Ad hoc Committee of the Croatian Society for Neurovascular Disorders, Croatian Medical Association: Recommendations for neuropathic pain treatment

Vida Demarin, Vanja Bašić-Kes, Iris Zavoreo, Marijana Bosnar-Puretić, Krešimir Rotim, Velimir Lupret, Mladen Perić, Željko Ivanec, Lidija Fumić, Ivo Lušić, Anka Aleksić-Shihabi, Biserka Kovač, Mira Ivanković, Helena Škobić, Boris Maslov, Natan Bornstein, Kurt Niederkorn, Osman Sinanović, Tanja Rundek

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or "electrical"). The diagnosis of neuropathic pain is based primarily on the history and physical examination finding. Although monotherapy is the ideal approach, rational polypharmacy is often pragmatically used. Several classes of drugs are moderately effective, but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.

Original languageEnglish (US)
Pages (from-to)181-191
Number of pages11
JournalActa Clinica Croatica
Volume47
Issue number3
StatePublished - Sep 1 2008

Keywords

  • Guideline
  • Neuralgia - etiology
  • Neuralgia - physiopathology
  • Neuralgia - therapy
  • Pain - therapy
  • Practice - guideline

ASJC Scopus subject areas

  • Medicine(all)

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    Demarin, V., Bašić-Kes, V., Zavoreo, I., Bosnar-Puretić, M., Rotim, K., Lupret, V., Perić, M., Ivanec, Ž., Fumić, L., Lušić, I., Aleksić-Shihabi, A., Kovač, B., Ivanković, M., Škobić, H., Maslov, B., Bornstein, N., Niederkorn, K., Sinanović, O., & Rundek, T. (2008). Ad hoc Committee of the Croatian Society for Neurovascular Disorders, Croatian Medical Association: Recommendations for neuropathic pain treatment. Acta Clinica Croatica, 47(3), 181-191.