[Physiopathology of neuropathic pain syndromes].
This article reviews the peripheral and central mechanisms of neuropathic pain. The main mechanisms involved in neuropathic pain are: (1) ectopic activities, (2) ephapses, (3) sensitization of nociceptors. Central morphological alterations could also be involved: (1) medullar neuronal reorganization, (2) hyperexcitability of central nervous system nociceptive neurones. The relative resistance of these neuropathic pains to opioid drugs could be related to a decrease in the number of opioid receptors to an amino acid mediator related spinal neurons hyperexitability and to an increase in non opioid peptides such as cholecystokinin.
Lantéri-Minet
M
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Département d'Evaluation et Traitement de la Douleur, CHU de Nice, Hôpital Pasteur, France.
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000818:Animals; D001921:Brain / Q000503:physiopathology; D002493:Central Nervous System Diseases / Q000503:physiopathology*; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy / Q000503:physiopathology*; D009474:Neurons / Q000502:physiology; D009619:Nociceptors / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*; D013577:Syndrome
D000701:Analgesics, Opioid