Diagnosis and treatment of neuropathic pain

被引:91
作者
Chong, MS
Bajwa, ZH
机构
[1] Kings Coll Hosp London, Dept Neurol, London SE5 9AZ, England
[2] Medway Hosp, Gillingham, Kent, England
[3] Harvard Univ, Sch Med, Dept Anesthesia & Neurol, Boston, MA USA
关键词
neuropathic pain; pain diagnosis; pain management; neuropathic pain classification; antiepileptic drug; invasive therapy; non-invasive therapy;
D O I
10.1016/S0885-3924(03)00064-2
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Currently, no consensus on the optimal management of neuropathic pain exists and practices vary greatly worldwide. Possible explanations for this include difficulties in developing agreed diagnostic protocols and the coexistence of neuropathic, nociceptive and, occasionally, idiopathic pain in the same patient. Also, neuropathic pain has historically been classified according to its etiology (e.g., painful diabetic neuropathy, trigeminal neuralgia, spinal cord injury) without regard for the presumed mechanism(s) underlying the specific symptoms. A combined etiologic/mechanistic classification might improve neuropathic pain management. The treatment of neuropathic pain is largely empirical, often relying heavily on data from small, generally poorly-designed clinical trials or anecdotal evidence. Consequently, diverse treatments are used, including non-invasive drug therapies (antidepressants, antiepileptic drugs and membrane stabilizing drugs), invasive therapies (nerve blocks, ablative surgery), and alternative therapies (e.g., acupuncture). This article reviews the current and historical practices in the diagnosis and treatment of neuropathic pain, and focuses on the USA, Europe and Japan.
引用
收藏
页码:S4 / S11
页数:8
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