Dolor neuropathicus

Dolor neuropathicus (ICD-10: M79.2) est notio gregis dolorum diversorum causis multiplicium^[1]. Dolores neuropathici et nervis nociceptivis excitandis et stimulis telis detrimenta faciendis et etiam stimulo salvo oriuntur^[2].

Cave: notitiae huius paginae nec praescriptiones nec consilia medica sunt.

Epidemiologia

Circiter octo centesimas omnium hominum aliquando dolorem neuropathicum patiuntur^[3].

Natura dolorum neuropathicorum

Syndroma principale est dolor. Post quamque laesionem nervi irritabiliores sive regeneratio eorundem non ad integrum fiunt, ita neurona facilius excitari (sensilem dans), aliquanto sive stimulo rapto, queant.

Symptomata positiva

Allodynia — Dolores, de consuetudine non stimulis dolorosis vegetati
Dysaesthesia — sensus et falsus et iniucundus, aut spontaneus aut incitatus
Paraesthesia — sensus falsus, non necessarie iniucundus, aut spontaneus aut incitatus
Hyperalgesia — Sensus auctus post stimulos dolorosos

Symptomata negativa

Hypaesthesia — Sensus reductus stimuli
Hypalgesia — Sensus reductus stimulorum dolorosorum
Analgesia — Amissio sensuum stimulorum dolorosorum

Differentia

Differentia varietatem non parvam ostendit^[4], per exemplum encephalomyelitis disseminata, dolor post apoplexiam cerebri, damnum medullae spinalis, neuropathia diabetica, neuralgia trigeminalis, neuralgia post-herpetica, dolor post amputationem, neuropathia compressione causa, et ceterae. Etiam in nonnullis tumoribus (syndroma paraneoplasticum) dolores tales neuropathici (per exemplum neuropathia/ganglionitis Denny-Brown^[5]) observati sunt.

Therapia

Tractatio imprimis medicamentorum ope ad mali levationem spectat. Medicamenta (praeter neuralgiae trigeminalis), per exemplum, Amitriptylinum, Duloxetinum, Gabapentinum, Pregabalinum^[6] ac neuralgiae trigeminalis Carbamazepinum praescribi possint (vid. etiam nex. ext.). In casibus gravibus etiam opioida respicere oporteant^[7].

Notae

↑ Beniczky S., Tajti J., Tímea Varga E., Vécsei L. (2005). "Evidence-based pharmacological treatment of neuropathic pain syndromes". J Neural Transm (Vindobonae) 112 (6): 735-49
↑ Treede R. D., Jensen T. S., Campbell J. N., Cruccu G., Dostrovsky J. O., Griffin J. W., Hansson P., Hughes R., Nurmikko T., Serra J. (2008). "Neuropathic pain: redefinition and a grading system for clinical and research purposes". Neurology 70 (18): 1630-5 .
↑ Torrance N., Smith B. H., Bennett M. I., Lee A. J. (2006). "The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey". Journal of Pain 7 (4): 281-9 .
↑ NICE de differentiis doloris neuropathici
↑ Denny-Brown D. (1948). "Primary sensory neuropathy with muscular changes associated with carcinoma". J Neurol Neurosurg Psychiatry 11 (2): 73-87 .
↑ Moore R. A., Straube S., Wiffen P. J., Derry S., McQuay H. J. (2009). "Pregabalin for acute and chronic pain in adults". Cochrane Database Syst Rev 8 (3): CD007076 .
↑ Gaskell H., Moore R. A., Derry S., Stannard C. (2014). "Oxycodone for neuropathic pain and fibromyalgia in adults". Cochrane Database Syst Rev 23 (6): CD010692 .

Nexus interni

Nexus externi

National Institute for Health and Excellence (NICE) (2013 & 2018): Consilium tractationis dolorum neuropathicorum (Anglice)

[1] Beniczky S., Tajti J., Tímea Varga E., Vécsei L. (2005). "Evidence-based pharmacological treatment of neuropathic pain syndromes". J Neural Transm (Vindobonae) 112 (6): 735-49

[2] Treede R. D., Jensen T. S., Campbell J. N., Cruccu G., Dostrovsky J. O., Griffin J. W., Hansson P., Hughes R., Nurmikko T., Serra J. (2008). "Neuropathic pain: redefinition and a grading system for clinical and research purposes". Neurology 70 (18): 1630-5 .

[3] Torrance N., Smith B. H., Bennett M. I., Lee A. J. (2006). "The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey". Journal of Pain 7 (4): 281-9 .

[4] NICE de differentiis doloris neuropathici

[5] Denny-Brown D. (1948). "Primary sensory neuropathy with muscular changes associated with carcinoma". J Neurol Neurosurg Psychiatry 11 (2): 73-87 .

[6] Moore R. A., Straube S., Wiffen P. J., Derry S., McQuay H. J. (2009). "Pregabalin for acute and chronic pain in adults". Cochrane Database Syst Rev 8 (3): CD007076 .

[7] Gaskell H., Moore R. A., Derry S., Stannard C. (2014). "Oxycodone for neuropathic pain and fibromyalgia in adults". Cochrane Database Syst Rev 23 (6): CD010692 .

[1]

[2]

[3]

[4]

[5]

[6]

[7]