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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].

EpidemiologiaRecensere

Circiter centesimae octo omnium hominum aliquando dolorem neuropathicum patiantur[3].

Natura dolorum neuropathicorumRecensere

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.

DifferentiaRecensere

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.

TherapiaRecensere

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].

NotaeRecensere

  1. Beniczky S., Tajti J., Tímea Varga E., Vécsei L. (2005). "Evidence-based pharmacological treatment of neuropathic pain syndromes". J Neural Transm (Vienna) 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". J 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 

Nexus interni

Nexus externiRecensere

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