[Neuropathic pains: background, new tools, new drugs].
Neuropathic pains are frequent with better understood underlying mechanisms. The introduction of a new questionnaire, named DN4 (neuropathic pain 4 questions) will certainly be useful to prevent persistent pain. Here we describe current approaches to diagnosis and pharmacological treatments. Antidepressants, anticonvulsants, opioids and topical local anesthetics are part of the evidence-based approach, alone or in combination. The choice of the drug is based on the type of pain, a predominantly diffused pain being firstly treated with tricyclic antidepressants, whereas paroxysmal and localized pain being more adequately treated with anti-epileptics. Pregabaline, the newest anticonvulsant launched in the Swiss market, appears to be effective as a treatment of painful diabetic polyneuropathy and postherpetic neuralgia.
Kuntzer
Thierry
T
Unité nerf-muscle, Service de neurologie, CHUV, 1011 Lausanne. thierry.kuntzer@chuv.ch
Decosterd
Isabelle
I
D000777:Anesthetics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use; D009422:Nervous System Diseases / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*
D000777:Anesthetics; D000927:Anticonvulsants; D000928:Antidepressive Agents; D009294:Narcotics