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Neuropathic pain

Neuropathic pain is a localized sensation of unpleasant discomfort caused by damage or disease that affects the somatosensory system.

It is a common and debilitating consequence of neuromyelitis optica spectrum disorder (NMOSD) myelitis, with no satisfactory treatment.

The IASP's widely used definition of pain states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Neuropathic pain constitutes a significant portion of chronic pain.

Does not involve sympathetic hyperactivity but may be associated with vegetative signs (eg, fatigue, loss of libido, loss of appetite) and depressed mood. People vary considerably in their tolerance for pain.

Epidemiology

Neuropathic pain constitutes a significant portion of chronic pain.

Up to 7% to 8% of the European population is affected, and in 5% of persons it may be severe.

Types

Central neuropathic pain

Chronic neuropathic pain

Neuropathic pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). Thus, neuropathic pain may be divided into peripheral neuropathic pain, central neuropathic pain, or mixed (peripheral and central) neuropathic pain.

Peripheral neuropathic syndromes have received greater attention in the research literature than central pain, and studies of syndromes such as postherpetic neuralgia and painful diabetic neuropathy provide the basis for current knowledge of neuropathic pain.

Etiology

Peripheral nerve injury is associated with microvascular disturbance; however, the role of the vascular system has not been well characterized in the context of neuropathic pain.

Is caused by damage or disease that affects the somatosensory system.

Clinical Features

Patients with neuropathic pain are usually more heavily burdened than patients with nociceptive pain. They suffer more often from insomnia, anxiety, and depression. Moreover, analgesic medication often has an insufficient effect on neuropathic pain.

It may be associated with abnormal sensations called dysesthesia, and pain from normally non-painful stimuli (allodynia). Neuropathic pain may have continuous and/or episodic (paroxysmal) components. The latter resemble an electric shocks. Common qualities include burning or coldness, “pins and needles” sensations, numbness and itching. Nociceptive pain, by contrast, is more commonly described as aching.

Treatment

neuropathic_pain.txt · Last modified: 2018/08/21 12:53 by administrador