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NeuPSIG guidelines on neuropathic pain assessment
Maija Haanpää1, Nadine Attal, Miroslav Backonja
1Rehabilitation ORTON, Helsinki, Finland Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland INSERM U-987, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France Université Versailles Saint-Quentin, France Department of Neurology, University of Wisconsin, Madison, WI, USA Division of Neurological Pain Research and Therapy, Department of Neurology, Universitatsklinikum Schleswig-Holstein, Kiel, Germany Institute of Health Research, Lancaster University, Lancaster University, Lancaster, UK Department of Neurology, La Sapienza University, Rome, Italy Pain Center, Department of Anesthesiology and Intensive Care, Clinical Pain Research, Karolinska University Hospital/Institutet, Stockholm, Sweden Johns Hopkins University, Baltimore, MD, USA Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK Danish Pain Research Center and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark Korso-Koivukylä Health Centre, Vantaa, Finland Network of Academic Health Centres, Departments of General Practice and Primary Healthcare, Institute of Clinical Medicine and Department of National Public Health, University of Helsinki, Helsinki, Finland Pain Research Institute, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK Department of Anaesthetics, Pain Medicine and Intensive Care, Imperial College London, London, UK Department of Neurology, QCSF Pain Clinic Research Center, University of California, San Francisco, CA, USA Department of Neurology, MC Mutual & Neuroscience Technologies, Barcelona Science Park, Barcelona, Spain Department of Neurology, University of Würzburg, Germany Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK Center for Biomedicine and Medical Technology Mannheim, Heidelberg University, Mannheim, Germany.
Updated guidelines for neuropathic pain assessment recommend screening questionnaires and clinical exams for diagnosis. Quantitative sensory testing and skin biopsy aid in specific cases, with standardized scales for measuring pain intensity and treatment effects.
Area of Science:
- Neurology
- Pain Medicine
Background:
- Neuropathic pain, stemming from somatosensory system damage, requires updated assessment guidelines.
- Previous guidelines were published in 2004, necessitating a revision based on advancements in diagnostic tools and understanding.
Purpose of the Study:
- To revise and update guidelines for the assessment of patients experiencing neuropathic pain.
- To provide recommendations on diagnostic tools and outcome measures for neuropathic pain.
Main Methods:
- Review and revision of existing 2004 guidelines for neuropathic pain assessment.
- Inclusion of updated diagnostic techniques such as quantitative sensory testing, trigeminal reflexes, laser-evoked potentials, and skin biopsy.
- Emphasis on validated scales for pain intensity and treatment effect measurement.
Main Results:
- Screening questionnaires can identify potential neuropathic pain patients, but require further validation for epidemiology.
- Clinical examination and sensory testing are foundational for diagnosis; quantitative sensory testing and skin biopsy are recommended for specific conditions like small fiber neuropathy.
- Laser-evoked potentials and trigeminal reflexes offer insights into specific nerve fiber pathway function.
Conclusions:
- Revised guidelines emphasize a multi-modal approach to neuropathic pain assessment, integrating clinical evaluation with advanced testing.
- Standardized outcome measures, including pain scales and assessments of function and quality of life, are crucial for clinical practice and research.
- Future trials should incorporate comprehensive outcome measures for robust evaluation of treatment efficacy.
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