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Neuropathic pain: clinical characteristics and diagnostic workup
Author(s) -
Hansson Per
Publication year - 2002
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1053/eujp.2001.0322
Subject(s) - neuropathic pain , medicine , mechanism (biology) , disease , medical history , peripheral neuropathy , stimulus (psychology) , sensory system , chronic pain , physical medicine and rehabilitation , anesthesia , neuroscience , physical therapy , pathology , surgery , psychology , philosophy , epistemology , psychotherapist , diabetes mellitus , endocrinology
Neuropathic pain is part of the neurological disease spectrum and may be an expression of severe medical pathology. Painful neuropathies have multiple disguises and may to a certain extent be mimicked by non‐neurological pain conditions. Painful neuropathic conditions express themselves with spontaneous and/or abnormal stimulus‐evoked pain. The diagnosis of peripheral or central neuropathic pain should be made only when the history and signs are indicative of neuropathy in conjunction with neuroanatomically correlated pain distribution and sensory abnormalities within the area of pain. A future mechanism‐based classification of pain has recently been suggested to facilitate the development of mechanism‐tailored treatment strategies. This is a sound approach and should be pursued. It is mandatory, however, to retain the traditional organ‐based diagnostic workup, which should precede further in‐depth characterization of specific pain mechanisms. Extensive preparatory work is needed on how to link certain symptoms and signs to specific mechanisms, as elucidated from animal studies, before we can introduce mechanism‐coupled treatment strategies. © 2002 European Federation of Chapters of the International Association for the Study of Pain