Journal ArticleDOI
Neuropathic pain Redefinition and a grading system for clinical and research purposes
Rolf-Detlef Treede,Troels S. Jensen,James N. Campbell,Giorgio Cruccu,Jonathan O. Dostrovsky,J. W. Griffin,Per Hansson,Richard A. C. Hughes,Turo Nurmikko,Jordi Serra +9 more
Reads0
Chats0
TLDR
A grading system of definite, probable, and possible neuropathic pain is proposed, which includes the grade possible, which can only be regarded as a working hypothesis, and the grades probable and definite, which require confirmatory evidence from a neurologic examination.Abstract:
Pain usually results from activation of nociceptive afferents by actually or potentially tissue-damaging stimuli. Pain may also arise by activity generated within the nervous system without adequate stimulation of its peripheral sensory endings. For this type of pain, the International Association for the Study of Pain introduced the term neuropathic pain, defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system." While this definition has been useful in distinguishing some characteristics of neuropathic and nociceptive types of pain, it lacks defined boundaries. Since the sensitivity of the nociceptive system is modulated by its adequate activation (e.g., by central sensitization), it has been difficult to distinguish neuropathic dysfunction from physiologic neuroplasticity. We present a more precise definition developed by a group of experts from the neurologic and pain community: pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. This revised definition fits into the nosology of neurologic disorders. The reference to the somatosensory system was derived from a wide range of neuropathic pain conditions ranging from painful neuropathy to central poststroke pain. Because of the lack of a specific diagnostic tool for neuropathic pain, a grading system of definite, probable, and possible neuropathic pain is proposed. The grade possible can only be regarded as a working hypothesis, which does not exclude but does not diagnose neuropathic pain. The grades probable and definite require confirmatory evidence from a neurologic examination. This grading system is proposed for clinical and research purposes.read more
Citations
More filters
Journal ArticleDOI
Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis.
Nanna B. Finnerup,Nadine Attal,Simon Haroutounian,Ewan D McNicol,Ralf Baron,Robert H. Dworkin,Ian Gilron,Maija Haanpää,Per Hansson,Per Hansson,Troels S. Jensen,Troels S. Jensen,Peter R. Kamerman,Karen Lund,Andrew Moore,Srinivasa N. Raja,Andrew S.C. Rice,Andrew S.C. Rice,Michael C. Rowbotham,Emily S. Sena,Emily S. Sena,Philip J. Siddall,Philip J. Siddall,Blair H. Smith,Mark S. Wallace +24 more
TL;DR: The results support a revision of the NeuPSIG recommendations for the pharmacotherapy of neuropathic pain and allow a strong recommendation for use and proposal as first-line treatment in neuropathicPain for tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, pregabalin, and gabapentin.
Journal ArticleDOI
Pharmacologic management of neuropathic pain: evidence-based recommendations.
Robert H. Dworkin,Alec B. O'Connor,Miroslav Backonja,John T. Farrar,Nanna B. Finnerup,Troels S. Jensen,Eija Kalso,John D. Loeser,Christine Miaskowski,Turo Nurmikko,Russell K. Portenoy,Andrew S.C. Rice,Brett R. Stacey,Rolf-Detlef Treede,Dennis C. Turk,Mark S. Wallace +15 more
TL;DR: Patients with neuropathic pain are challenging to manage and evidence‐based clinical recommendations for pharmacologic management are needed, and medications should be individualized, considering side effects, potential beneficial or deleterious effects on comorbidities, and whether prompt onset of pain relief is necessary.
Journal ArticleDOI
Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments
Solomon Tesfaye,Andrew J.M. Boulton,Peter J. Dyck,Roy Freeman,Michael Horowitz,Péter Kempler,Giuseppe Lauria,Rayaz A. Malik,Vincenza Spallone,Aaron I. Vinik,Luciano Bernardi,Paul Valensi +11 more
TL;DR: A joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetes in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies as mentioned in this paper.
Journal ArticleDOI
A classification of chronic pain for ICD-11.
Rolf-Detlef Treede,Winfried Rief,Antonia Barke,Qasim Aziz,Michael I. Bennett,Rafael Benoliel,Milton Cohen,Stefan Evers,Nanna B. Finnerup,Michael B. First,Maria Adele Giamberardino,Stein Kaasa,Eva Kosek,Patricia Lavand'homme,Michael K. Nicholas,Serge Perrot,Joachim Scholz,Stephan A. Schug,Blair H. Smith,Peter Svensson,Peter Svensson,Johan W.S. Vlaeyen,Johan W.S. Vlaeyen,Shuu Jiun Wang +23 more
TL;DR: The IASP Task Force, which comprises pain experts from across the globe, has developed a new and pragmatic classification of chronic pain for the upcoming 11th revision of the International Classification of Diseases, termed “multiple parenting.”
Journal ArticleDOI
Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage
TL;DR: Treatment needs to move from merely suppressing symptoms to a disease-modifying strategy aimed at both preventing maladaptive plasticity and reducing intrinsic risk.
References
More filters
Journal ArticleDOI
Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis
W. Ian McDonald,A Compston,Gilles Edan,Donald E. Goodkin,Hans-Peter Hartung,Fred D. Lublin,Henry F. McFarland,Donald W. Paty,Chris H. Polman,Stephen C. Reingold,Magnhild Sandberg-Wollheim,William A. Sibley,Alan J. Thompson,Stanley van den Noort,Brian Y. Weinshenker,Jerry S. Wolinsky +15 more
TL;DR: The revised criteria facilitate the diagnosis of MS in patients with a variety of presentations, including “monosymptomatic” disease suggestive of MS, disease with a typical relapsing‐remitting course, and disease with insidious progression, without clear attacks and remissions.
Journal ArticleDOI
The International Classification of Headache Disorders
TL;DR: The ICHD identifies and categorizes more than a hundred different kinds of headache in a logical, hierarchal system and has provided explicit diagnostic criteria for all of the headache disorders listed.
Journal ArticleDOI
Persistent postsurgical pain: risk factors and prevention
TL;DR: Strategies for identification of patients at risk and for prevention and possible treatment of this important entity of chronic pain are outlined.
Journal ArticleDOI
Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4)
Didier Bouhassira,Nadine Attal,Haiel Alchaar,François Boureau,Bruno Brochet,Jean Bruxelle,G. Cunin,Jacques Fermanian,Patrick Ginies,Aurélie Grun-Overdyking,Hélène Jafari-Schluep,Michel Lanteri-Minet,Bernard Laurent,Gérard Mick,Alain Serrie,Dominique Valade,Eric Vicaut +16 more
TL;DR: The 10‐item questionnaire developed in the present study constitutes a new diagnostic instrument, which might be helpful both in clinical research and daily practice and found that a relatively small number of items are sufficient to discriminate neuropathic pain.