Understanding Neuropathic Pain

These flashcards cover key concepts regarding neuropathic pain, its distinctions, treatments, and underlying pathophysiological mechanisms.

What is neuropathic pain defined as?

Pain produced by a lesion in the somatosensory nervous system.

What are the two classical divisions of neuropathic pain?

Peripheral and Central.

List some conditions under peripheral neuropathic pain.

Diabetic polyneuropathy, chemotherapy-induced neuropathic pain, radicular pain, post-surgical neuropathic pain.

Name two conditions classified as central neuropathic pain.

Post-stroke neuropathic pain and trigeminal neuralgia.

What tools are available to identify neuropathic pain characteristics?

DN4 test and LANSS.

Why is a physical examination important in the evaluation of neuropathic pain?

To distinguish between musculoskeletal pain symptoms that can be confused with neuropathic pain.

What are considered 'positive' signs in neuropathic pain assessment?

Hyperalgesia.

What are considered 'negative' signs in neuropathic pain assessment?

Hypoesthesia.

What constitutes the first-line treatment for non-oncological neuropathic pain?

Monotherapy with gabapentinoids, SSRIs, or TCAs.

What is the second-line treatment for neuropathic pain and why is tramadol included?

Use of tramadol due to its weak opioid and serotonin reuptake inhibitor properties.

Identify a third-line treatment for neuropathic pain.

NMDA receptor antagonists or anticonvulsants.

What is the role of microglia and astrocytes in neuropathic pain?

They perpetuate the pain environment by releasing pro-inflammatory cytokines.

What is diabetic neuropathy and how is it characterized?

A lesion of the somatosensory system in a diabetic patient, characterized by symmetrical, ascending pain.

What defines postherpetic neuralgia?

Persistent sensory symptoms lasting more than 90 days after herpes zoster resolution, limited to specific dermatome(s).

What is radiculopathy and its main cause?

Lesion of a nerve root due to compression, inflammation, or ischemia, most commonly due to a herniated disc.