We include in this article the results of a postal inquiry into chronic pain in SCI patients in Valencia (Spain), and our experience with their management. A mailed questionaire including lesion and chronic pain data was sent to al\ of the 380 SCI patients who live in the region of Valencia. We received 202 answers, with 145 questionaires being accurately answered and these were analysed for this study. The results show that chronic pain (that is, lasting more than 6 months) is very common (65.5. %).The most frequent type was deafferentation pain (phantom pain), described as burning or a painful numbness.Since 1988 we have been treating a sample of 33 patients suffering from resistant pain according to the fol\owing therapies: 1 amitryptiline + clonazepan + NSAID (nonsteroidal antiinflammatory drugs): 2 amitryptiline + clonazepan + 5-0H-tryptophane + TENS (transcutaneous electrical nerve stimulation): 3 amitryptiline + clonazepan + SCS (spinal cord stimulation): 4 morphine, by continuous intrathecal infusion.After almost 4 years using these therapies we can affirm that the results regarding analgesia reached 80% in all cases, and that morphine used by intrathecal route is very safe and useful in selected patients.

Summary. We have employed the alpha blocking drug Nicergoline in 14 patients with neuropathic bladder dysfunction of the upper motor neurone type.The oral administration of 15-30 mgrs/ day of this drug over a period of 9·5 months significantly improved the urodynamic parameters, with an increase of bladder capacity, a disappearance or amelioration of uninhibited bladder contrac tions and a decrease in urethral pressure, profile urethral length and residual urine.Two patients with vesico-ureteral reflux present before treatment showed radiological improvement after Nicergoline administration.Tolerance of Nicergoline had been excellent without appreciable side effects. In conclusion, Nicergoline seems to be active and well tolerated in the pharmaco logical treatment of neuropathic bladder dysfunction.