Dolor neuropathicus
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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].
Epidemiologia recensere
Circiter octo centesimas omnium hominum aliquando dolorem neuropathicum patiuntur[3].
Natura dolorum neuropathicorum recensere
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 recensere
- 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 recensere
- Hypaesthesia — Sensus reductus stimuli
- Hypalgesia — Sensus reductus stimulorum dolorosorum
- Analgesia — Amissio sensuum stimulorum dolorosorum
Differentia recensere
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 recensere
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 recensere
- ↑ 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 recensere
- National Institute for Health and Excellence (NICE) (2013 & 2018): Consilium tractationis dolorum neuropathicorum (Anglice)