic dysfunction has indeed been observed in certain cases of chronic itch. Another class of substances eliciting itch without releasing histamine are other proteinases of which kallikrein and mucunain, the active substance of cowhage, are two potent examples. Whether histamine or proteinases directly stimulate nerve endings or whether there are additional intermediate processes is not known. Similarly the types of receptor neurones are unknown, though it is probable that they have unmyelinated axons. Like pain itch can also arise from abnormal activity within the CNS as it may be observed in multiple sclerosis. Furthermore, there are some indications that q piods have a central pruritogenic action. Pruritus is still a huge puzzle of which only a few fragments have beThis workshop is intended to bring together scientist come recognizable. from the different fields of pruritus research in an attempt to initiate the development of a comprehensive concept of pruritus.
I