Revised definition of neuropathic pain and its grading system: an open case series illustrating its use in clinical practice.
The definition of neuropathic pain has recently been revised by an expert committee of the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG) as "pain arising as direct consequence of a lesion or disease affecting the somatosensory system," and a grading system of "definite," "probable," and "possible" neuropathic pain has been introduced. This open case series of 5 outpatients (3 men, 2 women; mean age 48 +/- 12 years) demonstrates how the grading system can be applied, in combination with appropriate confirmatory testing, to diagnosis neuropathic conditions in clinical practice. The proposed grading system includes a dynamic algorithm that enhances the physician's ability to determine with a greater level of certainty whether a pain condition is neuropathic. Its clinical use should be further validated in prospective studies.
Department of Neurology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
Christian
C
Geber
Ulf
U
Baumgärtner
Rainer
R
Schwab
Harald
H
Müller
Peter
P
Stoeter
Marianne
M
Dieterich
Clemens
C
Sommer
Frank
F
Birklein
Rolf-Detlef
RD
Treede
D000328:Adult; D018437:Brown-Sequard Syndrome / Q000150:complications / Q000175:diagnosis; D017271:Craniomandibular Disorders / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D009471:Neuromyelitis Optica / Q000150:complications / Q000175:diagnosis; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D010808:Physical Examination; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000150:complications / Q000175:diagnosis; D014277:Trigeminal Neuralgia / Q000150:complications / Q000175:diagnosis; D020424:Ulnar Neuropathies / Q000150:complications / Q000175:diagnosis