El dolor neuropático de tipo dolor central es un dolor por desaferenciación secundario a una lesión del sistema nervioso central: cerebro, tronco cerebral y. Durante muchos años, los fármacos antidepresivos se han utilizado para controlar el dolor neuropático y suelen ser el tratamiento de primera elección. manejo farmacológico del dolor neuropático. Pharmacological management of neuropathic Pain. Sandra Flórez MD*, Marta León MD**, Marcela Torres MSc.

Author: Guk Kagagami
Country: Egypt
Language: English (Spanish)
Genre: Automotive
Published (Last): 9 January 2015
Pages: 185
PDF File Size: 2.57 Mb
ePub File Size: 6.19 Mb
ISBN: 733-8-68392-810-9
Downloads: 40092
Price: Free* [*Free Regsitration Required]
Uploader: Vonris

Recommendations for the treatment of neuropathic pain. Camba c neuropatco, A. The introduction and development of new products with demonstrated efficacy in neuropathic pain has generated a clear need for an evidence based algorithm to treat the different types of neuropathic pain. Dolo present article aims to provide recommendations on the treatment of neuropathic pain supported by the scientific evidence and agreed on by consensus by a multidisciplinary group of experts in methodology and pain management.

The evidence was obtained from meta-analyses including the greatest amount of information available for each type of neuropathic pain. The literature search was performed by 5 reviewers, who focussed individually on the distinct forms of presentation of neuropathic pain. Meta-analyses and randomized, controlled clinical trials were selected.

Finally, retrieved articles were evaluated and clinical recommendations for the treatment of neuropathic pain were designed by the pain specialists. For some types of neuropathic pain, there is insufficient information. In these types of pain, recommendations based on scientific publications without evidence were included to provide the greatest possible amount of information on their treatment. Studies of safety and efficacy in postherpetic neuralgia PHNpainful diabetic neuropathy PDNand trigeminal neuralgia TN were reviewed as paradigms of peripheral neuropathic pain.

The scarce available information on central neuropathic pain CNP and sympathetic pain SP was also gathered. Based on the results obtained with this literature review and the evidence extracted, a decision algorithm was designed with the drugs currently available in the Spanish pharmacopeia for PHN and PDN, and separate decision algorithms were designed for TN and finally for CNP and SP.

These recommendations take into account the treatments that should be used initially – first line treatments – and subsequently the alternatives are outlined in order of preference, based on daily clinical practice according to the consensus of the pain specialists.

Peripheral neuropathic pain; Central neuropathic pain; Diabetic neuropathy; Postherpetic neuralgia; Trigeminal neuralgia; Central pain; Therapeutic algorithm; Meta-analysis. Es por ello que hay una clara necesidad de tener un algoritmo basado en la evidencia para tratar las diferentes condiciones del DN. Estudios de eficacia y seguridad. El dolor en la NDD se percibe como el resultado de la suma de 2 percepciones: La NT se puede dividir a su vez en: La NT presenta una incidencia anual de 4,5 por cada La NT se puede dividir a su vez, en: La tabla 7 muestra los resultados de los estudios seleccionados.


La oxcarbacepina tiene un menor nivel de evidencia que la carbamacepina.

There was a problem providing the content you requested

El baclofen y la lamotrigina tienen un nivel de evidencia C. Para ello, es conveniente que estos pacientes sean derivados a centros especializados en este tipo de tratamiento unidades de tratamiento del dolor. Merskey H, Bogduk N. Classification of Chronic Pain.

Clarfying definition of neuropathic pain. Algorithm for neuropathic pain treatment: EFNS guidelines on pharmacological treatment of neuropathic pain.

Pharmacological management of chronic neuropathic pain. Pharmacological management of chronic pain neuropathic pain – Consensus statement and guidelines from the Canadian Pain Society.

Pain Research Management; ; Pharmacologic management of neuropathic pain: Clinical features and pathophysiologic mechanisms of postherpetic neuralgia.

Prevalence of postherpetic neuralgia after a first episode of herpes zoster: Brain dynamics neuropativo perception of tactile allodynia touch-induced pain in postherpetic neuralgia. Epidemiology of herpes zoster in children and adolescents: Psychosocial risk factors for postherpetic neuralgia: The lifetime occurrence of herpes zoster and prevalence of post-herpetic neuralgia: Pain and its persistence in herpes zoster.

The cost of treatment for post-herpetic neuralgia in the UK. Pain and allodynia in postherpetic neuralgia: The density of remaining nerve endings in human skin with and without postherpetic neuralgia after shingles.

Bonezzi C, Demartini L. Treatment options in postherpetic neuralgia. Acta Neurol Scand Suppl. Analgesic therapy in postherpetic neuralgia: A quantitative systematic review. Tricyclic antidepressants, QT interval prolongation, and torsade de pointes.


Characterization of primary sensory neurons mediating static and dynamic allodynia in rat chronic constriction injury model. Spinalglia and proinflammatory cytokines mediate mirror-image neuropathic pain in rats. Mechanical allodynia following contusion injury of the rat spinal cord is associated with loss of GABAergic inhibition in the dorsal horn. Treatment of herpes zoster. Anti-nociception is selectively enhanced by parallel inhibition of multiple subtypes of monoamine transporters in rat models of persistent and neuropathic pain.


Allodynia and pinprick hypesthesia in acute herpes zoster, and the development of postherpetic neuralgia.

J Pain Symptom Manage. Topical amitriptyline versus lido-cain in the treatment of neuropatic pain. Curr Med Res Opin. Targeted pharmacotherapy of evoked phenomena in neuropathic pain: Med Clin North Am. Peripheral neuropathy in persons with diabetes. Clin Excell Nurse Pract. Endothelial and neural regulation of skin microvascular blood flow in patients with diabetic peripheral neuropathy: Diabetic peripheral neuropathic pain: Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: Diabetic peripheral neuropathy and depressive symptoms: Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep.

A review of the epidemiology of painful diabetic peripheral neuropathy, postherpetic neuralgia, and less commonly studied neuropathic pain conditions. The association of psychological factors, physical activity, neuropathy, and quality of life in type 2 diabetes. Depression and pain comorbidity: Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic neuralgia: Cruccu G, Truini A.

Trigeminal neuralgia and orofacial pains. The neurological basis of pain. Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. Backonja M, Serra J.

Pharmacologic management, part I: Mangement of nociceptive deafferentation and central pain by surgical intervention.

Pain syndrome in neurology. A review of complex regional pain syndrome.

Pharmacological treatment of peripheral neuropathic pain conditions base don shared commonalities despite multiple etiologies. Progress in pain research and management series. Sodium channel blockade may contribute to the analgesic efficacy of antidepressants. Amitriptyline versus placebo in postherpetic neuralgia. Venlafaxine extended release in the treatment of painful diabetic polyneuropathy: Efficacy of pharmacology treatments of neuropathic pain: Saarto T, Wiffen PJ.

Antidepressants for neuropathic pain. Cochrane Dplor Syst Rev. Treatment response in antidepressant-naive postherpetic neuralgia patients: Efficacy of oxycodone in neuropathic pain: Amitriptyline and fluphenazine in the treatment of postherpetic neuralgia. Treatment of pain syndromes with venlafaxine. Coluzzi F, Mattia C. Mechanism-based treatment in chronic neuropathic pain: The effect of venlafaxine on ongoing and experimentally induced pain in neuropathic pain patients: Rice AS, Maton S.