S192 WORKSHOP ON: TREATMENT OF HEAD AND NECK PAIN

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Introduction: Dr. S. Lipton, UK

History: Dr. J. Mumford, UK Orthodox methods of treating orofacial pa i

BY ACUPUNCTURE

5 minutes

n 5 minutes

Physiology: Dr. D. Bowsher, UK

Animal Models for Acupuncture, Dr. B. Pomeranz, Canada

5 minutes

5-10 minutes

Acupuncture - Sense and Nonsense Dr. G. A. Ulett, USA

10 minutes

289 Workshop I Sun 4:00 Vashon

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Areas to be covered:

GENERAL DISCUSSION

1. Ear acupuncture

2. T.N.S. and acupuncture

3. Migraine and acupuncture - (initiated by Dr. P. Nathan, UK)

4. Value in spondylitis; rotator cuff pain; trigger point pain

5. Value of other forms of acupuncture, e.g.: "pecking", Ryodoraku; dry needling; moxibustion.

N.B.: Participants who wish to speak, please notify Dr. S. Lipton of the aspect and time wanted. Please remember that, to widen the discussion and involve the maximum number of those present, 5 minutes is the maximum time allowed, and preferably half this. (Dr. S. Lipton; Pain Relief Foundation; Walton Hospital; Liverpool L9 lAE, England UK Tel: 051-523-1486).

PRURITUS: IMMUNOLOGICAL AND NEUROPHYSIOLOGICAL MECHANISMS Chairman: H. Fruhstorfer

Speakers: J.E. Bernstein, 6. Fjellner, J.M. Hanifin, H.E. Torebjdrk

[E;T]

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 sympa- thetic nerve fibres, and a sympathetic dysfunction has indeed been ob-

served in certain cases of chronic itch. Another class of substances eli- citing 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 activ-

ity 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 be-

come recognizable. This workshop is intended to bring together scientist

from the different fields of pruritus research in an attempt to initiate the development of a comprehensive concept of pruritus.