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Pain. 2019 Jan;160(1):53-59. doi: 10.1097/j.pain.0000000000001365.

The IASP classification of chronic pain for ICD-11: chronic neuropathic pain.

Author information

1
Departments of Anesthesiology and.
2
Pharmacology, Columbia University Medical Center, New York, NY, United States.
3
Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark.
4
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
5
INSERM U 987, Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Boulogne Billancourt, France.
6
Université Versailles Saint Quentin en Yvelines, Versailles, France.
7
Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
8
Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
9
Academic Unit of Palliative Care, University of Leeds, Leeds, United Kingdom.
10
Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, United States.
11
St. Vincent's Clinical School, University of New South Wales, Sydney, Australia.
12
Department of Human Neuroscience, Sapienza University, Rome, Italy.
13
Department of Surgery and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
14
Division of Brain, Imaging and Behavior-Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
15
Department of Neurology, Krankenhaus Lindenbrunn, Coppenbrügge, Germany.
16
Faculty of Medicine, University of Münster, Münster, Germany.
17
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, United States.
18
Department of Medicine and Science of Aging, CeSI-MeT, G D'Annunzio University of Chieti, Chieti, Italy.
19
Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
20
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
21
European Palliative Care Research Centre (PRC), Oslo, Norway.
22
Department of Oncology, Oslo University Hospital, Oslo, Norway.
23
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
24
Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany.
25
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
26
Department of Anesthesiology and Acute Postoperative Pain Service, Saint Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
27
Pain Management Research Institute, Royal North Shore Hospital, University of Sydney, Sydney, Australia.
28
Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, United Kingdom.
29
INSERM U 987, Pain Clinic, Cochin Hospital, Paris Descartes University, Paris, France.
30
Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
31
Pain Research, Department of Surgery and Cancer, Imperial College, London, United Kingdom.
32
California Pacific Medical Center Research Institute, San Francisco, CA, United States.
33
Anaesthesiology and Pain Medicine, Medical School, University of Western Australia and Royal Perth Hospital, Perth, Australia.
34
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
35
Division of Population Health and Genomics, University of Dundee, Dundee, Scotland.
36
Section of Clinical Oral Physiology, School of Dentistry, Aarhus University, Aarhus, Denmark.
37
Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
38
Research Group Health Psychology, University of Leuven, Leuven, Belgium.
39
Experimental Health Psychology, Maastricht University, Maastricht, the Netherlands.
40
Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
41
Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
42
Department of Neurophysiology, CBTM, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.

Abstract

The upcoming 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organization (WHO) offers a unique opportunity to improve the representation of painful disorders. For this purpose, the International Association for the Study of Pain (IASP) has convened an interdisciplinary task force of pain specialists. Here, we present the case for a reclassification of nervous system lesions or diseases associated with persistent or recurrent pain for ≥3 months. The new classification lists the most common conditions of peripheral neuropathic pain: trigeminal neuralgia, peripheral nerve injury, painful polyneuropathy, postherpetic neuralgia, and painful radiculopathy. Conditions of central neuropathic pain include pain caused by spinal cord or brain injury, poststroke pain, and pain associated with multiple sclerosis. Diseases not explicitly mentioned in the classification are captured in residual categories of ICD-11. Conditions of chronic neuropathic pain are either insufficiently defined or missing in the current version of the ICD, despite their prevalence and clinical importance. We provide the short definitions of diagnostic entities for which we submitted more detailed content models to the WHO. Definitions and content models were established in collaboration with the Classification Committee of the IASP's Neuropathic Pain Special Interest Group (NeuPSIG). Up to 10% of the general population experience neuropathic pain. The majority of these patients do not receive satisfactory relief with existing treatments. A precise classification of chronic neuropathic pain in ICD-11 is necessary to document this public health need and the therapeutic challenges related to chronic neuropathic pain.

PMID:
30586071
PMCID:
PMC6310153
[Available on 2020-01-01]
DOI:
10.1097/j.pain.0000000000001365

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