Pristop k zdravljenju nevropatske bolečine : prikaz kliničnih primerov = Approach to the treatment of neuropathic pain : case reports
Pražnikar, Aleš
The International Association for Studying Pain (IASP) defines neuropathic pain as pain induced or caused by primary nervous system impairment or dysfunction. Neuropathic pain is defined as pain in ...an area with sensory disturbances attributable to an impaired part of the peripheral and/or central nervous system. The clinical presentation in an individual patient is the result of several various pathophysiological mechanisms, and the influence of an individual mechanism may vary even in patients with the same diagnosis and similar clinical complaints. Neuropathic pain significantly reduces quality of life of patients and their families, and co-morbidity is usually found (anxiety, depression, sleep disturbances, etc.). Due to the nature of chronic pain, management should inevitably be conducted by a team and should be based on the methods of physical medicine (TENS, kinesitherapy), clinical psychology (evaluation, cognitive-behavioural therapy), pharmacotherapy (tricyclic antidepressants, cell membrane stabilising agents such as antiepileptic drugs or lidocaine, opioids, etc.) and ivasive procedures and methods. This paper presents a few clinical cases of patients with neuropathic pain: a patient with painful symmetric distal polyneuropathy and diabetes, fifth facial nerve neuralgia, postherpetic neuralgia and central pain after stroke, as well as the principles of treatment based on our experiences and sources.
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