Neuropathic pain

[Tanya Shivari]

Neuropathic pain results from damage to or dysfunction of the peripheral or central nervous system, rather than stimulation of pain receptors. Diagnosis is suggested by pain out of proportion to tissue injury, dysesthesia (eg, burning, tingling), and signs of nerve injury detected during neurologic examination. Although neuropathic pain responds to opioids, treatment is often with adjuvant drugs (eg, antidepressants, antiseizure drugs, baclofen , topical drugs).
(See also Overview of Pain.)
Pain can develop after injury to any level of the nervous system, peripheral or central; the sympathetic nervous system may be involved (causing sympathetically maintained pain). Specific syndromes include

Postherpetic neuralgia
Root avulsions
Painful traumatic mononeuropathy
Painful polyneuropathy (including neuropathy due to diabetes or chemotherapy)
Central pain syndromes (potentially caused by virtually any lesion at any level of the nervous system)
Postsurgical pain syndromes (eg, postmastectomy syndrome, postthoracotomy syndrome, phantom limb pain)
Complex regional pain syndrome (reflex sympathetic dystrophy and causalgia)