title: Recommendations for neuropathic pain treatment.
abstract: Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical"). The diagnosis of neuropathic pain is based primarily on the history and physical examination finding. Although monotherapy is the ideal approach, rational polypharmacy is often pragmatically used. Several classes of drugs are moderately effective, but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.
authors.affiliation: University Department of Neurology, Sestre milosrdnice University Hospital, Zagreb, Croatia.
authors.forename: Vida
authors.initials: V
authors.lastname: Demarin
authors.forename: Vanja
authors.initials: V
authors.lastname: Basić-Kes
authors.forename: Iris
authors.initials: I
authors.lastname: Zavoreo
authors.forename: Marijana
authors.initials: M
authors.lastname: Bosnar-Puretić
authors.forename: Kresimir
authors.initials: K
authors.lastname: Rotim
authors.forename: Velimir
authors.initials: V
authors.lastname: Lupret
authors.forename: Mladen
authors.initials: M
authors.lastname: Perić
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Ivanec
authors.forename: Lidija
authors.initials: L
authors.lastname: Fumić
authors.forename: Ivo
authors.initials: I
authors.lastname: Lusić
authors.forename: Anka
authors.initials: A
authors.lastname: Aleksić-Shihabis
authors.forename: Biserka
authors.initials: B
authors.lastname: Kovac
authors.forename: Mira
authors.initials: M
authors.lastname: Ivanković
authors.forename: Helena
authors.initials: H
authors.lastname: Skobić
authors.forename: Boris
authors.initials: B
authors.lastname: Maslov
authors.forename: Natan
authors.initials: N
authors.lastname: Bornstein
authors.forename: Kurt
authors.initials: K
authors.lastname: Niederkorn
authors.forename: Osman
authors.initials: O
authors.lastname: Sinanović
authors.forename: Tanja
authors.initials: T
authors.lastname: Rundek
mesh_terms: D015670:Acupuncture Therapy; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation