Dolor neuropathicus
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Dolor neuropathicus (ICD-10: M79.2) est notio gregis dolorum diversorum causis multiplicium[1]. Dolores neuropathici et nervis nociceptivis excitandis et stimulis telis detrimenta faciendis et etiam stimulo salvo oriuntur[2].
Epidemiologia[recensere | fontem recensere]
Circiter octo centesimas omnium hominum aliquando dolorem neuropathicum patiuntur[3].
Natura dolorum neuropathicorum[recensere | fontem recensere]
Syndroma principale est dolor. Post quamque laesionem nervi irritabiliores sive regeneratio eorundem non ad integrum fiunt, ita neurona facilius excitari (sensilem dans), aliquanto sive stimulo rapto, queant.
Symptomata positiva[recensere | fontem recensere]
- Allodynia — Dolores, de consuetudine non stimulis dolorosis vegetati
- Dysaesthesia — sensus et falsus et iniucundus, aut spontaneus aut incitatus
- Paraesthesia — sensus falsus, non necessarie iniucundus, aut spontaneus aut incitatus
- Hyperalgesia — Sensus auctus post stimulos dolorosos
Symptomata negativa[recensere | fontem recensere]
- Hypaesthesia — Sensus reductus stimuli
- Hypalgesia — Sensus reductus stimulorum dolorosorum
- Analgesia — Amissio sensuum stimulorum dolorosorum
Differentia[recensere | fontem recensere]
Differentia varietatem non parvam ostendit[4], per exemplum encephalomyelitis disseminata, dolor post apoplexiam cerebri, damnum medullae spinalis, neuropathia diabetica, neuralgia trigeminalis, neuralgia post-herpetica, dolor post amputationem, neuropathia compressione causa, et ceterae. Etiam in nonnullis tumoribus (syndroma paraneoplasticum) dolores tales neuropathici (per exemplum neuropathia/ganglionitis Denny-Brown[5]) observati sunt.
Therapia[recensere | fontem recensere]
Tractatio imprimis medicamentorum ope ad mali levationem spectat. Medicamenta (praeter neuralgiae trigeminalis), per exemplum, Amitriptylinum, Duloxetinum, Gabapentinum, Pregabalinum[6] ac neuralgiae trigeminalis Carbamazepinum praescribi possint (vid. etiam nex. ext.). In casibus gravibus etiam opioida respicere oporteant[7].
Notae[recensere | fontem recensere]
- ↑ Beniczky S., Tajti J., Tímea Varga E., Vécsei L. (2005). "Evidence-based pharmacological treatment of neuropathic pain syndromes". J Neural Transm (Vindobonae) 112 (6): 735-49
- ↑ Treede R. D., Jensen T. S., Campbell J. N., Cruccu G., Dostrovsky J. O., Griffin J. W., Hansson P., Hughes R., Nurmikko T., Serra J. (2008). "Neuropathic pain: redefinition and a grading system for clinical and research purposes". Neurology 70 (18): 1630-5.
- ↑ Torrance N., Smith B. H., Bennett M. I., Lee A. J. (2006). "The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey". Journal of Pain 7 (4): 281-9.
- ↑ NICE de differentiis doloris neuropathici
- ↑ Denny-Brown D. (1948). "Primary sensory neuropathy with muscular changes associated with carcinoma". J Neurol Neurosurg Psychiatry 11 (2): 73-87.
- ↑ Moore R. A., Straube S., Wiffen P. J., Derry S., McQuay H. J. (2009). "Pregabalin for acute and chronic pain in adults". Cochrane Database Syst Rev 8 (3): CD007076.
- ↑ Gaskell H., Moore R. A., Derry S., Stannard C. (2014). "Oxycodone for neuropathic pain and fibromyalgia in adults". Cochrane Database Syst Rev 23 (6): CD010692.
Nexus interni
Nexus externi[recensere | fontem recensere]
- National Institute for Health and Excellence (NICE) (2013 & 2018): Consilium tractationis dolorum neuropathicorum (Anglice)