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Arch Neurol. 2003 Nov;60(11):1520.
Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations.
Dworkin RH,
Backonja M,
Rowbotham MC,
Allen RR,
Argoff CR,
Bennett GJ,
Bushnell MC,
Farrar JT,
Galer BS,
Haythornthwaite JA,
Hewitt DJ,
Loeser JD,
Max MB,
Saltarelli M,
Schmader KE,
Stein C,
Thompson D,
Turk DC,
Wallace MS,
Watkins LR,
Weinstein SM.
Department of Anesthesiology, University of Rochester School of Meedicine and Dentistry, Rochester, NY 14642. robert_dworkin@urmc.rochester.edu
Chronic neuropathic pain, caused by lesions in the peripheral or central nervous system, comes in many forms. We describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiologic mechanisms. Randomized controlled clinical trials of gabapentin, the 5% lidocaine patch, opioid analgesics, tramadol hydrochloride, and tricyclic antidepressants provide an evidence-based approach to the treatment of neuropathic pain, and specific recommendations are presented for use of these medications. Continued progress in basic and clinical research on the pathophysiologic mechanisms of neuropathic pain may make it possible to predict effective treatments for individual patients by application of a pain mechanism-based approach.
PMID: 14623723 [PubMed - indexed for MEDLINE]