title: Quantitative sensory testing and mapping: a review of nonautomated quantitative methods for examination of the patient with neuropathic pain.
abstract: OBJECTIVE
  Despite a growing interest in neuropathic pain, neurologists and pain specialists do not have a standard, validated, office examination for the evaluation of neuropathic pain signs to complement the neurologic, musculoskeletal, and general physical examinations. An office neuropathic pain examination focused on quantifying sensory features of neuropathic pain, ranging from deficits to allodynia and hyperalgesia, and evoked by a physiologically representative array of stimuli, will be an essential tool to monitor treatment effectiveness and for clinical investigation into the mechanisms and management of neuropathic pain. Such an examination should include mapping of areas of stimulus-evoked neuropathic pain and standardized, reproducible quantitative sensory testing (QST) of tactile, punctuate, pressure, and thermal modalities.
  
  
  METHODS
  We review quantitative sensory testing methodology in general and specific tests for the evaluation of neuropathic pain phenomena.
  
  
  RESULTS
  Numerous quantitative sensory testing techniques for dynamic mechanical, pressure, vibration, and thermal sensory testing and mapping have been described. We propose a comprehensive neuropathic pain evaluation protocol that is based upon these available techniques.
  
  
  CONCLUSIONS
  A comprehensive neuropathic pain evaluation protocol is essential for further advancement of clinical research in neuropathic pain. A protocol that uses tools readily available in clinical practice, when established and validated, can be used widely and thus accelerate data collection for clinical research and increase clinical awareness of the features of neuropathic pain.
authors.affiliation: University of Minnesota, 425 Delaware street SE, MMC 295, Minneapolis, MN, USA. walkx001@umn.edu
authors.forename: David
authors.initials: D
authors.lastname: Walk
authors.forename: Nalini
authors.initials: N
authors.lastname: Sehgal
authors.forename: Tobias
authors.initials: T
authors.lastname: Moeller-Bertram
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edwards
authors.forename: Ajay
authors.initials: A
authors.lastname: Wasan
authors.forename: Mark
authors.initials: M
authors.lastname: Wallace
authors.forename: Gordon
authors.initials: G
authors.lastname: Irving
authors.forename: Charles
authors.initials: C
authors.lastname: Argoff
authors.forename: Misha-Miroslav
authors.initials: MM
authors.lastname: Backonja
mesh_terms: D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis; D009437:Neuralgia / Q000175:diagnosis* / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology*; D010808:Physical Examination / Q000379:methods; D010812:Physical Stimulation / Q000379:methods; D011601:Psychophysics