Neuropathic pain

被引:0
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作者
Luana Colloca
Taylor Ludman
Didier Bouhassira
Ralf Baron
Anthony H. Dickenson
David Yarnitsky
Roy Freeman
Andrea Truini
Nadine Attal
Nanna B. Finnerup
Christopher Eccleston
Eija Kalso
David L. Bennett
Robert H. Dworkin
Srinivasa N. Raja
机构
[1] University of Maryland,Department of Pain and Translational Symptom Science, School of Nursing and Department of Anesthesiology School of Medicine
[2] INSERM,Department of Neurology, Division of Neurological Pain Research and Therapy
[3] Unit 987,Department of Neuroscience
[4] Ambroise Paré Hospital,Department of Neurology
[5] UVSQ,Department of Neurology
[6] Klinik fur Neurologie Christian-Albrechts-Universität Kiel,Department of Neurology and Psychiatry
[7] Physiology and Pharmacology,Department of Clinical Medicine — The Danish Pain Research Center
[8] University College London,Department of Clinical and Health Psychology
[9] Rambam Health Care Campus,Division of Pain Medicine, Department of Anesthesiology
[10] Technion Faculty of Medicine,Nuffield Department of Clinical Neuroscience
[11] Beth Israel Deaconess Medical Center,Department of Anesthesiology
[12] Harvard Medical School,Department of Anesthesiology and Critical Care Medicine
[13] Sapienza University,undefined
[14] Pain Evaluation and Treatment Centre of Hôpital Ambroise Paré,undefined
[15] Aarhus University,undefined
[16] Centre for Pain Research,undefined
[17] University of Bath,undefined
[18] Ghent University,undefined
[19] Intensive Care and Pain Medicine,undefined
[20] University of Helsinki and Helsinki University Hospital,undefined
[21] University of Oxford,undefined
[22] School of Medicine and Dentistry,undefined
[23] University of Rochester,undefined
[24] Johns Hopkins University School of Medicine,undefined
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摘要
Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7–10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.
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