Clinical presentation and diagnosis of neuropathic pain

Detalhes bibliográficos
Autor(a) principal: Barros, Guilherme Antônio Moreira De
Data de Publicação: 2016
Outros Autores: Colhado, Orlando Carlos Gomes, Giublin, Mário Luiz
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://dx.doi.org/10.5935/1806-0013.20160040
http://hdl.handle.net/11449/157811
Resumo: ABSTRACTBACKGROUND AND OBJECTIVES: Neuropathic pain is reason for distress and incapacity of several patients, being that symptoms, mechanisms and management distinguish it from nociceptive pain. This study aimed at discussing the clinical presentation and diagnosis of neuropathic pain.CONTENTS: Neuropathic pain is manifested by several symptoms, being continuous burning pain, shock sensation and mechanical alodynia the most common ones. Neurophysiologic studies and skin biopsy suggest that burning pain is reflex of spontaneous activity of afferent nociceptive fibers, while shock sensation is originated from high frequency ectopic stimuli, generated in demyelinated Aβ fibers. Clinical exam, made up of history and elementary physical neurological evaluation, is critical for the adequate diagnosis of the type of pain, as well as more detailed exams, such as quantitative sensory tests and confocal optic microscopy, may bring further subsidies to the diagnosis of the type of pain.CONCLUSION: Clinical presentation of neuropathic pain has characteristics which help the accurate diagnosis of the syndrome or disease responsible for the onset of the complaint. Adequate clinical evaluation, including directed physical neurologic exam, sensory quantitative tests and cornea confocal microscopy cooperate for a more accurate diagnosis.
id UNSP_2aeb4f73bf12a7865beb8b11a23628ab
oai_identifier_str oai:repositorio.unesp.br:11449/157811
network_acronym_str UNSP
network_name_str Repositório Institucional da UNESP
repository_id_str 2946
spelling Clinical presentation and diagnosis of neuropathic painQuadro clínico e diagnóstico da dor neuropáticaClinical presentationDiagnosisNeuropathic painDiagnósticoDor neuropáticaQuadro clínicoABSTRACTBACKGROUND AND OBJECTIVES: Neuropathic pain is reason for distress and incapacity of several patients, being that symptoms, mechanisms and management distinguish it from nociceptive pain. This study aimed at discussing the clinical presentation and diagnosis of neuropathic pain.CONTENTS: Neuropathic pain is manifested by several symptoms, being continuous burning pain, shock sensation and mechanical alodynia the most common ones. Neurophysiologic studies and skin biopsy suggest that burning pain is reflex of spontaneous activity of afferent nociceptive fibers, while shock sensation is originated from high frequency ectopic stimuli, generated in demyelinated Aβ fibers. Clinical exam, made up of history and elementary physical neurological evaluation, is critical for the adequate diagnosis of the type of pain, as well as more detailed exams, such as quantitative sensory tests and confocal optic microscopy, may bring further subsidies to the diagnosis of the type of pain.CONCLUSION: Clinical presentation of neuropathic pain has characteristics which help the accurate diagnosis of the syndrome or disease responsible for the onset of the complaint. Adequate clinical evaluation, including directed physical neurologic exam, sensory quantitative tests and cornea confocal microscopy cooperate for a more accurate diagnosis.RESUMOJUSTIFICATIVA E OBJETIVOS: A dor neuropática é motivo de sofrimento e incapacidade para muitos pacientes, sendo que os seus sintomas, mecanismos e tratamento a distinguem da dor nociceptiva. O objetivo deste estudo foi discutir o quadro clínico e o diagnóstico da dor neuropática.CONTEÚDO: A dor neuropática se manifesta por meio de vários sintomas, sendo os mais comuns a dor contínua em queimação, sensação de choque e alodínea mecânica. Estudos neurofisiológicos e biópsia de pele sugerem que dor em queimação é reflexo de atividade espontânea em fibras nociceptivas aferentes, enquanto a sensação de choque presumidamente é originada de estímulos ectópicos de alta frequência, gerados em fibras Aβ desmielinizadas. O exame clínico, constituído por anamnese e exame físico neurológico elementar é de primordial importância para o adequado diagnóstico do tipo de dor. Assim como exames mais minuciosos, como os testes sensoriais quantitativos e a microscopia ótica confocal, podem trazer subsídios mais aprofundados ao diagnóstico do tipo de dor.CONCLUSÃO: O quadro clínico da dor neuropática possui características que auxiliam no correto diagnóstico da síndrome ou doença que seja a responsável pelo aparecimento da queixa. Adequado exame clínico, incluindo a realização de exame físico neurológico dirigido, juntamente com os testes quantitativos sensoriais e com o exame de microscopia confocal de córnea colaboram para a execução mais precisa do diagnóstico.Universidade Estadual Paulista Faculdade de Medicina de BotucatuUniversidade Estadual de Maringá Faculdade de MedicinaUniversidade Federal do Paraná Clínica de DorUniversidade Estadual Paulista Faculdade de Medicina de BotucatuSociedade Brasileira para o Estudo da DorUniversidade Estadual Paulista (Unesp)Universidade Estadual de Maringá Faculdade de MedicinaUniversidade Federal do Paraná Clínica de DorBarros, Guilherme Antônio Moreira DeColhado, Orlando Carlos GomesGiublin, Mário Luiz2018-11-12T17:27:03Z2018-11-12T17:27:03Z2016info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article15-19application/pdfhttp://dx.doi.org/10.5935/1806-0013.20160040Revista Dor. Sociedade Brasileira para o Estudo da Dor, v. 17, p. 15-19, 2016.1806-0013http://hdl.handle.net/11449/15781110.5935/1806-0013.20160040S1806-00132016000500015S1806-00132016000500015.pdfSciELOreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengRevista Dorinfo:eu-repo/semantics/openAccess2023-10-11T06:03:53Zoai:repositorio.unesp.br:11449/157811Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T14:35:21.765395Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Clinical presentation and diagnosis of neuropathic pain
Quadro clínico e diagnóstico da dor neuropática
title Clinical presentation and diagnosis of neuropathic pain
spellingShingle Clinical presentation and diagnosis of neuropathic pain
Barros, Guilherme Antônio Moreira De
Clinical presentation
Diagnosis
Neuropathic pain
Diagnóstico
Dor neuropática
Quadro clínico
title_short Clinical presentation and diagnosis of neuropathic pain
title_full Clinical presentation and diagnosis of neuropathic pain
title_fullStr Clinical presentation and diagnosis of neuropathic pain
title_full_unstemmed Clinical presentation and diagnosis of neuropathic pain
title_sort Clinical presentation and diagnosis of neuropathic pain
author Barros, Guilherme Antônio Moreira De
author_facet Barros, Guilherme Antônio Moreira De
Colhado, Orlando Carlos Gomes
Giublin, Mário Luiz
author_role author
author2 Colhado, Orlando Carlos Gomes
Giublin, Mário Luiz
author2_role author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (Unesp)
Universidade Estadual de Maringá Faculdade de Medicina
Universidade Federal do Paraná Clínica de Dor
dc.contributor.author.fl_str_mv Barros, Guilherme Antônio Moreira De
Colhado, Orlando Carlos Gomes
Giublin, Mário Luiz
dc.subject.por.fl_str_mv Clinical presentation
Diagnosis
Neuropathic pain
Diagnóstico
Dor neuropática
Quadro clínico
topic Clinical presentation
Diagnosis
Neuropathic pain
Diagnóstico
Dor neuropática
Quadro clínico
description ABSTRACTBACKGROUND AND OBJECTIVES: Neuropathic pain is reason for distress and incapacity of several patients, being that symptoms, mechanisms and management distinguish it from nociceptive pain. This study aimed at discussing the clinical presentation and diagnosis of neuropathic pain.CONTENTS: Neuropathic pain is manifested by several symptoms, being continuous burning pain, shock sensation and mechanical alodynia the most common ones. Neurophysiologic studies and skin biopsy suggest that burning pain is reflex of spontaneous activity of afferent nociceptive fibers, while shock sensation is originated from high frequency ectopic stimuli, generated in demyelinated Aβ fibers. Clinical exam, made up of history and elementary physical neurological evaluation, is critical for the adequate diagnosis of the type of pain, as well as more detailed exams, such as quantitative sensory tests and confocal optic microscopy, may bring further subsidies to the diagnosis of the type of pain.CONCLUSION: Clinical presentation of neuropathic pain has characteristics which help the accurate diagnosis of the syndrome or disease responsible for the onset of the complaint. Adequate clinical evaluation, including directed physical neurologic exam, sensory quantitative tests and cornea confocal microscopy cooperate for a more accurate diagnosis.
publishDate 2016
dc.date.none.fl_str_mv 2016
2018-11-12T17:27:03Z
2018-11-12T17:27:03Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.5935/1806-0013.20160040
Revista Dor. Sociedade Brasileira para o Estudo da Dor, v. 17, p. 15-19, 2016.
1806-0013
http://hdl.handle.net/11449/157811
10.5935/1806-0013.20160040
S1806-00132016000500015
S1806-00132016000500015.pdf
url http://dx.doi.org/10.5935/1806-0013.20160040
http://hdl.handle.net/11449/157811
identifier_str_mv Revista Dor. Sociedade Brasileira para o Estudo da Dor, v. 17, p. 15-19, 2016.
1806-0013
10.5935/1806-0013.20160040
S1806-00132016000500015
S1806-00132016000500015.pdf
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Revista Dor
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 15-19
application/pdf
dc.publisher.none.fl_str_mv Sociedade Brasileira para o Estudo da Dor
publisher.none.fl_str_mv Sociedade Brasileira para o Estudo da Dor
dc.source.none.fl_str_mv SciELO
reponame:Repositório Institucional da UNESP
instname:Universidade Estadual Paulista (UNESP)
instacron:UNESP
instname_str Universidade Estadual Paulista (UNESP)
instacron_str UNESP
institution UNESP
reponame_str Repositório Institucional da UNESP
collection Repositório Institucional da UNESP
repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
repository.mail.fl_str_mv
_version_ 1808128384302055424