Neuropathic pain

Main Article Content

Giuseppe Re *
Virgilio Ricci
Fabrizio Rasi
(*) Corresponding Author:
Giuseppe Re | lucia.zoppi@pagepress.org

Abstract

Neuropathic pain is the expression of a dysfunction or primary lesion of a nerve in the peripheral or central nervous system, or both, rather than the biological signal transmitted by the nerve following peripheral nociceptor activation. It represents about 20% of all painful syndromes, with an estimated prevalence of 1.5%, however is actual incidence is hard to pinpoint due to the difficulties encountered in distinguishing it from chronic pain, of which it represents a significant percentage, on account of the not infrequent concurrence of conditions. It is crucial to recognise the variety of symptoms with which it can present: these can be negative and positive and, in turn, motor, sensitive and autonomic. In public health terms, it is important to emphasise that the diagnosis of neuropathic pain does not in most cases require sophisticated procedures and does not therefore weigh on health expenditure. In clinical practice, a validated scale (the LANSS is mentioned) is useful for identifying patients presenting neuropathic pain symptoms. Therapy is based on three categories of medication: tricyclic antidepressants, anti-epileptics and opioids at high doses: neuropathic pain has a bad reputation for often resisting common therapeutic approaches and responding less well that nociceptor pain to monotherapy. Therapeutic strategies are all the more adequate the more they are based on symptoms and therefore on the pain generation mechanisms, although the recommendations are dictated more by expert opinions that double-blind randomised trials.

Downloads month by month

Downloads

Download data is not yet available.

Article Details

Author Biographies

Giuseppe Re, Medicina Interna, Terapia Antalgica e Neurologia, Ospedali di Lugo e Ravenna

Virgilio Ricci, Medicina Interna, Terapia Antalgica e Neurologia, Ospedali di Lugo e Ravenna

Fabrizio Rasi, Medicina Interna, Terapia Antalgica e Neurologia, Ospedali di Lugo e Ravenna